How to Diagnose Breast Cancer and Treatment Options

Breast Cancer diagnosis and Treatment Options
Medically reviewed by Dr. Mavra Farrukh

Overview

Breast cancer is one of the most prevalent health issues that is causing a considerable number of deaths yearly. Breast cancer screening, early diagnosis, and self-awareness campaigns are helpful tools for dealing with this deadly disease.

The formation of nodules, cysts, or tumors might be considered a red flag as it may lead to breast cancer disease. 

Breast cancer is caused by abnormal cell growth in the tissues of the breast and its surrounding area, including the underarms and above or below areas of the breast. This article aims to provide awareness about breast cancer types, stages, symptoms, and causes of breast cancer.

Let us look at every aspect of breast cancer in detail.

What is Breast Cancer?

The formation of malignant tumors in the chest region, breast, and surrounding tissues is known as breast cancer. The condition is fatal and, if left untreated, can lead to the amputation of one or both breasts. Breasts are important to women’s physical appearance, and removing them can severely impact their self-esteem. The severity of the disease depends on the stage and type of cancer. Moreover, the individual’s condition and other underlying diseases may increase cancer severity.

Treatment in the early stages of all breast cancer types is almost the same. However, the intensity of therapy may differ with the types and stages of breast cancer.

In comparison between genders, breast cancer is more prevalent in females than males. Women are more likely to develop breast cancer due to hormonal changes during various conditions, such as pregnancy, polycystic syndrome, or other underlying factors.

As of 2010, breast cancer is the most prevalent disease in women across the globe. Over time, there has been an increasing trend. Several risk factors and associated medical conditions have been identified as the possible causes of cancer formation in breast tissues and surrounding areas.

What are the early signs of breast cancer?

Breast cancer symptoms may vary for each person. Some possible signs of breast cancer include:

  • A breast lump or lump near the armpit
  • A change in your breast’s shape, size or contour.
  • Changes to the skin on your breast or nipple (dimpled, puckered, scaly or inflamed).
  • Redness of the skin on your breast.
  • A hardened area under your skin.
  • A blood-stained or fluid discharge from your nipple.

According to the National Cancer Institute, breast cancer is the most commonly diagnosed cancer in men and women, with more than 1.6 million new cases diagnosed yearly.

Breast cancer can take various forms, depending on where it spreads in the breast and whether or not it has spread elsewhere. 

Different types and conditions of breast cancer exist; some are rare, while others are more frequently seen.

Invasive breast cancer

Cancer cells that have penetrated through the duct lining into the surrounding breast tissue are considered invasive breast cancer; this type of breast cancer is the most common.

Most cases of invasive breast cancer are classified as NST (No Special Type) due to its lack of special features. Sometimes NST is referred to as NOS (not otherwise specified). Invasive ductal carcinoma was its former name. Approximately 70% of invasive breast cancers are of this type.

A special type of cancer means that the cells show particular characteristics when viewed under a microscope. Some rare types of breast cancer are classified as specific types.

The following are the most common symptoms of invasive breast cancer:

  • An armpit or breast lump
  • An increase in breast size or change in shape
  • Puckering, dimpling, a rash or redness of the overlying breast skin
  • Nipple discharge in women who aren’t pregnant or breastfeeding
  • Erection of the nipples 

Changes in the size or shape of the breast, swelling or thickening of part of the breast, irritation or dimpling of the breast skin or nipple retraction or inversion could indicate a tumor or cancerous cells, so talk to your doctor immediately if you have any of the above signs.

For diagnosis purposes, your doctor may recommend some tests. 

  • A Mammogram, an x-ray of the breast used to diagnose invasive breast cancer. Mammograms are recommended for women over 35, but ultrasound is recommended for women under 35.
  • Biopsies involve the sampling and examination of small samples of tissue from your breast.

Mammograms or ultrasounds can detect breast cancer,  which a biopsy may follow to identify the type. A lymph node ultrasound may also be performed under your arm. The lymph nodes may also be biopsied if they appear abnormal.

Is a Lump a sign of cancer? Talk to a Doctor to find out more

Invasive lobular breast cancer

The second most common type of breast cancer is invasive lobular breast cancer. It is an aggressive form of breast cancer that originates in the cells that line the lobules and spreads to the surrounding tissue. A lobule is a gland that produces milk during breastfeeding.

Around 15% of breast cancers are invasive lobular carcinomas. Regardless of the woman’s age, this type can develop at any stage of life. However, it is most common in women between 45 and 55. Men are very rarely diagnosed with breast cancer. Also, breast cancer that is invasive lobular is very uncommon in men.

