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Breast Cancer

 201-227-6008   |    cancer@holyname.org

Overview

Breast cancer is the second most common cancer in women after skin cancer. About one in eight women, more than 3.1 million Americans, will develop the disease, though the incidence rate is declining slightly, mainly due to a decrease in hormone therapy. At the same time, survival rates have increased because of raised awareness of early detection and a personalized approach to treatment.

The Patricia Lynch Cancer Center at Holy Name has a multi-disciplinary team of experienced and skilled breast surgeons, oncologists, radiologists, nurses and support staff. Together, they provide compassionate care in creating a personal strategy for each patient's unique medical, emotional and lifestyle needs.


  • Changes in the appearance of the nipple or breast

  • Dimpling around the nipple or on the breast skin

  • Lump in the breast or underarm

  • Nipple discharge

  • Nipple turning inward

  • Rash or redness of the breast

  • Swelling or skin thickening of the breast

The cause of breast cancer is unknown. Most often, it begins with the cells in the milk-producing ducts, called invasive ductal carcinoma. It also frequently occurs in the tissue making up different glands, or lobules, and is known as invasive lobular carcinoma. But breast cancer can start in other breast cells and tissues.

Certain hormonal, lifestyle and environmental factors may increase the risk of breast cancer, but researchers still do not know why these conditions may lead to the disease in some people and not others. Most likely, it is caused by an unknown interaction of genetic makeup and environmental factors.

  • Being female – women are much more likely to develop breast cancer than men. It is estimated one out of eight women will develop breast cancer, while only about one in every 1,000 men is diagnosed with the disease.

  • Aging – the risk for breast cancer increases with age. Only 5 percent of women under 40 develop the disease while 2 out of 3 invasive cancers are found in women over 55.

  • Personal history – women who had breast cancer are 3 – 4 times more likely to develop another type of breast cancer.

  • Family history – if a woman's mother, sister or daughter was diagnosed with breast cancer, especially at a young age, the risk is about 13 percent higher.

  • Inherited genes – certain gene mutations that can be passed from parents to children may increase the risk between 5 and 10 percent for breast cancer. These include, but are not limited to BRCA1 and BRCA2.

  • Radiation exposure – women who received radiation treatments to the chest as a child or young adult are 3 to 7 times more likely to develop breast cancer.

  • Obesity – being obese increases the risk of the disease.

  • Early menstruation – women who get their period before age 12 have a 20 percent increased risk.

  • Late menopause – women who begin menopause at an older age are more likely to develop breast cancer.

  • Later childbirth – women who give birth to their first child after age 30 have an increased risk; those who deliver after 35 have a 40 percent higher chance of developing the disease.

  • Never pregnant – women who have never been pregnant have an increased risk compared to women who have been pregnant at least once.

  • Hormonal therapy – women who take hormone medications with a combination of estrogen and progesterone for menopause symptoms have a 75 percent higher risk of breast cancer. This risk decreases once the medication is stopped.

  • Alcohol – having 3 alcohol drinks a week raises the risk of breast cancer by 15 percent and it increases 10 percent for each additional drink.

  • Breast Exam – women should do self-exams every month and a physician should examine both breasts and armpits for any lumps or abnormalities annually.

  • Mammogram is an X-ray of the breast and the most common way to screen for breast cancer.

  • 3D Mammogram, an advanced technology that captures multiple images of the breast from several angles, is performed at the same time as a 2D mammogram.

  • Contrast Enhanced Spectral Mammography is used for women at a high risk of developing breast cancer, evaluating how patients are responding to treatment and helping problem solve with inconclusive mammograms.

  • Breast ultrasound is a painless screening using sound waves to help determine whether a lump is a solid mass or a fluid-filled cyst.

  • Breast magnetic resonance imaging (MRI) provides a more detailed image and is typically done when mammograms and ultrasounds are inconclusive.

  • A biopsy is a sample of cells taken to determine whether they are cancerous.

There are many different types of breast cancer and treatment options may differ depending on the type and stage of the cancer.

  • Ductal carcinoma in situ (DCIS) - A non-invasive breast cancer limited to inside the duct of the breast, meaning it hasn't spread, and is classified as Stage 0. It has no symptoms and is usually spotted on a mammogram.

  • HER2 - A growth-promoting protein located on the outside of breast cells. Tumors with higher levels of HER2 tend to grow and spread faster than other types of breast cancers.

  • Hormone receptor positive - When cancer cells grow in response (receptor positive) to the hormones estrogen or progesterone.

  • Inflammatory breast cancer (IBC) - This type of breast cancer is rare, aggressive and fast-growing. Cancer cells block lymph vessels in the breast, causing a buildup of fluid (lymph) in the breast skin. The breast will often look swollen, red, purple or bruised. The skin may also have ridges or appear pitted, like an orange peel. The disease typically develops quickly and may not create a tumor that can be felt. Immediate care is recommended. If an infection or rash on the breast does not clear up after treatment with antibiotics or topical remedies, prompt follow-up care is advised.

  • Invasive ductal carcinoma (IDC) - This is the most common type of breast cancer. It begins growing in the milk duct and then invades the surrounding tissue. A lump or mass may be found during a breast self-exam or there may be no symptoms. A mammogram may also reveal a suspicious mass, which requires further testing.

