October 1 through October 31, 2022 is Breast Cancer Awareness Month. During this annual campaign, this month is used to raise awareness about the impact of breast cancer in both women and men.
According to the National Breast Cancer Foundation, Inc. in 2022, an estimated 287,500 new cases of invasive breast cancer will be diagnosed in women in the U.S. as well as 51,400 new cases of non-invasive breast cancer. This year, an estimated 43,550 women will die from breast cancer in the U.S. The American Cancer Society, “breast cancer death rates declined from 40% from 1989 to 2016 among women. The progress is attributed to improvements in early detection”.
There are different types of breast cancer found both in women and men. The types are:
- Ductal Carcinoma In Situ (DCIS) – non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. It is a very early cancer that is highly treatable, but if it’s left untreated or undetected, it may spread into the surrounding breast tissue.
- Invasive Ductal Carcinoma (IDC) – invasive cancer where abnormal cancer cells begin forming in the milk ducts into other parts of the breast tissue. Invasive cancer cells can also spread to other parts of the body.
- Lobular Carcinoma In Situ (LCIS) – a condition where abnormal cells are found in the lobules (milk glands) of the breast. The atypical cells have not spread outside of the lobules into the surrounding breast tissue. LCIS is highly treatable and seldom becomes invasive cancer. However, having LCIS in one breast increases the risk of developing breast cancer in the other breast.
- Invasive Lobular Cancer (ILC) – begins in the lobules of the breast and spreads to surrounding normal tissue. It can also spread through the blood and lymph systems to other parts of the body. Invasive lobular breast cancer is the second most common type of breast cancer. Over 10% of invasive breast cancers are ILC. Mammograms are less likely to detect this form of cancer than other types of breast cancers. An MRI might be needed.
- Triple Negative Breast Cancer – the three most common types of receptors known to fuel most breast cancer growth, estrogen, progesterone, and the HER-2/neu gene, are not present in the cancer tumor. This means that the breast cancer cells have tested negative for human epidermal growth factor receptor 2 (HER-2), estrogen receptors (ER), and progesterone receptors (PR). Since the tumor cells lack the necessary receptors, common treatments like hormone therapy and drugs that target estrogen, progesterone, and HER-2 are ineffective. Using chemotherapy to treat triple-negative breast cancer is still an effective option. In fact, triple-negative breast cancer may respond even better to chemotherapy in the earlier stages than many other forms of cancer. Triple-negative breast cancer occurs in about 10-20% of diagnosed breast cancers and is more likely to affect younger people, African Americans, Hispanics, and/or those with a BRCA1 gene mutation.
- Inflammatory Breast Cancer (IBC) – is an aggressive and fast-growing breast cancer in which cancer cells infiltrate the skin and lymph vessels of the breast. It often produces no distinct tumor or lump that can be felt and isolated within the breast. But when the lymph vessels become blocked by the breast cancer cells, symptoms begin to appear. A diagnosis of inflammatory breast cancer is classified as Stage 3 breast cancer and is diagnosed through your physician’s clinical judgment and a biopsy. A biopsy for inflammatory breast cancer is a biopsy of the skin of the breast. Typically, IBC grows rapidly and requires aggressive treatment. This is the only type of breast cancer that requires urgent treatment, beginning with chemotherapy. Most oncologists recommend both local treatment of the affected breast and systemic treatment (whole body treatment). Surgery, radiation therapy, chemotherapy, and hormone treatments may be included in the regimen. With aggressive treatment, the survival rate for inflammatory breast cancer patients has improved significantly in recent years.
- Metastatic Breast Cancer – also known as Stage 4 breast cancer. Cancer has spread to other parts of the body. This usually includes the lungs, liver, bones, or brain. The symptoms may vary, depending on how far your breast cancer has spread and what type of tissue the new cancer growth has invaded. All symptoms should be reported to your physician.
- Breast Cancer During Pregnancy – It is possible to be diagnosed with breast cancer during pregnancy, although it is rare and breast cancer is not caused by pregnancy. Women who are diagnosed with breast cancer during pregnancy have tremendous additional strain due to concern for the safety of the unborn child. It can be a traumatic and extremely difficult situation, but there is still hope for both mother and child, thanks to the many treatments (lumpectomy, mastectomy, chemotherapy, and hormone therapy) options available. If you are pregnant and have been diagnosed, be sure to communicate carefully with your obstetric care team as well as your oncology team, and it never hurts to verify that they have open communication with each other. Your medical team will take extra care in designing the treatment plan that best controls breast cancer while protecting your unborn child. Although the cancer itself cannot spread to and harm the unborn child, sometimes the best treatment plan for the mother may put the unborn child at risk. These decisions will require the expertise and consultation between your obstetrician, surgeon, medical oncologist, and radiation oncologist. You will also need the emotional support of family and friends and may benefit from the professional assistance of a skilled counselor or psychologist.
