In the Spotlight
Breast cancer is a disease where abnormal cells in the breast grow uncontrollably and form lumps or tumors. If left untreated, breast cancer can spread to other parts of the body, or metastasize. Both men and women can have breast cancer, although male breast cancer is rare. The odds that a woman will be diagnosed with breast cancer in her lifetime are one in eight. Awareness, early detection, proper diagnosis, and the right treatment can all help ensure the best possible outcome.
When found and treated early, breast cancer often can be effectively treated. That is why it is important to be aware of risk factors. It is also important to take the right steps to find breast cancer before it spreads.
Not having children, or having children later in life
Starting your menstrual period at an early age
Starting menopause at a late age
Having had breast cancer previously
Having close family members who have had breast cancer
Having a genetic condition, such as mutations in BRCA1 or BRCA2 genes
Previous radiation therapy/exposure to the breasts or chest
Being overweight or obese
Using hormone replacement therapy for a long time
Having one or more of these risk factors does not mean that you will develop breast cancer. However, you should bring them to your provider's attention. Sharing this with your health care team helps them recommend the right tests for you.
The health care team has many ways to diagnose breast cancer. Sometimes, different tests will be used together. This helps your provider confirm breast cancer and find out its characteristics.
Clinical Breast Examination - A lump or other change in the breast or armpit could be a sign of breast cancer. It is important to call your provider if you notice any unusual changes in how your breast looks or feels. Your provider will then perform a clinical exam.
Mammogram - a mammogram is an x-ray of the breast. This test allows a radiologist to look for abnormalities. The VA, in line with other national guidelines, recommends that women over 50 get mammograms every two years. Women between the ages of 40 and 50 and older than 75, should talk to their provider about the risks and benefits of having mammograms and make a decision based on their individual situations. Women with a history of breast cancer, close family relatives with breast cancer, or other strong risk factors may want to have additional or more frequent screening tests and should talk to their providers.
Other Tests That May Be Used
Ultrasound - Sound waves are used to look at a specific part of the breast tissue. This test helps determine a lump's characteristics, such as whether it is fluid-filled or solid. This test may also be used to assist with tissue biopsy and aspiration of masses detected.
Tissue sampling (i.e., fine needle aspiration, core needle biopsy) - If breast cancer is suspected, usually a needle and local anesthesia are used to take a sample of the abnormal area. The sample is then tested to determine its characteristics.
MRI (Magnetic Resonance Imaging) - MRI is a certain type of imaging study. It is sometimes used to take a closer look at breast tissue when a mammogram picks up an abnormality. It is usually not used as screening. This is because of the expense and availability of MRIs. Plus, it may also pick up abnormalities that are not cancer but still need to be further evaluated.
The overall five-year survival rate from breast cancer is nearly 90 percent. If the cancer is caught while it is still located only in the breast, the survival rate increases to nearly 99 percent.
Breast cancer treatment must be tailored to each patient's needs and the type and seriousness of breast cancer. One or more treatment options may be used to treat breast cancer.
Lumpectomy - the lump and a small amount of surrounding tissue are removed from the breast
Chemotherapy - drugs are used to shrink or kill the cancer
Mastectomy - the breast tissue is removed with the goal of removing the cancer
Radiation therapy - high-energy rays (similar to x-rays) are aimed at the lump to destroy the cancer
Hormonal therapy - drugs are used to block cells from getting the hormones they need to grow
Biological therapy - the body's immune system is used to fight the cancer
In Her Words
"After surviving breast cancer, I think I'm living more in the moment - I don't let anybody get to me anymore. I'm being kinder and gentler to me now," says breast cancer survivor Carol Widel, 69, of Pittsburgh, a former Air Force dental assistant."At the VA itself, everybody - from the nurses to the radiation team - was constantly on my side. In Pittsburgh, at least, it was the Cadillac of health care."
Many women find it helpful to join support groups before, during, and after treatment for breast cancer. To find a local support group, you can contact:
Breast Cancer and You: What You Need to Know
Breast Cancer (National Cancer Institute) provides general health information about breast cancer symptoms, diagnosis, treatment, and questions to ask the doctor.
Breast Cancer Treatment (CDC) Breast cancer is treated in several ways. It depends on the kind of breast cancer and how far it has spread. Treatments include surgery, chemotherapy, hormonal therapy, biologic therapy, and radiation. People with breast cancer often get more than one kind of treatment.
Fact Sheet: Breast (SEER) provides a summary of the latest numbers of major cancer types.
Breast Cancer FAQS - Answers to frequently asked questions.
Other Source Documents
Walter LC., Lindquist K., Covinsky KE., Relationship between health status and use of screening mammography and Papanicolaou smears among women older than 70 years of age, Ann Internal Med. 2004; 140:681-688.
Laronga C., Breast cancer guide to diagnosis and treatment, UpToDate, 2011
Updated/Reviewed: October 1, 2011