By Bernard Freeman
The Reach of Breast Cancer
Did you know that breast cancer is the second most common cancer in women? Or that men can get breast cancer? Or that, when caught and treated early, many types of breast cancer have almost a 100% cure rate?
Breast cancer — which occurs when breast cells grow out of control, form a tumor and become malignant — affected more than 250,000 people in 2018, according to the National Cancer Institute. About 3.5 million women are living with breast cancer in the United States, and more than 12% of women will be diagnosed with breast cancer in their lifetime.
The number of deaths from breast cancer is 20.6 per 100,000 women per year; the death rate among all cancers (men and women) is 163.5 per 100,000 people, so breast cancer has a much higher rate of survival. It typically responds very well to treatment; almost nine out of 10 women treated for breast cancer are alive five years after their diagnoses. The success of treatment is heavily dependent on how early in the cancer’s development it’s diagnosed; more than 60% of cases are found in the early stages of cancer, before it’s metastasized to other organs, the treatment of which has a 99% five-year survival rate.
Breast cancer, like all types of cancer, doesn’t have a lot of easy answers about what causes it or what people can do to lessen their chances of developing a tumor. However, researchers have identified some contributing factors.
A family history of cancer is a big one. Women whose grandmothers, mothers or sisters had breast cancer should talk to their doctors about effective testing techniques at an earlier age than is normally recommended. Other possible factors include having dense breast tissue; exposing breast tissue to estrogen because of late menopause, never giving birth, early menstruation or being older at the birth of a woman’s first child. Taking hormones also may contribute. Health factors like alcohol use and obesity also may contribute to cancer risk for all cancers.
We don’t know how to prevent cancer, but there are steps women can take that are thought to reduce the risk of breast cancer; these protective factors include estrogen-only hormone therapy after a hysterectomy, healthy eating and exercise and other lifestyle factors.
What to Watch For
Since early diagnosis plays such an outsized role in successfully treating breast cancer, people should know what signs to look for and what the screening process will be like when you go to the doctor.
According to the American Cancer Society, the most common symptom of breast cancer is a new lump or mass in the breast that wasn’t previously there. A mass that is painless and hard and has irregular edges is more likely to be cancer, but malignant tumors can be soft, tender, round or painful. When you find a new lump, go to the doctor. This means women need to know what their breasts look and feel like, so regular self-exams are beneficial.
Other possible symptoms include swelling of the breast, skin dimpling or irritation, breast pain, nipple retraction, pain or discharge or the skin of the breast or nipple turning red, scaly or thick. Breast cancer also can manifest in swollen nodes in the armpit or around the collarbone.
During your annual physical, your doctor will examine your breasts and lymph nodes for changes. This will typically be the first step even when you go in knowing something has changed. Breast tissue can change with time; women develop cysts, and menstruation and menopause can affect tissue as well. Your doctor also will ask you about your family history with all types of cancer, but particularly breast, uterine and ovarian cancers. Based on the exam and discussion, she may decide further testing, such as an ultrasound, is needed.
In an ultrasound, the doctor is able to isolate the affected area and get a visual of sorts of the lump; its size, shape, density and other factors can help them determine if this is a tumor or a cyst or just a change in fatty breast tissue.
Another screening is a mammogram, which is an X-ray that can find tumors that aren’t felt with physical exams. These are recommended for all women 40 years old and older, but women who are at higher risk may start them earlier. In addition to tumors, mammograms can find small calcium deposits that are a sign of breast cancer.