Breast Cancer

CareMount Medical Cancer Center believes in helping women understand breast cancer including detection, diagnosis, treatment options, and risk factors. After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. Breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining, largely due to factors such as earlier detection, a more personalized approach to treatment and a better understanding of the disease. This cancer occurs when some breast cells begin to grow abnormally. These cells divide more rapidly than healthy cells and continue to accumulate, forming a lump or mass.

Most breast cancers start in the milk ducts or lobules and are called ductal carcinoma or lobular carcinoma. Noninvasive cancer does not go beyond the milk ducts. Invasive cancer spreads into surrounding tissues of the breast. Cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.

Researchers have identified hormonal, lifestyle, genetic and environmental factors that may increase your risk of breast cancer. While most cases occur in women, it can also occur in men. 

Risk Factors

Studies have shown that your risk for breast cancer is due to a combination of factors. Having a risk factor does not mean you will get the disease, and not all risk factors have the same effect. If you have risk factors, talk with your doctor about ways you can lower your risk and screening for breast cancer.

Risk factors include

• Getting older. The risk for breast cancer increases with age; most breast cancers are diagnosed after age 50.
• Family history of breast cancer. A woman’s risk is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who has had breast cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.
• Genetic mutations. Inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer.
• Menstruation and Menopause. Women who start their periods before age 12 are exposed to hormones longer, raising the risk for breast cancer by a small amount.  Similarly, starting menopause after age 55 also raises the risk.
• Late or no pregnancy. Having the first pregnancy after age 30 and never having a full-term pregnancy can raise breast cancer risk.
• Not being physically active. Women who are not physically active have a higher risk of getting breast cancer.
• Being overweight or obese after menopause. Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.
• Having dense breasts. Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
• Using combination hormone therapy. Taking hormones to replace missing estrogen and progesterone in menopause for more than five years raises the risk for breast cancer. The hormones that have been shown to increase risk are estrogen and progestin when taken together.
• Taking oral contraceptives (birth control pills). Certain forms of oral contraceptive pills have been found to raise breast cancer risk.
• Personal history of breast cancer. Women who have had breast cancer are more likely to get it a second time.
• Previous treatment using radiation therapy. Women who had radiation therapy to the chest or breasts (for example, treatment of Hodgkin’s lymphoma) before age 30 have a higher risk of getting breast cancer later in life.
• Women who took the drug diethylstilbestrol (DES), which was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage, have a higher risk. Women whose mothers took DES while pregnant with them are also at risk.
• Drinking alcohol. Studies show that a woman’s risk for breast cancer increases with the more alcohol she drinks.

When to See a Doctor

CareMount Medical doctors encourage patients to be aware of how their breasts normally look and feel and to report any changes, including swelling, dimpling, redness, scaly nipple or breast skin/nipple discharge, to their physician immediately. Some women find it helpful to do a monthly breast self-exam to look for lumps or changes in their breasts. If you feel a lump in your breast, even if your breast imaging studies are normal, make an appointment with your doctor immediately or call the CareMount Medical Cancer Center Referral Line at 1-844-484-3292.

Breast Cancer Team

• Carl F. Calica, MD FACS
• Simon H. Chin, MD
• Beth C. Freedman, MD
• Julie M. Gold, MD
• Jonathan S. Goldberg, MD
• Jeffrey L. Halaas, MD PhD
• Maud L. Lemercier, MD
• Amanda L. Messina, MD FACS
• Karoline S. Nowillo, MD
• Lyda E. Rojas Carroll, MD, FACS
• Douglas A. Roth, MD FACS 
• Jason Rubin, MD, FACP
• Adam B. Semegran, MD FACS
• Saad Yousuf, MD

Breast Cancer Screening and Genetic Testing

Medical experts suggest mammograms every one to two years for most women starting at the age of 40. Women with a high risk of breast cancer will likely be screened more often.

A person’s risk of breast cancer nearly doubles if a close relative has been diagnosed with this type of cancer. There are criteria set forth by the National Comprehensive Cancer Network to determine who should undergo genetic testing.

Diagnosis

Mammograms are the main test used to screen for breast cancer. Routine screening helps doctors find cancer early. At CareMount Medical we are at the forefront of breast cancer diagnosis by using 3D mammography methods, MRI guided biopsy and a wire-free radar breast localization system.

If a mammogram finds a spot that looks like it could be cancer, doctors usually follow up with a biopsy. During a biopsy, a doctor takes one or more small samples of tissue from the breast so that the cells can be examined under a microscope to see if they are cancerous.

Taking a Closer Look at the Most Common Breast Cancer Variations

Cancer can begin in different areas of the breast — the ducts, the lobules, or in some cases, the tissue in between. When identifying the specific type of breast cancer, the pathologist will also check if the cancer has spread into the surrounding tissues. The following terms are used to describe the extent of the cancer: In situ (breast cancers have not spread beyond the milk ducts) and invasive or infiltrating (cancers have spread into the surrounding breast tissue).

Treatments

Breast cancer treatment requires a team approach including a breast surgeon, radiologist, pathologist, medical oncologist, plastic surgeon and radiation oncologist. The CareMount Medical Cancer Center team specializes in caring for women at every stage, from diagnosis to recovery.

While each case is unique, women with early-stage breast cancer often receive two types of treatments; local treatment which targets the breast directly including surgery and radiation; and systemic treatment which targets the whole body including chemotherapy, targeted therapy and hormone therapy.

Generally, the medical oncologist appointment occurs after surgery but there are instances in which chemotherapy or anti-endocrine therapy may be administered first.

Prevention

Currently, there are more than 3.6 million women with a history of breast cancer in the U.S. This includes women currently being treated and women who have finished treatment. If you have a strong family history of breast cancer, ask your doctor what you can do to prevent cancer, including genetic testing.

Schedule a Consultation

To schedule an appointment or obtain a second opinion on your diagnosis, please call the CareMount Medical Cancer Center Referral Line at 1-844-484-3292.