There is not always a firm lump in invasive lobular breast cancer. It is more likely that you will have a thickened section of breast tissue.

Here are some possible symptoms:

  • Inflammation
  • Inverted nipple 
  • Dimpling or thickening of the skin

Breast cancer, regardless of its type, can cause these specific symptoms. Symptoms such as those listed above can help identify breast cancer in general.

For diagnosis, x-rays of the breasts, an ultrasound, a breast biopsy, and a breast MRI scan are commonly ordered. 

Triple-negative breast cancer

The triple-negative breast cancer is known as a rare type of breast cancer. About 15 percent of breast cancers are of this type.

Cancer cells with triple-negative properties lack receptors for estrogen, progesterone, and her2 proteins, which make up estrogen and progesterone. 

It is rare for men to develop triple-negative breast cancer. In the majority of men who are suffering from cancer, estrogen receptors are found within their cells.

Triple-negative breast cancer is a rare type of cancer. BRCA1 gene faults are also found in some women with triple-negative breast cancer. Families with BRCA1 gene faults are more likely to get breast cancer.

Cancer cells are tested for these receptors using a sample from your body. Depending on whether you had a biopsy of cancer or had surgery to remove it, you might have this test.

Inflammatory breast cancer

Inflammatory is a rare type of breast cancer. There are 1 to 5  inflammatory breast cancer cases out of 100 breast cancers. A cancerous cell in the breast blocks the lymphatic channels. The lymphatic system is composed of lymph channels (or lymph ducts). Lymphatic channels usually drain body tissues and organs from excess tissue fluid. Blocked lymph channels are unable to do this function properly. This blockage causes redness, firmness, or hardness, temperature increase, and inflammation of the affected breast.

Symptoms may also include:

  • An increase in ridges or thickening of the breast skin
  • Orange peel-like pitted skin
  • The development of a breast lump
  • Nipple discharge
  • An inverted nipple

Several factors can influence an inflammatory breast cancer patient’s life expectancy. A few of these are:

  • Age 
  • The general state of your health
  • A cancer cell’s ability to respond to hormonal therapy
  • Location of cancer/tumor 
  • Response to treatment of cancer
  • The extent to which cancer has spread and whether it has only affected the lymph nodes or other organs
  • An indication of how abnormal the cancer cells appear under a microscope (the grade)

Other rare types of breast cancer 

In the UK, breast cancer is the most common type of cancer. The most common type of breast cancer is invasive breast cancer (NST). Other rare types of breast cancer exist as well. Some of the rare types of breast cancer are:

  • Cancer of the medulla
  • Cancer of the mucoid or colloid type
  • Cancer of the tubules
  • Breast adenoid cystic carcinoma
  • Metaplastic breast cancer
  • Lymphoma of the breast
  • Basal-type breast cancer
  • Cystosarcoma phyllodes

Paget’s Disease of the Breast

In approximately half of the cases of Paget’s disease, the nipple is flat or inverted. 9 out of 10 times, this is an invasive form of breast cancer. It is also possible for people with Paget’s disease who do not have lumps to develop invasive breast cancer. It usually develops in the nipple or the dark skin area around it (the areola). Breast cancer might be behind the nipple if Paget’s disease is present. Although rare, Paget’s disease can occur without underlying cancer in the breast.

Are you having breast cancer symptoms? Talk to a doctor for proper diagnosis

Causative and Risk Factors of Breast cancer 

Knowing the risk factors for breast cancer can help you remain cautious and get tested at the right time. If you are wondering who is mainly affected by breast cancer? The following are some common risk factors:

Age 

As we age, our risk of developing breast cancer increases. It is estimated that 0.06% of women who are 20 years old in the next decade will develop breast cancer. At 70 years of age, this figure rises to 3.84%. Breast cancer is most common in women over 50.

Family History and Genetic Factors

There is a higher risk of breast cancer in people with close relatives who have breast cancer or have had it, as genetics is passed down from generation to generation.

Breast cancer, ovarian cancer, or both are more likely to develop in people with specific mutations in the BRCA1 and BRCA2 genes. Mutations also increase breast cancer risk in the TP53 gene.

Ask your doctor about genetic testing if you’ve ever had breast, ovarian, fallopian tube, or peritoneal cancer.

Lactation and estrogen exposure

There is evidence that estrogen may increase the risk of breast cancer when exposed for an extended period.

