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Frequently asked questions about breast cancer

Breast Cancer FAQ

What is breast cancer?

In breast cancer, certain cells in the breast grow uncontrollably, forming a solid mass called a tumor. Most of the lumps that women find in the breast turn out not to be cancerous. These non-cancerous abnormalities are called benign. To know whether or not a problem with the breast is a tumor, breast tissue must be examined under a microscope.

What are some of the symptoms of breast cancer?

Often, the first sign of breast cancer can’t be felt. But some of the most common symptoms include a lump or lumps, pain, or nipple discharge. Less common symptoms include persistent changes to the breast such as thickening, tenderness, swelling, redness or scaliness, or nipple abnormalities. A hard, irregular mass in the breast is more likely than a soft mass to be cancerous. But some breast cancers are in fact tender, soft, or rounded.

How is breast cancer staged?

Staging involves both the size of the tumor and whether or not it has spread to other parts of the body such as the lymph nodes. Staging is very important because it helps healthcare professionals determine the best treatment options to fight your cancer.

  • Stage 0. The tumor has stayed in the part of the breast where it started
  • Stage I. The tumor has spread into nearby parts of the breast, but not outside of the breast. The tumor is 2 centimeters or smaller
  • Stage II. The tumor is between 2 – 5 centimeters, or it has spread outside the breast to the lymph nodes under the arm on the same side as the breast cancer
  • Stage III. The tumor is larger than 5 centimeters, or has spread to areas around the breast
  • Stage IV. The tumor has spread beyond the breast and nearby areas, possibly to the base of the neck, lungs, liver, bones, or brain

Staging is complex, so be sure to ask your doctors and nurses any questions you have about it.

How is breast cancer diagnosed?

A healthcare professional will examine the breasts for lumps, looking for suspicious abnormalities in texture, size, and relationship to the skin and muscles of the chest. If there are any signs of cancer, the doctor will suggest more tests. Tests fall into three main groups: imaging tests, nipple discharge exams, and biopsies.

“Imaging” means making a picture of the inside of the body. This can be accomplished with X-rays (mammogram), magnetic fields (MRI), sound waves (ultrasound), or radioactive materials. Imaging tests can help detect breast cancer and tell a doctor how far it has spread, and if a treatment given so far is working.

Sometimes, a person will be tested for breast cancer because she is having nipple discharge. Using a microscope, a doctor can examine this fluid for cancerous cells.

A biopsy is the only way to really know if a cancer is present. When a mammogram or other exam finds an abnormality in the breast, a biopsy is often performed. To confirm that a breast contains a tumor, a doctor will remove a sample of the suspicious tissue to examine in detail. Biopsies can be useful in determining if someone has a tumor in the breast and, if so, whether or not it is invasive (metastatic).

How is breast cancer treated?

There are 2 main types of breast cancer treatments: Local treatments include surgery and radiation. These treat specific tumors without affecting other parts of the body. Systemic or advanced treatments include chemotherapy, hormone therapy, and immunotherapy. These treatments circulate throughout the body to treat cancer cells that may have spread from the breast. In some cases, combinations of these treatment types are used.

Treatment may be given before or after surgery. When given before surgery, this is called neoadjuvant therapy (usually systemic chemotherapy), used to shrink a tumor. When given after surgery, this is called adjuvant therapy. Adjuvant therapy targets cancer cells that may have spread in the early stages of the disease.

How is surgery used to treat breast cancer?

Surgery is used to remove as much of the tumor as possible from the breast. Surgeries called lumpectomies and partial mastectomies remove only part of the breast. But in a surgery called a radical mastectomy, all of the breast tissue is removed.

Sometimes, other surgeries are required to examine the lymph nodes under the arm, or to reconstruct the breast.

What are some of the possible side effects of chemotherapy?

In addition to attacking cancer cells, anti-cancer drugs also harm cells that grow quickly, including the blood cells that fight infections, the cells that line the mouth and digestive tract, and the hair follicles. Chemo can cause:

  • Anemia
  • A low white blood cell count (neutropenia)
  • Infection
  • Fatigue
  • Nausea
  • Vomiting
  • Hair loss
  • Loss of appetite
  • Changes in menstrual cycle
  • Mouth sores
  • Numbness or tingling of the skin (paresthesia)

People being treated with chemotherapy should talk with their doctors and nurses about the side effects they are experiencing, and how best to manage them.

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US.XON.10.04.013 Last Update: May 2010