  • Invasive lobular carcinoma (ILC) - Although this is the second most common type of breast cancer, it still accounts for only about 10 percent of all cases. It starts in the milk-producing lobules of the breast and invades the surrounding tissue. It may produce no symptoms, be discovered as a palpable mass during a self-exam, or as a density in a mammogram.

  • Metastatic breast cancer - A diagnosis of metastatic breast cancer means the cancer has spread to other organs in the body.

  • Paget's disease of the breast - This rare form of breast cancer causes a skin change in the areola or nipple. Signs include nipple or areola redness, an eczema-like rash, a break in the skin or crusting. Nipple discharge or inversion may also occur. It typically affects women in their 50s but can appear at younger or older ages.

  • Triple negative - The name of this type of breast cancer refers to its characteristics, estrogen-receptor negative, progesterone-receptor negative and HER2-receptor negative. This means targeted therapies that attack specific genes or proteins on cancer cells are not effective, though it typically responds to chemotherapy. Between 10 and 15 percent of breast cancer patients have triple negative, a particularly aggressive form of the disease.

Staging the disease means finding out how far, if at all, the cancer has spread. Staging, which is done for every type of breast cancer, helps to create a personal treatment plan for each patient. The stage of a breast cancer is usually determined after surgery, when the tumor and lymph nodes*, if necessary, are examined. Stages are classified based on the size of the largest tumor, lymph node involvement and whether other organs are affected.

Stage 0 - This is noninvasive breast cancer, or ductal carcinoma in situ (DCIS). Cancer cells are limited to the lining of the ducts and have not spread beyond the ducts.

Stage 1 - Considered invasive breast cancer, the tumor is no larger than 2 centimeters, but some cancer cells have spread from the ducts or lobules into nearby fatty tissue of the breast. Lymph nodes have not been affected.

Stage 2 - Invasive breast cancer with a tumor between 2 and 5 centimeters, or a smaller tumor with cancer cells that have spread to the lymph nodes.

Stage 3 - This stage has three subsets, which differ based on the number of lymph nodes affected and the size of the tumor. Invasive breast cancer may have spread to the chest wall or skin of the breast.

Stage 4 - Invasive breast cancer has spread beyond the breast and nearby lymph nodes to other parts of the body, usually organs such as lungs, brain, liver, skin, or bones and distant lymph nodes. Inflammatory breast cancer is classified as Stage 4 breast cancer.

* Lymph nodes collect and filter cells from fluids before returning the fluid to the bloodstream. When breast cancer has been diagnosed, lymph nodes are tested to determine whether cancer cells have spread to the nodes.

  • Sentinel lymph node biopsy - The sentinel lymph nodes are the first ones where breast cancer spreads. They are removed during surgery to see whether they contain cancer cells.

  • Axillary Node Dissection - Axillary nodes are located in the armpit and are removed if oncologists believe the cancer has spread.

The Patricia Lynch Cancer Center at Holy Name has highly skilled medical teams that determine the best treatment option based on the type of breast cancer, its stage, grade, size and whether it is sensitive to hormones. Many women have breast cancer surgery and receive other treatments before or after, such as chemotherapy, radiation or hormone therapy.

Surgery

There are different types of surgery that may be performed to treat breast cancer. Patients should speak with their physicians to go over all the options.

Lumpectomy, known as breast-saving surgery, removes the tumor and a small amount of healthy tissue. It is typically used for small tumors.

Mastectomy, is a procedure that removes the entire breast.

Radiation Therapy

Radiation therapy uses radiation beams to kill cancer cells. It is often used after a lumpectomy for early-stage breast cancer and after a mastectomy for larger tumors or cancer that has spread to the lymph nodes.

Chemotherapy

Chemotherapy is the use of drugs, in oral or intravenous form, to destroy cancer cells. It is often used when the cancer has a high chance of recurring or spreading to other areas of the body. It is occasionally given before surgery to shrink the tumor.

Hormone Therapy

Hormone therapy is used to treat breast cancers that are sensitive to hormones. They are often referred to as estrogen receptor positive or progesterone receptor positive cancers. Hormone therapy may be used before or after surgery and other treatments to help decrease recurrence.

Different types of hormone therapy are used based on the type of cancer:

  • Medications that block hormones from attaching to cancer cells, slowing the growth of the tumor and killing cancer cells.

  • Drugs that stop the body from making estrogen.

  • Medications that target the estrogen receptors on cancer cells, blocking and then killing the receptors.

  • Surgery or medications that stop hormone production in the ovaries.

Targeted Medications

Targeted drugs attack specific abnormalities in cancer cells that help them grow and multiply. Depending on the type of breast cancer cells, different medications may be effective in killing the cells that make up particular tumors.

Reconstruction

For women who want breast reconstruction after a mastectomy, our breast surgeons work closely with our plastic surgeons to give each patient her desired outcome. Each step of the procedure is explained thoroughly so patients feel empowered in making their own decisions.

Genetic Testing

Many people with breast cancer may benefit from genetic testing, which can determine whether certain genes are damaged, or mutated. These mutations may increase the risk of various cancers and may also affect other family members.

Holy Name provides comprehensive genetic testing, including education and counseling for cancer patients. Click here to learn more about Holy Name's genetic testing services.


Inspiring Breast Cancer Patient Stories

The Patricia Lynch Cancer Center provides the best care to every patient. Here our some of their stories.

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