Among women in America, breast cancer trails only skin cancer as the most commonly diagnosed cancer. Advances in early detection, however, have raised the five-year survival rate for women with stage 0 or stage I breast cancers to almost 100 percent. Currently, there are more than 3.1 million breast cancer survivors in the United States. At Memorial Hermann Cancer Centers, we have partnered with our Breast Care Centers to provide exceptional screening, diagnosis, treatment and follow-up for patients with breast cancer in Greater Houston.
The following information will help you learn more about breast cancer, how it is diagnosed, treatment options available and how you can sign up for a breast cancer screening online using our convenient ScheduleNow tool.
What is Breast Cancer?
Like most cancers, breast cancer begins as an uncontrolled growth of normal cells in the tissues of the breast. The vast majority of breast cancers are carcinomas – a type of cancer that forms in the epithelial cells that line organs and tissues throughout the body. In the case of breast cancer, this formation is found in mammary glands. When a tumor grows large enough, it can be spotted on an X-ray or felt as a lump during a screening examination.
The good news is that most lumps found in the breast are non-cancerous (benign). However, the presence of some non-cancerous tumors can indicate a higher risk of developing breast cancer in the future. Cancerous (malignant) tumors, on the other hand can grow into surrounding tissues and potentially metastasize (or spread) to other parts of the body.
Types of Breast Cancer
Most breast cancers are localized to the mammary gland, either in the ducts that carry milk to the nipple (ductal carcinoma) or in the milk-producing glands themselves (lobular carcinoma).
If a screening exam shows (a suspicious pattern of cell growth, a biopsy will be performed, and if there is a diagnosis of cancer, the exact type of breast cancer will be identified. Further testing will then be conducted to help your determine if the cancer has spread into surrounding tissues. Cancer that has not spread is called an in situ breast cancer, while cancer that has spread, it is called an invasive breast cancer.
In addition to ductal and lobular carcinomas, the following types of breast cancer exist:
- Estrogen Receptor (ER)-Positive Breast Cancer: Many breast cancers have estrogen receptors on the surface of their cells and as a result are sensitive to the hormone estrogen. They are called estrogen receptor-positive cancer or ER-positive cancer.
- Progesterone Receptor (PR)-Positive Breast Cancer: Other breast cancer cells have progesterone receptors on the surface of the cell, making them sensitive to progesterone. These tumors are called PR-positive cancers.
- HER2-Positive Breast Cancer: Some women have HER2-positive breast cancer. HER2 is a gene that helps cells grow, divide and repair themselves. When cancer cells have too many copies of this gene, they grow faster. Tumor cells can be any combination of ER/PR and HER2 positive or ER/PR and HER2 negative, with an excess of receptors on the cell’s surface.
- Inflammatory Breast Cancer: This is a less common type of invasive breast cancer that accounts for about 1 percent to 5 percent of all breast cancers. Typically, the skin of the breast appears red and swollen, and can be confused with symptoms of infection or cellulitis.
Common Causes and Risk Factors of Breast Cancer
Breast cancer can develop for a variety of reasons. Some of these factors are in our control (lifestyle and habits), while others are not (genetics). Following are some common risk factors for women. If you are concerned about your specific risk for breast cancer, contact your doctor to discuss the best course of action to help reduce your risk of breast cancer.
- Family history: Your risk may increase if an immediate family member has been diagnosed with breast cancer, particularly mothers, sisters and daughters.
- Age: Most breast cancers are diagnosed in women older than age 50.
- Race: While the risk is higher for white women, African-American women have a higher risk of not surviving the disease..
- Menstruation and menopause: Beginning menstruation before age 12 or entering menopause after age 55 means prolonged lifetime exposure to estrogen and progesterone, which may increase your risk.
- Hormone therapy: Risk increases when the combination of estrogen and progesterone has been used for four or more years. This treatment for menopausal symptoms may also make malignant tumors harder to detect on mammograms.
- Not having children or pregnancy after age 30: Estrogen levels are lower during pregnancy, which may protect breast tissue from estrogen exposure. However, if your first full-term pregnancy comes later in life after age 30, your prolonged, uninterrupted exposure to estrogen could increase your lifetime risk of breast cancer.
- Exposure to radiation: Risk increases if you received radiation treatments to your chest as a child or young adult, but the risk is greatest if treatments occurred as an adolescent during breast development.
- Genetics: Mutations in one of several genes, namely BRCA1 and BRCA2 genes, can increase your risk. These genes normally help prevent cancer by making proteins that keep cells from growing abnormally. Since genetic mutations can be inherited, Memorial Hermann offers genetic counseling and testing for women who elect to get tested to determine if they also carry the mutation.
- Personal history: Having breast cancer in one breast significantly increases your risk of developing it in the other breast.
- Alcohol consumption: Your risk increases with the amount of alcohol consumed, starting with two alcoholic drinks daily.
- Excess weight: Your risk increases if you gain weight during adolescence, after menopause or if you have more body fat around and above the waist.
- Dense breast tissue: Breasts are considered “dense” if they have an overabundance of fibrous or glandular tissue and minimal amounts of fat. Approximately 43 percent of women between the ages of 40 to 74 years old are classified as having dense breasts.
