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Breast Cancer

Please note: Information about breast cancer in men can be found here.

Definition

When abnormal cells grow out of control, they are called cancers. Breast cancer often starts as a small lump in the breast and is one of the most common cancers in women. With time, the cancer may grow and spread to other organs, such as skin, lymph nodes, the liver, brain, lungs, and spine.

Breast cancer is the third leading cause of death for women in the U.S. The good news is that breast cancer is a disease that can be treated and cured. Finding the cancer cells early and doing the right treatment has lowered the death rate from breast cancer in the last 20 years. Treatment for breast cancer includes surgery, radiation, chemotherapy, and endocrine/anti-hormone therapy.

Getting Diagnosed / Treatment

The Breast Oncology Research Program coordinates research and treatment efforts to provide outstanding care to those diagnosed with breast cancer.

Most of patients with breast cancer are treated in the Breast Care Clinic. Read about:

• the Breast Care Clinic
• View the list of Breast Care Clinic physicians -on the UMHS website

Make an Appointment

There are two other clinics that treat breast cancer patients:

• the Breast & Ovarian Cancer Risk Evaluation Clinic
  some forms of breast cancer have a genetic component and this clinic helps women define their risk. Read more here



• the Breast Wellness Clinic
  provides coordinated mammography and clinical breast examination for women who have had a diagnosis of breast cancer and have completed their treatments at the U-M, or are at increased risk for developing breast cancer. Read more here

How does breast cancer occur?

The cause of breast cancer is not known. Any woman can get breast cancer, but some women are more likely to develop it than others. Factors that increase your risk of having breast cancer include:

• having a mother or sister with breast cancer
• starting your menstrual period at a young age or going through menopause in your 50’s
• being over age 50
• never having given birth or having your first child after age 30
• taking hormone (estrogen) replacement therapy
• smoking
• excessive use of alcohol
• obesity.

It appears that taking estrogen after menopause causes a slight increase in the risk of breast cancer. At this time, there is no sure proof that taking birth control pills for a long time does or does not cause breast cancer.

What are the symptoms?

Most often, the first sign of breast cancer is a lump in the breast. The lump is found most often in the upper, outer part of the breast. Most of the time the lump is not painful. It may grow slowly or quickly. Other signs of breast cancer include:

• color change, dimpling, or puckering of the skin in area of breast
• a change in the size or shape of the breast
• fluid discharge from the nipple
• lumps felt in the armpit.

How is it diagnosed?

Many women find their own breast cancers, either by accident or from a breast self-exam. Often breast cancers are found at a health checkup or on a screening mammogram.

Mammograms can detect some cancers before a lump can be felt. They detect about 80-90% of cancerous lumps. Mammograms and other tests, such as ultrasounds and sometimes MRI scans are also used to check lumps once they have been found on exam. Most breast lumps are not cancer. Often they are fluid-filled cysts in the breast tissue that get larger and smaller with the menstrual cycle. Every lump must be checked through:

• a breast exam by a health care provider
• a mammogram
• a ultrasound scan
• a needle or surgical biopsy if needed

These tests should be done even if the lump is not seen on the mammogram.

If you need to have a needle biopsy, you are given a local anesthetic to numb the area of your breast being tested. Then your health care provider inserts a needle into the breast lump and withdraws fluid or tissue from the lump. If fluid fills the needle, the lump is a cyst and most often is not cancer. Taking out the fluid also makes the fluid-filled lumps go away. Tissue withdrawn by the needle may be checked in the lab, but not always.

If you have a surgical biopsy, your health care provider will give you an anesthetic, make a cut in the breast, and remove some or all of the lump. This breast tissue will be checked under a microscope. If the biopsy sample shows cancer tissue, tests may be done. These tests will show if anti-hormone therapy such as Tamoxifen, might work for you. The estrogen receptor (ER) test is one of these tests. You may have another procedure to remove lymph nodes from your armpit to see if cancer has spread beyond the breast. This procedure is called axillary node dissection.

How is it treated?

If a breast lump is cancer tissue, the decision for treatment will be made by you and your health care provider. A surgeon or oncologist (cancer specialist) may also be asked for advice. Your treatment plan depends on:

• your age
• the stage of growth of the cancer
• the type of cancer
• whether the cancer has spread to lymph nodes or other parts of your body.

Possible surgical treatments are either a mastectomy (complete removal of the breast) or breast conserving therapy. The second option consists of taking the cancer tissue out of the breast and treating the remaining breast tissue with radiation. Women treated in this manner often have very good cosmetic results. Even if a mastectomy is needed (about 30-40% of patients need this), building a new breast, called reconstruction, offers a natural looking breast replacement.

You will also see a medical oncologist to help you decide if further treatment, such as chemotherapy and / or endocrine (anti-hormone) treatment is also needed to decrease the odds of having the cancer come back.

How can I take care of myself?

If you have been told you have breast cancer:

• Discuss your cancer and treatment options with your doctor so that you know your choices. It is also alright to get a second opinion on treatment options from another doctor.
• Tell your doctor if your treatment causes discomfort. Most often there are ways to relieve the discomfort.
• Get routine checkups after your treatment is done.
• Keep doing monthly self-exams, even if both your breasts have been removed, to look for any cancer that has come back.

There are many groups and agencies that can help women with breast cancer. Ask your health care provider or call your local American Cancer Society office.

Breast cancer survival keeps getting better .As more women do routine self-exams, more cancers are found early. As mammograms and other screening methods improve, more cancers are being found before they can even be felt. Finding and treating breast cancer early greatly increases your chances of survival and cure.

Although finding out you have breast cancer is frightening, you should keep in mind that things are getting better. In the U.S., more than 80% of women with breast cancer are cured, which is much higher than it used to be.

You might wish to be part of a clinical trial. Your oncology team may discuss this option with you in order to improve breast cancer treatment even further.

To help detect breast cancer early:

• Do a breast self-exam every month.
• Have a breast exam by your health care provider at least once a year.
• Have a mammogram every year after age 50.
• Never ignore a lump or change in the look or feel of your breast. Remember that a cancerous tumor is most often not painful.

Research suggests that routine exercise may help prevent breast cancer. Exercise often and stay fit.

Continue Reading about breast cancer

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Developed by McKesson Health Solutions LLC.
Published by McKesson Health Solutions LLC.
This content is reviewed periodically and is subject to change as new health information becomes available.

The above was reviewed and updated by Mark Helvie, MD, UMHS Department of Radiology, February 2004).

The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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University of Michigan Comprehensive Cancer Center
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Ann Arbor, MI 48109

This site is part of the U-M Health System. The information presented is not a tool for self diagnosis or a substitute for professional care. © 2008 U-M Comprehensive Cancer Center