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Breast cancer


Alternative Names:

Cancer - breast; Carcinoma - ductal; Carcinoma - lobular; DCIS; LCIS; HER2-positive breast cancer; ER-positive breast cancer; Ductal carcinoma in situ; Lobular carcinoma in situ

Symptoms:

Early breast cancer usually does not cause symptoms. This is why regular breast exams are important. As the cancer grows, symptoms may include:

  • Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt
  • Change in the size, shape, or feel of the breast or nipple -- for example, you may have redness, dimpling, or puckering that looks like the skin of an orange
  • Fluid from the nipple -- may be bloody, clear to yellow, green, or look like pus

In men, breast cancer symptoms include breast lump and breast pain and tenderness.

Symptoms of advanced breast cancer may include:

  • Bone pain
  • Breast pain or discomfort
  • Skin ulcers
  • Swelling of the lymph nodes in the armpit (next to the breast with cancer)
  • Weight loss
Support Groups:

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. 

Outlook (Prognosis):

New, improved treatments are helping persons with breast cancer live longer. Even with treatment, breast cancer can spread to other parts of the body. Sometimes, cancer returns even after the entire tumor has been removed and nearby lymph nodes are found to be cancer-free.

Some women who have had breast cancer develop a new breast cancer that is not related to the original tumor.

How well you do after being treated for breast cancer depends on many things. The more advanced your cancer, the poorer the outcome. Other factors that determine the risk of recurrence and the likelihood of successful treatment include:

  • Location of the tumor and how far it has spread
  • Whether the tumor is hormone receptor-positive or -negative
  • Tumor markers
  • Gene expression
  • Tumor size and shape
  • Rate of cell division or how quickly the tumor is growing

After considering all of the above, your doctor can discuss your risk of having a recurrence of breast cancer.

Possible Complications:

You may experience side effects or complications from cancer treatment. These may include temporary pain or swelling of the breast and surrounding area. Ask your doctor about the possible side effects from treatment.

When to Contact a Medical Professional:

Contact your health care provider if:

  • You have a breast or armpit lump
  • You have nipple discharge

Call your health care provider if you develop symptoms after being treated for breast cancer:

  • Nipple discharge
  • Rash on the breast
  • New lumps in the breast
  • Swelling in the area
  • Pain, especially chest pain, abdominal pain, or bone pain
Prevention:

Talk to your health care provider about how often you should have mammogram. Early breast cancers found by a mammogram have a good chance of being cured.

Tamoxifen is approved for breast cancer prevention in women aged 35 and older who are at high risk. Discuss this with your doctor.

Women at very high risk of breast cancer may consider preventive (prophylactic) mastectomy. This is surgery to remove the breasts before breast cancer is diagnosed. Possible candidates include:

  • Women who have already had one breast removed due to cancer
  • Women with a strong family history of breast cancer
  • Women with genes or genetic mutations that raise their risk of breast cancer (such as BRCA1 or BRCA2)

Many risk factors, such as your genes and family history, cannot be controlled. But making healthy lifestyle changes may reduce your overall chance of getting cancer. This includes:

  • Eating healthy foods
  • Maintaining a healthy weight
  • Limiting alcohol consumption to one drink per day (women at high risk of breast cancer should not drink alcohol at all)
References:

Cuzick J, DeCensi A, Arun B, et al. Preventive therapy for breast cancer: a consensus statement. Lancet Oncol. 2011;12(5):496-503.

National Cancer Institute: PDQ Breast Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified 08/22/2013. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional. Accessed November 12, 2013.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Breast cancer. Version 3.2013. Available at: http://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed November 12, 2013.

Warner E. Clinical practice. Breast-cancer screening. N Engl J Med. 2011;365:1025-1032.

Wolff AC, Comchek SM, Davidson NE, et al. Cancer of the breast. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 91.


Review Date: 10/30/2013
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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