Signs and Symptoms of Breast Cancer
Although many types of breast cancer can cause a lump in the breast, not all do, especially not in the early stages. A large number of breast cancers are found during screening mammograms, which can detect breast cancer at an earlier stage, often before lumps can be felt and/or symptoms develop. Talk with your doctor if you notice any of the following abnormalities:
- A lump, thickening or swelling in the breast or armpit
- Clear or bloody discharge from the nipple
- Pain or persistent tenderness of the breast, nipple or armpit
- Change in size or shape of the breast or nipple
- Inverted or flat nipple
- Scaly, red, swollen or dimpled skin around the breast or nipple
Breast Cancer Diagnosis and Screening
According to BreastCancer.org, one in eight women in the U.S. will develop invasive breast cancer throughout the course of her lifetime, which is why scheduling regular breast exams is so important.
Memorial Hermann has several, advanced breast cancer screening options, providing you with the imaging or procedure that is appropriate for your clinical finding.
Breast Cancer Stages
If you’ve been diagnosed with breast cancer, your doctor will determine if the cancer is contained within your breast or has spread to other parts of your body. This process is called staging and includes an assessment of your condition, including tumor size, lymph node status, receptors status and breast cancer grade. Once results have been reviewed, you will be assigned a corresponding cancer stage. While no two people – and no two diseases – are the same, staging provides a guideline for doctors to develop your course of treatment.
The following is a simplified example of the breast cancer staging process. For more in-depth information, visit BreastCancer.org’s official staging guide.
- Stage 0: These are non-invasive breast cancers (typically ductal carcinomas) with no evidence of the cancer invading surrounding normal breast tissue. Patients with Stage 0 breast cancer have an almost 100 percent survival rate.
- Stage I: These are breast cancers that have invaded surrounding normal breast tissue. To be classified as a Stage I cancer, the tumor must be less than or equal to 2 centimeters in size.
- Stage II: Tumors between 2 and 5 centimeters found within the breast or one to three axillary (armpit area) lymph nodes are considered Stage II breast cancer. Cancer cells have begun to spread to the lymphatic system (the network of tissues and organs that help rid the body of toxins and waste) and other parts of the body.
- Stage III: Patients with Stage III invasive breast cancer have tumors larger than 5 centimeters across and cancer cells found in up to nine axillary lymph nodes. Lesions or a thickening of the skin of the breast may also be present.
- Stage IV: Stage IV breast cancers have spread beyond the breast and nearby lymph nodes to organs like the lungs, bones, liver or brain. Treatment is available for Stage IV breast cancer, but it is generally not curative. However, palliative care and other techniques can extend traditional life expectancies for terminal cancer patients by months, or even years.
Breast Cancer Grades
Breast cancer cells are given a grade when they are removed during a breast biopsy and examined under a microscope. This grade is based on how much the cancer cells look like normal body cells. Ultimately, breast cancer grades factor into traditional cancer staging, which can help doctors determine the proper course of treatment.
- Grade 1 or well-differentiated cancer cells look more like normal breast tissue and are slower-growing.
- Grade 2 or moderately-differentiated cancer cells grow faster than Grade 1 cells and may only look slightly different than normal breast tissue.
- Grade 3 or poorly differentiated cancer cells look vastly different from normal cells and will probably grow and spread faster.
Treatment Options for Breast Cancer
At Memorial Hermann Cancer Centers, we provide personalized breast cancer treatment plans to meet the individual needs of each patient. Treatment options such as surgery, chemotherapy, radiation therapy and immunotherapy may be recommended for one patient, while another patient may need only surgery and radiation therapy.
Memorial Hermann offers a full range of surgical treatments for breast cancer. A specially trained team of affiliated oncologists and cancer nurses will provide you with the information you need to help make the most informed decisions about your breast cancer treatment.
Chemotherapy is a common method for treating many different types of cancer, including breast cancer. Chemotherapy drugs kill or otherwise stop cancer cells from growing. These drugs may be administered before surgery to shrink tumors (neoadjuvant chemotherapy), after surgery to ensure the cancer is eradicated (adjuvant chemotherapy) or to ease the symptoms of late stage cancer (palliative chemotherapy).
For more information about how Memorial Hermann uses chemotherapy to treat cancer, visit our Chemotherapy page.
Radiation therapy may be utilized in certain cases, including:
- After surgery, to decrease the chance of recurrence if you have positive lymph nodes
- After a mastectomy if you have positive margins, a large tumor or skin involvement
- In combination with chemotherapy to treat cancer if surgery is not an option
- To treat breast cancer that has spread to other areas such as the bones or brain
For more information on how Memorial Hermann uses radiation therapy to treat cancer, visit our Radiation Oncology page.
Immunotherapy is a new type of cancer treatment currently undergoing research in the breast cancer field. The treatment utilizes medicines to stimulate the body’s immune system to recognize and destroy cancer cells. Immunotherapy is becoming a popular method of treatment for cancer that cannot be removed with surgery, has recurred after chemotherapy treatment or has spread to other parts of the body.
For more information on how Memorial Hermann uses immunotherapy to treat cancer, visit our Medical Oncology page.
Choose Memorial Hermann for Breast Cancer Treatment
If you’ve been diagnosed with breast cancer and need assistance, our nurse navigators can help you find a provider or other support resources. To connect with a nurse navigator, call (833) 770-7771.