Breast Cancer

Breast cancer is the most common form of cancer among women in the United States. It is second only to lung cancer in cancer-related deaths. More than 180,000 women will be diagnosed with breast cancer this year. More than 43,000 women may die from the disease. In the United States, one out of nine women will develop breast cancer during her lifetime.

The encouraging news is that breast cancer is being detected earlier, while the tumor is very small. The majority of new breast cancers show no signs that the cancer has spread beyond the breast. With prompt treatment, the outlook for women with breast cancer is good. When cancer is detected early, treatment not only saves your life but also your breast.

Breast cancer occurs when certain cells in the breast become cancerous and form a tumor. Breast tumors usually appear in the milk-producing lobules or in the milk ducts that lead to the nipple.

Breast Cancer in Men

Men with breast cancer are rare, but about 1,600 men are diagnosed with breast cancer each year. Another 400 die of breast cancer.

Men can have the same types of breast cancer as women. However, 70% of male breast cancers are ductal carcinoma, making it the most common. Like women's breast cancer, men's breast cancer can be cured or controlled if it is detected early and treated promptly.

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Symptoms

The signs of breast cancer include:

  • Lump or thickening that does not go away or that changes.
  • Swelling, puckering or dimpling of the breast
  • Skin irritation
  • Pain or tenderness of the nipple

The first symptom men usually notice is a painless lump. Other symptoms might include nipple discharge (possibly bloody), nipple retraction and skin ulceration.

For a variety of reasons, men may not get early treatment for breast cancer. Men are unlikely to regularly examine their breasts. When men notice symptoms, they tend to delay seeing a doctor. Men are usually somewhat older than women at the time of diagnosis (age 65 on average).

Causes and Risk Factors

For Breast Cancer in Women

  • Being female (though rare cases appear in men)
  • Over age 50 (75% of cases)
  • Women whose mothers or sisters have had breast cancer
  • Women who have never borne children
  • Women who bore their first child after age 30

Recent research indicates that certain genes including BRCA1 appear to be genetically connected to an increased risk of breast cancer. Mutations or alterations of the BRCA1 gene increase the chances of developing breast cancer from 60 to 85%. Genetic screening can help determine whether a woman has the gene.

For Breast Cancer in Men

As with women, a man's risk of breast cancer increases with age. Other risk factors for male breast cancer include:

  • Estrogen administration
  • Hyperestrogenism-associated diseases (e.g., cirrhosis, Klinefelter's syndrome)
  • Radiation exposure
  • Testicular injury
  • Mumps orchitis
  • Family history of breast cancer (male or female)
  • Families with the BRCA2 mutation on chromosome 13q

Genetic Risk Assessment

The GenRISKĀ® Adult Genetics Program at Cedars-Sinai offers complete genetic risk assessment, counseling and genetic testing if necessary. The results of such an assessment can help provide a woman or man with valuable information about how to manage her or his risk of getting breast cancer or options to consider if he or she is diagnosed as having breast cancer.

The causes and prevention of breast cancer are still unclear. The best protection is detection and treatment at the earliest stage of the disease.

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Diagnosis

There are several ways to confirm a diagnosis of breast cancer:

  • Biopsies including needle localized breast biopsies such as core needle biopsy or fine needle biopsy. For biopsies, a small piece of the tumor is taken and looked at under a microscope by a pathologist.
  • Clinical exam performed by a healthcare professional
  • Ultrasound to pinpoint tumor location
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Treatments

The choice of treatment depends on the patient's age and general health and the type and stage of cancer. The stage is determined by the size of the tumor and whether it is localized in the breast, has reached the lymph nodes of the armpit (axilla) or has spread (metastasized) to the liver, brain, lungs or bones.

Early breast cancer is highly treatable by:

The goal is to remove or destroy all cancer cells in the body. In advanced cases, the goal is to provide relief from discomfort and improve the quality of life of the patient

Oncologists may recommend one or a combination of treatments. Decisions are based on existing medical knowledge and experience as well as recent research.

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