Breast Cancer

What are the different types of breast cancer?

There are several types of breast cancer, including:

• The most common type begins in the lining of the ducts and is called ductal carcinoma.
• Another common type, called lobular carcinoma, occurs in the lobules (milk-producing glands).
• Paget's disease is a rare form of breast cancer that begins in the glands in or under the skin. It is often characterized by inflamed, red patches on the skin. The patches can occur in sweat glands, in the groin, or near the anus. Because Paget's disease often originates from breast duct cancer, the eczema-like cancer usually appears around the nipple.

When breast cancer metastasizes, or spreads outside the breast, cancer cells are often found in the lymph nodes under the arm. If the cancer has reached these nodes, it may mean that cancer cells have spread to other parts of the body.

Cancer that spreads is the same disease and has the same name as the original, or primary cancer. When breast cancer spreads, it is called metastatic breast cancer, even though the secondary tumor is in another organ. This may also be called "distant" disease.

Types of breast cancer, in alphabetical order, are:

• adenocarcinoma
• ductal carcinoma in situ (DCIS)
• infiltrating (or invasive) ductal carcinoma (IDC)
• infiltrating (or invasive) lobular carcinoma (ILC)
• inflammatory breast cancer
• lobular carcinoma in situ (LCIS) (also called lobular neoplasia)
• medullary carcinoma
• mucinous carcinoma
• Paget's disease of the nipple
• phyllodes tumor (also spelled phylloides)
• tubular carcinoma

Find out more about the stages of breast cancer »

What are the signs and symptoms of breast cancer?

The following are the most common symptoms of breast cancer. However, each individual may experience symptoms differently. Early breast cancer usually does not cause pain and may cause no symptoms at all. And, some breast cancers never cause symptoms or other indications of a problem.

As the cancer grows, however, it can cause changes that women and men should watch for, such as:

• a lump or thickening (a mass, swelling, skin irritation, or distortion) in or near the breast or in the underarm area
• a change in the size or shape of the breast
• a change in the color or feel of the skin of the breast, areola, or nipple (dimpled, puckered, or scaly)
• nipple discharge, erosion, inversion, or tenderness

A woman (or man) should consult a physician when any of these changes are noticed.

What are the risk factors for breast cancer?

Any woman may develop breast cancer. However, the following risk factors may increase the likelihood of developing the disease.

Risk factors that cannot be changed:

• gender — Breast cancer occurs nearly 100 times more often in women than in men.
• aging — Two out of three women with invasive cancer are diagnosed after age 55.
• personal history of breast cancer
• previous breast irradiation
• family history and genetic factors — Having a close relative, such as a mother or sister, with breast cancer increases the risk. This includes changes in certain genes such as BRCA1, BRCA2, and others.
• benign breast disease
• previous breast biopsy in which the tissue showed atypical hyperplasia
• menstrual periods that began early in life
• menopause that began later in life

The most frequently cited lifestyle-related risk factors:

• smoking
  
• not having children, or first child after age 30
  
• oral contraceptives
  
• obesity and a high-fat diet
  
• physical inactivity
  
• alcohol
  
• long-term, post-menopausal use of combined estrogen and progestin (HRT)
  
• weight gain and obesity after menopause

Environmental risk factors:

• Exposure to pesticides, or other chemicals, is currently being examined as a possible risk factor.

Find out more about hormone replacement therapy and other risk factors for breast cancer »

Find out more about the genetic risks for breast cancer »

How is breast cancer diagnosed?

It is important to remember that a lump or other changes in the breast, or an abnormal area on a mammogram, may be caused by cancer or by other, less serious problems.

To determine the cause of any signs or symptoms, your physician will perform a careful physical exam that includes a personal and family medical history as well as determining current overall health status. In addition to a physical examination by your physician, an imaging test will be performed.

Based on these exams, your physician may decide that no further tests are needed and no treatment is necessary. In such cases, your physician may want to check you regularly to watch for any changes.

Often, however, the physician must remove fluid or tissue from the breast to be sent to the lab to look for cancer cells. The procedure, called biopsy, may be performed using a needle to acquire a tissue sample or a surgical method.