Ways of Diagnosing Breast Cancer
Breast cancer can be diagnosed through multiple tests, including mammograms, ultrasound, MRI, and biopsy.
- A mammogram is an x-ray of the breast. While screening mammograms are routinely administered to detect breast cancer in women who have no apparent symptoms, diagnostic mammograms are used after suspicious results on a screening mammogram or after some signs of breast cancer alert the physician to check the tissue. A diagnostic mammogram can help determine if these symptoms are indicative of the presence of cancer. As compared to screening mammograms, diagnostic mammograms provide a more detailed x-ray of the breast using specialized techniques. They are also used in special circumstances, such as for patients with breast implants. In addition to finding tumors that are too small to feel, mammograms many also spot ductal carcinoma in situ (DCIS). These are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.
- A breast ultrasound is a scan that uses penetrating sound waves that do not affect or damage the tissue and cannot be heard by humans. The breast tissue deflects these waves causing echoes, which a computer uses to paint a picture of what’s going on inside the breast tissue (no radiation is involved). A mass filled with liquid shows up differently than a solid mass.
- During diagnostic examinations, it is helpful to get a variety of images and perspectives. If your initial exams are not conclusive, your doctor may recommend a breast MRI (magnetic resonance imaging) to assess the size and specific location within the breast. An MRI can also identify any other abnormal findings within the breast. During a breast MRI, a magnet connected to a computer transmits magnetic energy and radio waves (not radiation) through the breast tissue. It scans the tissue, making detailed pictures of areas within the breast. These images help the medical team distinguish between normal and diseased tissue.
- A breast biopsy is a test that removes tissue or sometimes fluid from the suspicious area. The removed cells are examined under a microscope and further tested to check for the presence of breast cancer. A biopsy is the only diagnostic procedure that can definitely determine if the suspicious area is cancerous. The good news is that 80% of women who have a breast biopsy do not have breast cancer. There are three types of biopsies: 1) Fine-needle aspiration, 2) Core-needle biopsy, and 3) Surgical biopsy. The last two are the most commonly used on the breast.
Men and Breast Cancer
Breast cancer occurs mainly in women, but men can get it too. Many people do not realize that men have breast tissue and that they can develop breast cancer. Cells in nearly any part of the body can become cancerous and can spread to other areas. Although it is rare, an estimated 2,710 men will be diagnosed with breast cancer, and 530 will die from the disease.
According to the CDC, the most common symptoms of breast cancer in men are:
- A lump or swelling in the breast
- Redness or flaky skin in the breast
- Irritation or dimpling of breast skin
- Nipple discharge
- Pulling in of the nipple or pain in the nipple area
These symptoms can happen with other conditions that are not cancer. If you have any symptoms or changes.
Several factors can increase a man’s chance of getting breast cancer. Having risk factors does not mean you will get breast cancer:
- Getting older. The risk for breast cancer increases with age. Most breast cancers are found after age 50.
- Genetic mutations. Inherited changes (mutations) in certain genes, such as BRCA1 and BRCA2, increase breast cancer risk.
- Family history of breast cancer. A man’s risk for breast cancer is higher if a close family member has had breast cancer.
- Radiation therapy treatment. Men who had radiation therapy to the chest have a higher risk of getting breast cancer.
- Hormone therapy treatment. Drugs containing estrogen (a hormone that helps developed and maintain female sex characteristics), which were used to treat prostate cancer in the past, increase men’s breast cancer risk.
- Klinefelter syndrome. It is a rare genetic condition in which a male has an extra X chromosome. This can lead to the body making higher levels of estrogen and lower levels of androgens (hormones that help develop and maintain male sex characteristics).
- Certain conditions that affect the testicles. Injury to, swelling in, or surgery to remove the testicles can increase breast cancer risk.
- Liver disease. Cirrhosis (scarring) of the liver can lower androgen levels and raise estrogen levels in men, increasing the risk of breast cancer.
- Overweight and obesity. Older men who are overweight or have obesity have a higher risk of getting breast cancer than men at a normal weight.
During Breast Cancer Awareness Month there are two days that are part of the month that is important.
- October 13, 2022 is National Metastatic Breast Cancer Awareness Day. On this day, it is to shift the focus of the breast cancer movement and focus on those that are currently living with metastatic breast cancer.
- October 21, 2022 is National Mammography Day. The date for this day changes each year. It is always on the third Friday in October. National Today refers to this day as the cousin to Breast Cancer Awareness Month. This day serves as a reminder to all women that the best defense is early detection. A mammogram can often detect a problem before there is any outward physical sign.
During the month of October, show your support for those fighting breast cancer by wearing pink or simply a pink ribbon. There are also many walks and activities to participate in throughout the month. The National Breast Cancer Foundation, Inc. has a Community Sharing Calendar of different ways to show your support during the month. This year’s theme is RISE. Week one is Education, Week 2 is Empowerment, Week 3 is Action, Week 4 is Community, and Week 5 is Hope. In looking at the calendar, it gives ideas for readings and other activities to show support.