Breast Cancer Information

The National Cancer Institute estimates that one out of every eight women in the United States will have breast cancer during her lifetime, with the highest percentage of women being diagnosed between ages 40 and 50. Research has shown that the following conditions place a woman at increased risk for breast cancer:

Personal history of breast cancer – Women who have had breast cancer face an increased risk of getting breast cancer again.

Genetic alterations – Changes in certain genes (BRCA1, BRCA2, and others) make women more susceptible to breast cancer. In families in which many women have had the disease, gene testing can show whether a woman has specific genetic changes known to increase her susceptibility to breast cancer.

Family history – A woman's risk for developing breast cancer increases if her mother, sister, daughter, or two or more other close relatives, such as cousins, have a history of breast cancer, especially at a young age.

Certain breast changes – Having a diagnosis of atypical hyperplasia or lobular carcinoma in situ or having had two or more breast biopsies for other benign conditions may increase a woman's risk for developing cancer.

Other factors associated with an increased risk for breast cancer include:

• Breast density – Women age 45 and older, whose mammograms show at least 75 percent dense tissue, are at increased risk. Dense breasts contain many glands and ligaments, which make breast tumors difficult to "see," and the dense tissue itself is associated with an increased chance of developing breast cancer.
• Radiation therapy – Women whose breasts were exposed to radiation during their childhood, especially those who were treated with radiation for Hodgkin's disease, are at an increased risk for developing breast cancer throughout their lives. Studies show that the younger a woman was when she received her treatment, the higher her risk for developing breast cancer later in life.
• Late childbearing – Women who had their first child after the age of 30 have a greater chance of developing breast cancer than women who had their children at a younger age.

Also at a somewhat increased risk for developing breast cancer are women who started menstruating at an early age (before age 12), experienced menopause late (after age 55), never had children, or took hormone replacement therapy or birth control pills for long periods of time. Each of these factors increases the amount of time a woman's body is exposed to estrogen. The longer this exposure, the more likely she is to develop breast cancer.

It’s critical to know, however, that survival rates increase dramatically when breast cancer is detected and treated early. Regular self breast exams every month, and mammograms every one to two years after age 40, help with early detection.

Breast Cancer Stages

Early stage breast cancer

Stage 0 breast cancer is sometimes called non-invasive carcinoma or carcinoma in situ. This very early stage of the disease is sometimes interpreted as a precancerous condition. In stage 0, there is no evidence of cancer cells breaking out of the part of the breast in which it started, or of getting through to or invading neighboring normal tissue. There are two types of breast cancer in situ: ductal carcinoma in situ (DCIS), also called intraductal carcinoma, and lobular carcinoma in situ (LCIS). DCIS refers to cancer cells in an area of abnormal tissue in the lining of a breast duct. If DCIS lesions are left untreated, over time cancer cells may break through the duct and spread to nearby tissue, becoming an invasive breast cancer. LCIS refers to abnormal cells in the lining of a breast lobule. These abnormal cells seldom become invasive cancer. However, their presence is a sign of an increased risk of developing breast cancer.

Stage I breast cancer describes invasive cancer, in which cancer cells have broken through to or invaded neighboring normal tissue. This is an early stage of the disease, in which the tumor measures up to two centimeters and no lymph nodes are involved. Women with early stage breast cancer may have breast-sparing surgery (i.e., lumpectomy) followed by radiation therapy as their primary local treatment, or they may have a mastectomy (removal of the entire breast) with or without breast reconstruction (plastic surgery) to rebuild the breast. Sometimes radiation therapy is also given to the chest wall after lumpectomy or mastectomy. In addition, chemotherapy and/or hormonal therapy, called "adjuvant" therapy, may also be given to try to destroy any remaining cancer cells and to prevent the cancer from recurring.

Stage II or III breast cancer

Stage II breast cancer, while still a serious disease, is more easily treated than cancer in the later stages. Stage II breast cancer describes invasive cancer in which either the tumor measures between two to five centimeters, or the cancer has spread to the lymph nodes under the arm on the same side as the breast cancer. Stage II breast cancer is divided into subcategories known as stage IIA and stage IIB. Stage III breast cancer, or locally advanced cancer, means that the tumor in the breast is more than two inches in diameter across and the cancer is extensive in the underarm lymph nodes, or has spread to other lymph nodes or tissues near the breast. Stage III is divided into subcategories known as stage IIIA and stage IIIB.

Conventional stage II and stage III breast cancer treatment can consist of surgery, radiation therapy, chemotherapy, or a combination of the three. In addition, you may also receive hormonal therapy, or adjuvant therapy, to try to destroy remaining cancer cells and to prevent the cancer from recurring.

Stage IV breast cancer

Stage IV breast cancer describes cancer that has spread from the breast to other parts of the body. Stage IV breast cancer is called metastatic breast cancer. In stage IV, a tumor has spread beyond the breast, underarm, and internal mammary lymph nodes. The tumor may have also spread to the supraclavicular lymph nodes (nodes located at the base of the neck, above the collarbone), bones, lungs, liver, or brain.

Stage IV breast cancer is a serious illness, but fortunately, today there are a number of treatments available that can give women new hope. Conventional treatments for stage IV breast cancer may include surgery, radiation therapy, chemotherapy, and hormonal therapy.

Recurrent breast cancer

Recurrent breast cancer means the breast cancer has come back in spite of the initial treatment. Most recurrences appear within the first two or three years after treatment, but breast cancer can recur many years later. Breast cancer that returns locally (i.e., in the area of the surgery) is called a local recurrence. If the disease returns in another part of the body, it is called metastatic breast cancer.

Leading-edge treatments, including TomoTherapy^®, make it possible for our doctors at Cancer Treatment Centers of America (CTCA) to retreat some previously treated areas that have a recurrence of cancer. This advanced therapy combines a form of Intensity Modulated Radiation Therapy with CT scanning technology to deliver radiation with unprecedented accuracy to hard-to-reach areas.