A biopsy is a procedure performed to remove tissue or cells from the body for examination under a microscope. A breast biopsy is a procedure in which samples of breast tissue are removed with a special biopsy needle or during surgery to determine if cancer or other abnormal cells are present.

Biopsies may be performed under local or general anesthesia. There are several types of breast biopsy procedures. The type of biopsy performed will depend upon the location and size of the breast lump or abnormality.

Find out more about diagnosis procedures for Breast Cancer »

Find out more about Mammography »

Treatment

There are many different treatments for breast cancer that involve the clinical care of a physician or other healthcare professional. Listed in the directory below are some, for which we have provided a brief overview.

Clinical Trials for Breast Cancer Research

There are many breast cancer clinical trials and studies underway across the United States - and in other countries. They are sponsored by government agencies, healthcare organizations, private industry, and non-profit foundations - working together in an unprecedented spirit of collegial and collaborative cooperation.

Find out more about clinical trials for breast cancer »

Breast Health: Three-Step Plan for Preventive Care

The thought of having breast cancer is frightening to everyone, and especially devastating to women. However, ignoring the possibility that you may develop breast cancer or avoiding the processes to detect cancer can be dangerous.

Although there are some women who are at higher risk, the fact is that all women are at risk for breast cancer. That is why it is so important to follow this three-step plan for preventive care. Although breast cancer cannot be prevented at the present time, early detection of problems provides the greatest possibility of successful treatment.

What is the three-step plan?

Routine care is the best way to keep you and your breasts healthy. Although detecting breast cancer at its earliest stages is the main goal of routine breast care, other benign conditions, such as fibrocystic breasts, are often discovered through routine care.

Step 1. Breast Self-Examination (BSE)

A woman should begin practicing breast self-examination by the age of 20 and continue the practice throughout her life - even during pregnancy and after menopause. BSE should be done regularly at the same time every month. Regular BSE teaches you to know how your breasts normally feel so that you can more readily detect any change. Changes may include:

• development of a lump
• a discharge other than breast milk
• swelling of the breast
• skin irritation or dimpling
• nipple abnormalities (i.e., pain, redness, scaliness, turning inward)

If you notice any of these changes, see your healthcare provider as soon as possible for evaluation.

Step 2. Clinical Examination

A breast examination by a physician or nurse trained to evaluate breast problems should be part of a woman's physical examination. The American Cancer Society recommends:

• Between the ages of 20 and 39, women should have a clinical breast examination by a health professional every three years.
• After age 40, women should have a breast examination by a health professional every year.

A physical breast examination by a physician or nurse is very similar to the procedures used for breast self-examination. Women who routinely practice BSE will be prepared to ask questions and have their concerns addressed during this time.

Step 3. Mammography

Mammography is a low-dose x-ray of the breasts to find changes that may occur. It is the most common imaging technique. Mammography can detect cancer or other problems before a lump becomes large enough to be felt, as well as assist in the diagnosis of other breast problems. However, a biopsy is required to confirm the presence of cancer.

Since there is controversy among cancer organizations regarding when to begin having mammograms, as well as how often, talk with your physician about a mammography schedule that is appropriate for you based on your overall health and medical history, risk factors, and personal opinion or preference.

According to the National Cancer Institute, women in their 40s and older should begin having a screening mammogram on a regular basis, every one to two years. But, the American Cancer Society recommends that by age 40, women should have a screening mammogram every year. (A diagnostic mammogram may be required when a questionable area is found during a screening mammogram.)

Both organizations suggest that women who may be at increased risk for breast cancer should talk with their physicians about whether to begin having mammograms at an earlier age.

More Information

Listed below you will find some additional information regarding breast cancer. If you cannot find the information in which you are interested, please visit our Health Library additional information.

General Information About Breast Cancer

Mammograms

Genetics of Breast Cancer

Stages of Breast Cancer

Hereditary Breast Ovarian Cancer Syndrome (BRCA1 / BRCA2)

How to Perform a Breast Self-Examination (BSE)

Radiation Therapy for Breast Cancer Treatment

Breast Biopsy

Breast Magnetic Resonance Imaging (MRI)

Getting Back to Health after Cancer

Coping with Cancer