Breast Cancer Awareness Month 2021

October is Breast Cancer Awareness Month. According to the American Cancer Society, breast cancer is the most common form of cancer in American women after skin cancers. In fact, a woman in the U.S. has a 12% risk (a 1-in-8 chance) of developing breast cancer in her lifetime. Furthermore, there is a 1-in-38 chance that one will die from breast cancer. Thus, raising awareness is incredibly important. Regular screenings help in the detection of precancerous and cancerous breast tissue that may be present in otherwise healthy individuals. With proper diagnoses and treatment in the initial stages, breast cancer can be one of the most treatable forms of cancer.

The primary types of breast cancer

Ductal carcinoma: It is the most common type of breast cancer and begins in the lining of the milk ducts (thin tubes that carry milk from the lobules of the breast to the nipple). Ductal carcinoma may be either ductal carcinoma in situ (DCIS, noninvasive condition) or invasive ductal carcinoma (IDC).

Lobular carcinoma: This cancer begins in the lobules (milk glands) of the breast and may be either lobular carcinoma in situ (LCIS, noninvasive) or invasive lobular carcinoma (ILC). LCIS rarely becomes invasive, but having it in one breast increases the risk of developing invasive cancer in either breast.

Inflammatory breast cancer: A type of breast cancer in which the breast looks red and swollen and feel warm. The redness and warmth occur because the cancer cells block the lymph vessels in the skin.

Triple-negative breast cancer: This describes breast cancer cells that do not have estrogen receptors, progesterone receptors or large numbers of HER2/neu protein. It is also called ER-negative PR-negative HER2/neu-negative breast cancer.

Recurrent breast cancer: Breast cancer can recur when treatment doesn’t fully remove or destroy all the cancer cells.

Signs and symptoms of breast cancer

The most common signs of breast cancer include:

• Lump in the breast or underarm (armpit)

• Swelling or thickening of all or part of the breast

• Dimpling or irritation of breast skin

• Localized, persistent breast pain

• Redness, scaliness or thickening of the nipple or breast skin

• Nipple retraction or discharge (other than breast milk)

• Any change in the size or shape of the breast

It is important to remember that breast lumps are common, particularly in premenopausal women. There are many different kinds of lumps, most of which are not cancerous tumors. The majority of lumps turn out to be benign, such as the soft, fluid-filled lumps that feel tender (especially before the period), the rubbery lumps that move around under the skin and are usually painless, or the fibrocystic changes leading to painful, lumpy breasts. Benign lumps develop from fatty tissue deposits or breastfeeding when sacs filled with milk form cysts. One can even get a lump as a result of an injury, such as when your breast gets bruised or after breast surgery. Every woman should learn about these signs and do monthly breast self-exams along with regular mammograms, which, along with knowledge of risk factors of breast cancer, can help women keep this disease at bay.

What is my risk for breast cancer?

Being a woman is the main risk factor for breast cancer, as the disease is most commonly found in women in ages 55 and older. Multiple uncontrollable factors — such as race and ethnicity, personal/family history, breast density and menstrual period history — increase the risk of breast cancer occurrence. In addition, having changes in certain breast cancer genes (BRCA1 and BRCA2) increases the risk of developing breast cancer.

Another category is the lifestyle-related risk factors, such as the use of birth control pills, hormone therapy after menopause, childbirth, alcohol consumption, extra weight and sedentariness.

It is important to keep in mind that having one or several risk factors does not mean a woman will develop breast cancer. Although is it important to be familiar with all of the risk factors and especially for those that can be controlled by lifestyle to lower the risk of breast cancer. Physical activity of at least 150 minutes at moderate intensity or 75 minutes at vigorous intensity activity (or a combination of these) is recommended. Further, the ACS advises that women have no more than one alcoholic drink per day to reduce breast cancer risk. Regular breast cancer screening is also recommended by ACS for all women above the age of 40.

Breast cancer screening

Breast cancer screening guidelines are set forth by the American College of Radiology and the Society of Breast Imaging. They include a risk assessment for the woman at age 30 to see if screening earlier than age 40 is needed. Women previously diagnosed with breast cancer might also benefit from supplemental screening with magnetic resonance imaging, especially if their cancer was diagnosed at or before the age of 50. Three tests are typically used in detecting breast cancer:

• A mammogram is an X-ray of the breast used to detect and evaluate breast changes. Its detection ability depends on tumor size and breast tissue density. Three-dimensional (3D) mammography is a type of digital mammography in which X-ray machines are used to take pictures of thin slices of the breast from different angles and computer software is used to construct an image.

• Breast ultrasound is often used along with mammography for high-risk women who cannot undergo MRI and women with dense breast tissue.

• A breast MRI is used to screen high-risk people and gather more information about a suspicious areas found on a mammogram or an ultrasound.

According to the American Breast Cancer Foundation, healthcare providers can treat breast cancer in many different ways. Each individual’s treatment depends on the stage of breast cancer and the plan their doctor recommends. The different types of treatments that are available are sentinel lymph node biopsy, radiation (including external beam radiation and brachytherapy, which is internal radiation), chemotherapy, targeted drug therapy and breast-conserving surgery (also referred to as a partial or segmental mastectomy or lumpectomy).