A woman could be exposed to this type of exposure if she starts menstruating early or enters menopause too late. The body’s estrogen levels are higher during these times.

Breastfeeding reduces the risk of developing breast cancer, especially if done for over a year. As a result of pregnancy and breastfeeding, estrogen exposure drops.

Obesity 

Increasing estrogen levels may cause obesity following menopause and increase breast cancer risk. It is also possible that sugar intake is a contributing factor.

Alcohol consumption

Inflammatory breast cancer can be caused by drinking excessive amounts of alcohol. Research has repeatedly shown that women who drink alcohol have a higher risk of breast cancer than those who do not—drinking moderately to heavily has a greater risk than drinking less.

Exposure to radiation

Radiation treatment for another type of cancer may increase your risk of developing breast cancer later in life.

Treatments involving hormones

According to the NCI, oral contraceptives may slightly increase the risk of breast cancer.

Moreover, according to the American Cancer Society, estrogen-progesterone therapy is associated with an increased risk of breast cancer.

Race

According to the Centers for Disease Control and Prevention (CDC), the mortality rate from breast cancer among black women is approximately 40% higher than that among white women. Asian and Pacific Islander women have a lower risk of breast cancer than white women. Hispanic women have a lower risk of breast cancer than white women.

According to research, the death rate from breast cancer is higher for African American women than for any other group. There are likely biological and socioeconomic reasons for this. According to a study published in 2021, for example, black women have a higher risk of developing aggressive breast cancer.

The low socioeconomic status of some patients may also contribute to racial disparities in cancer treatment. Health insurance is tied directly to employment in the United States, so people from marginalized groups often have difficulty accessing quality insurance.

There’s evidence that getting access to healthcare may be part of the reason people from marginalized groups get breast cancer diagnoses so late, when survival, even with treatment, is not guaranteed. A 2020 study found an association between insurance status and early-stage breast cancer detection.

Cosmetic implants 

Researchers found no increase in breast cancer risk associated with cosmetic breast augmentation in a meta-analysis of 17 studies published in 2015. These participants had a lower incidence than expected, according to the research.

A study published in 2021 showed that women with cosmetic implants had a significantly lower risk of breast cancer than those without implants.

Similarly, a meta-analysis published in 2013 found that women diagnosed with breast cancer after receiving cosmetic breast implants were more likely to die of it.

The researchers did not consider other variables that may influence breast cancer mortality, such as body mass index, age at diagnosis, or stage of cancer at diagnosis. At least one study included in the analysis examined overall mortality rather than breast cancer-specific mortality, potentially affecting the results. Therefore, it is recommended that a person be cautious when interpreting the findings.

Do you have a breast lump or pain? Talk to a Doctor Online for answers

Stages of Breast Cancer

Doctors determine the cancer stage depending on the tumor’s size and if it’s spread to lymph nodes or other parts of the body.

In order to determine which stage of breast cancer you have, there are different techniques. There are 0 to 4 stages, each with its subcategory. Each of these main stages is described below. Tumor substages can tell you much about it, like whether it has HER2 receptors.

Stage 0

The ductal carcinoma in situ stage is also known as stage 0 cancer. No surrounding tissues have been affected by the cancerous cells within the ducts.

Stage 1 

During Stage 1, a tumor is relatively small, measuring between 2 and 3 centimeters (cm). No lymph nodes have been affected, or there are a few cancer cells in the lymph nodes.

Stage 2: 

The tumor has been extended to two centimeters in diameter. It now has affected nearby lymph nodes or expanded to two to five centimeters in diameter without affecting nearby lymph nodes.

Stage 3 

There is a possibility that the tumor will reach stage 3 when it is more significant than 5 cm and has spread to a few lymph nodes.

Stage 4

An individual with stage 4 cancer usually has cancer that has spread to distant organs, such as the bone, liver, brain, or lungs.

Breast Cancer Treatment

The main treatment options include:

  • Biological therapy, or targeted drug therapy
  • Hormone therapy
  • Chemotherapy
  • Radiation therapy
  • Surgery

Biological treatment

It is possible to kill breast cancer with targeted drugs. The following are examples:

  • Trastuzumab (Herceptin)
  • Lapatinib (Tykerb)
  • Bevacizumab (Avastin)

In addition to breast cancer, other cancers can also be treated with severe adverse effects. Discuss a treatment’s risks and side effects with a doctor before deciding on it.

