Understanding Breast Cancer

Cancer is a broad term for a class of diseases characterized by abnormal cells that grow and invade  healthy cells in the body.  Breast cancer starts in the cells of the breast as a group of cancer cells that can then invade surrounding tissues or spread (metastasize) to other areas of the body.

Cancer occurs when changes called mutations take place in genes that regulate cell growth. The mutations let the cells divide and multiply in an uncontrolled way.

Breast cancer is cancer that develops in breast cells. Typically, the cancer forms in either the lobules or the ducts of the breast. Lobules are the glands that produce milk, and ducts are the pathways that bring the milk from the glands to the nipple. Cancer can also occur in the fatty tissue or the fibrous connective tissue within your breast.

The uncontrolled cancer cells often invade other healthy breast tissue and can travel to the lymph nodes under the arms. The lymph nodes are a primary pathway that help the cancer cells move to other parts of the body

Breast cancer symptoms

In its early stages, breast cancer may not cause any symptoms. In many cases, a tumor may be too small to be felt, but an abnormality can still be seen on a mammogram. If a tumor can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancer.

Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:

  • a breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
  • breast pain
  • red, pitted skin over your entire breast
  • swelling in all or part of your breast
  • a nipple discharge other than breast milk
  • bloody discharge from your nipple
  • peeling, scaling, or flaking of skin on your nipple or breast
  • a sudden, unexplained change in the shape or size of your breast
  • inverted nipple
  • changes to the appearance of the skin on your breasts
  • a lump or swelling under your arm

If you have any of these symptoms, it doesn’t necessarily mean you have breast cancer. For instance, pain in your breast or a breast lump can be caused by a benign cyst. Still, if you find a lump in your breast or have other symptoms, you should see your doctor for further examination and testing. 

Types of breast cancer

There are several types of breast cancer, and they are broken into two main categories: “invasive” and “noninvasive,” or in situ. While invasive cancer has spread from the breast ducts or glands to other parts of the breast, noninvasive cancer has not spread from the original tissue.

These two categories are used to describe the most common types of breast cancer, which include:

  • Ductal carcinoma in situ. Ductal carcinoma in situ (DCIS) is a noninvasive condition. With DCIS, the cancer cells are confined to the ducts in your breast and haven’t invaded the surrounding breast tissue.
  • Lobular carcinoma in situ. Lobular carcinoma in situ (LCIS) is cancer that grows in the milk-producing glands of your breast. Like DCIS, the cancer cells haven’t invaded the surrounding tissue.
  • Invasive ductal carcinoma. Invasive ductal carcinoma (IDC) is the most common type of breast cancer. This type of breast cancer begins in your breast’s milk ducts and then invades nearby tissue in the breast. Once the breast cancer has spread to the tissue outside your milk ducts, it can begin to spread to other nearby organs and tissue.
  • Invasive lobular carcinoma. Invasive lobular carcinoma (ILC) first develops in your breast’s lobules and has invaded nearby tissue.

Other, less common types of breast cancer include:

  • Paget disease of the nipple. This type of breast cancer begins in the ducts of the nipple, but as it grows, it begins to affect the skin and areola of the nipple.
  • Phyllodes tumor. This very rare type of breast cancer grows in the connective tissue of the breast. Most of these tumors are benign, but some are cancerous.
  • Angiosarcoma. This is cancer that grows on the blood vessels or lymph vessels in the breast.

The type of cancer you have determines your treatment options, as well as your likely long-term outcome.

Inflammatory breast cancer

Inflammatory breast cancer (IBC) is a rare but aggressive type of breast cancer. IBC makes up only between 1 and 5 percent trusted source of all breast cancer cases.

With this condition, cells block the lymph nodes near the breasts, so the lymph vessels in the breast can’t properly drain. Instead of creating a tumor, IBC causes your breast to swell, look red, and feel very warm. A cancerous breast may appear pitted and thick, like an orange peel.

IBC can be very aggressive and can progress quickly. For this reason, it’s important to call your doctor right away if you notice any symptoms.

Male Breast Cancer

All people, whether male or female, are born with some breast cells and tissue. Even though males do not develop milk-producing breasts, a man’s breast cells and tissue can still develop cancer. Even so, male breast cancer is very rare. Less than one percent of all breast cancer cases develop in men, and only one in a thousand men will ever be diagnosed with breast cancer.

Breast cancer in men is usually detected as a hard lump underneath the nipple and areola. Men carry a higher mortality than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment. 

Infiltrating Ductal Carcinoma

Of the men who develop breast cancer, the vast majority of those cases are infiltrating Ductal Carcinoma(IDC), which means cells in or around the ducts begin to invade surrounding tissue. Very rarely, a man might be diagnosed withinflammatory breast cancer, or Paget disease, of the nipple.

Risk Factors

  • Radiation exposure
  • High levels of the hormone estrogen
  • Family history of breast cancer, especially breast cancer that is related to the BRCA2 gene.

Signs & Symptoms

Male breast cancer can exhibit the same symptoms as breast cancer in women, including a lump. Anyone who notices anything unusual about their breasts, whether male or female, should contact their physician immediately. Survival rates and treatment for men with breast cancer are very similar to those for women. Early detection of breast cancer increases treatment options and often reduces the risk of dying from breast cancer.

Genetic Testing

Although treatment outcomes are very similar to women at the same stage of detection, a man diagnosed with breast cancer should also consider seeing a genetics counselor for a consultation. If a man tests positive for a defective gene (most commonly either BRCA1 or BRCA2) that can lead to a future diagnosis of breast cancer and his children have a 50% chance of carrying the gene. In addition:

  • A male child of a man with breast cancer who inherits the defective BRCA2 gene has only approximately 6% chance of eventually developing breast cancer and just over 1% with BRCA1.
  • A female child of a man with breast cancer who inherits the defective gene has a risk between 40% and 80% of eventually developing breast cancer.
  • Men with a genetic predisposition to breast cancer are also at higher risk of getting prostate cancer at a younger age than usually diagnosed.