Surgery 

Along with removing some breast tissue, a mastectomy involves surgically removing all or part of a breast. During cancer surgery, the surgeon must decide how to reconstruct the shape and function of a breast; some patients choose reconstructive surgery to replace a lost breast or cosmetic procedures that allow them to alter their appearance.

Chemotherapy

Doctors may prescribe cytotoxic chemotherapy drugs in cases with a high risk of recurrence or the spread of cancer. Adjuvant chemotherapy is chemotherapy given after surgery to halt breast cancer spread.

Sometimes, a doctor may recommend chemotherapy before surgery to reduce the tumor’s size and facilitate its removal. The term “neoadjuvant chemotherapy” refers to this process.

What is immunotherapy for breast cancer?

Immunotherapy is the use of medicines to enhance a person’s immune system to the extent that it recognizes and destroys cancer cells more effectively. Immunotherapy typically works on specific proteins that are a part of the immune, hence boosting the immune response. Some immunotherapy drugs, such as monoclonal antibodies, control cancer cells in more than one way. They may also be classified under targeted therapy because they block a specific protein on the cancer cell to keep it from growing. However, these drugs typically have side effects different from chemotherapeutic drugs.

What is precision medicine for breast cancer?

Precision medicine for breast cancer is basically an approach to diagnosis, treatment and prevention that maps your genetic makeup and the genes or other markers present within the cancer cells. Using this approach, your blood or tumor tissue is collected for analysis, often genetic. The information helps predict, diagnose or determine a treatment plan. 

Breast Cancer During Pregnancy

Pregnant women can safely receive treatment for breast cancer. However, the types of treatment and the time when they are able to get the treatment might be affected by the pregnancy.

Furthermore, a mother cannot pass cancer on to her baby.

What is the prognosis for breast cancer?

The survival rates for breast cancer are significantly improving due to better treatment options and information available. According to the stats, the overall five-year survival rate for breast cancer is 90%. Moreover, the five-year survival rate for breast cancer that has spread beyond the local region is 86%, while the five-year survival rate for metastatic breast cancer is only 28%. 

When to Consult a Doctor for Breast Cancer?

Do not delay an evaluation if you are concerned about an abnormal lump in your breast or armpit. Your doctor can diagnose you and offer you several treatment options based on your stage and type of cancer. 

Connect with our online doctor at Your Doctors Online to get your questions answered and learn more about breast cancer. 

What questions should I ask my healthcare provider?

Learning about your diagnosis can help you make informed decisions about your health. You may ask your doctor about

  • The location of the tumor, 
  • The spread
  • The stage of breast cancer
  • Regarding the estrogen receptor (ER), progesterone receptor (PR) and HER2 tests, 
  • Your treatment options
  • If breast cancer surgery is an option 
  • The duration of the treatment
Talk to our doctor and fight breast cancer!

FAQs About Breast Cancer Answered by Your Doctors Online Team

Is breast cancer painful?

In the early stages of breast cancer, a lump or mass in the breast should be considered a warning sign. Painless lumps are more common. During menstruation, some women may experience nipple or breast pain.
Breast cancer usually causes gradual pain. A healthcare professional should be consulted if you experience persistent or severe breast pain.

What are the causes of breast cancer?

Genetic mutations or damage to DNA are responsible for developing breast cancer. BRCA1 and BRCA2 genes, for example, can cause cancer when they are inherited and can be associated with estrogen exposure, genetic defects, or inherited cancer genes.

What type of breast cancer has the highest recurrence rate?

According to research, estrogen receptor-positive breast cancer is more likely to recur after five years. In this study, the researchers examined the risk of late recurrence of breast cancer, that is, after 10 or more years.

Is breast cancer curable?

Several successful treatments and therapies have been suggested for breast cancer. Depending on the size and location of the tumor and whether it has metastasized into other parts of the body, treatment may vary.

How does breast cancer cause death?

Breast cancer will claim the lives of 42,170 women this year. There has been a slight increase in incidence rates (by 0.3% per year) in recent years. Among women, breast cancer is the second leading cause of cancer deaths (only lung cancer kills more women). It is estimated to cause the deaths of 1 in 38 women (about 2.6%).

What to expect during a breast cancer screening or diagnostic procedure?

Initially, a breast exam is conducted by your doctor that involves an examination of the breasts and armpits. Moreover, a mammogram, ultrasound and biopsy may be ordered for screening or diagnosis.

Can cancer form in other parts of the breast?

Typically, cancer cells form in the ducts and grow outside the ducts invading the breast tissue.

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