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Cancer

Breast Cancer

Breast Cancer: Symptoms, Causes, and Prevention

Breast cancer is a type of malignancy that originates in the ducts or lobules of the breast tissue, where cells grow and divide uncontrollably, forming a tumor. It is the leading cause of cancer-related mortality among women. However, early detection and timely treatment can significantly improve survival outcomes.
Person wearing a white shirt holding a pink ribbon on the chest to raise awareness for breast cancer prevention

Overview of Breast Cancer

Breast cancer arises from abnormal and uncontrolled proliferation of cells within the breast. This process may result in the formation of palpable lumps or masses. Such masses can be benign (non-cancerous, non-invasive) or malignant (cancerous, with the potential to spread to axillary lymph nodes and distant organs). Malignant cells proliferate uncontrollably, leading to excessive tissue growth and potentially severe health consequences.

Breast cancer is categorized into five stages according to tumor size and the extent of metastasis:

  • Stage 0: Also known as ductal carcinoma in situ (DCIS).
  • Stage 1: Tumor ≤2 cm without lymph node involvement or with minimal lymphatic spread.
  • Stage 2: Tumor 2–5 cm with possible lymph node involvement.
  • Stage 3: Tumor up to 5 cm with multiple lymph node metastases, or >5 cm with limited nodal spread.
  • Stage 4: Distant metastasis to bone, liver, brain, or lungs.

Symptoms of Breast Cancer

Common clinical manifestations include:

  • Breast lump: Palpable mass or thickening within the breast tissue.
  • Nipple discharge: May include serous or bloody fluid.
  • Skin changes: Redness, dimpling, or peau d’orange (orange peel appearance).
  • Breast pain or tenderness: Localized discomfort or hypersensitivity.
  • Skin irritation or itching.
  • Axillary changes: Skin alterations in the axilla or adjacent areas.

These signs warrant prompt medical evaluation and diagnostic testing to confirm the diagnosis. Consulting a healthcare professional is strongly recommended.

Woman performing a breast self-exam to check for pain or abnormal symptoms that may indicate breast cancer
Persistent breast or underarm pain outside the monthly cycle can be an early sign of breast cancer.

When to See a Doctor

Any of the above symptoms should prompt immediate medical consultation. Early diagnosis and intervention reduce disease progression and improve prognosis.

Causes of Breast Cancer

Etiologic factors include:

  • Reproductive and lactational history (late childbirth, nulliparity, not breastfeeding).
  • Genetic predisposition (family history of breast cancer).
  • Early menarche and late menopause.
  • Benign breast conditions (fibrocystic changes).
  • Environmental exposures (pollution, toxins).
  • Unhealthy lifestyle factors (obesity, physical inactivity, poor diet, smoking, and alcohol consumption).

Risk Factors for Breast Cancer

Key risk determinants include:

  • Sex and age: Higher risk in women, especially >50 years old.
  • Genetic mutations: BRCA1, BRCA2, ATM, PALB2, TP53.
  • Family history: First-degree relatives with breast cancer.
  • Race/ethnicity: Higher incidence in White women and in African American women <40 years.
  • Tall stature: Associated with increased risk.
  • Dense breast tissue: Increases both risk and diagnostic difficulty via mammography.
  • Benign proliferative lesions with atypia.
  • Menstrual factors: Early menarche and late menopause.
  • Prior chest irradiation at a young age.
  • Diethylstilbestrol (DES) exposure.
Young woman holding a menstrual calendar looking concerned about irregular periods, which can increase breast cancer risk
Women with irregular menstrual cycles may face a higher risk of developing breast cancer.

Diagnosis and Treatment of Breast Cancer

Diagnostic Approaches

Histopathological confirmation is essential. The “triple assessment” is commonly employed:

Clinical examination: Asymmetry of the breasts, nipple retraction, skin dimpling/discoloration.

Imaging:

  • Mammography: Initial screening to detect spiculated masses, irregular densities, microcalcifications, or architectural distortion.
  • Ultrasound: Especially useful in younger patients or dense breasts to distinguish solid from cystic lesions and guide biopsies.

Biopsy:

  • Fine-needle aspiration (FNA): High sensitivity (~90%) and specificity (98–100%).
  • Core needle biopsy or excisional biopsy.
  • Sentinel lymph node biopsy to assess nodal involvement.
Series of mammogram images showing highlighted areas of potential breast cancer, with ultrasound often used as an alternative screening method for younger patients
Ultrasound is an effective alternative to mammography for breast cancer screening in younger patients.

Treatment by Stage

Stage 0:

Lobular carcinoma in situ: Management individualized based on risk factors; options include mastectomy or breast-conserving surgery plus adjuvant radiotherapy and endocrine therapy.

Ductal carcinoma in situ: Standard care involves breast-conserving surgery with adjuvant radiotherapy.

Stage 1: Breast-conserving surgery or modified radical mastectomy (Patey procedure). Postoperative radiotherapy is mandatory after breast conservation.

Stage 2: Similar to Stage 1 but with lower rates of breast-conserving surgery.

Stage 3: Neoadjuvant radiotherapy followed by Patey procedure and adjuvant radiotherapy. Systemic chemotherapy may be indicated.

Stage 4: Palliative treatment with systemic chemotherapy where feasible.

Note: All medications and treatment modalities must be prescribed and supervised by a qualified physician.

Lifestyle and Prevention of Breast Cancer

Healthy Habits

  • Strict adherence to medical recommendations.
  • Maintain a positive lifestyle and minimize stress.
  • Promptly report any new symptoms during treatment.
  • Regular follow-up to monitor disease status and adjust therapy.

Nutrition

  • Avoid diets high in saturated fat or deficient in vitamin A.
  • Adopt a balanced, nutrient-rich diet.

Effective Preventive Strategies

  • Annual breast examination for women ≥35 years old to detect small, asymptomatic lesions.
  • Learn and practice self-breast examination.
  • Maintain a healthy weight, exercise regularly, and limit alcohol intake.
  • Minimize postmenopausal hormone therapy where possible.
Healthcare professional performing a regular breast screening examination on a patient using advanced imaging equipment
Regular breast screenings help detect cancer early and improve treatment outcomes.

Dr. Andrew Parker is a board-certified internal medicine physician with over 10 years of clinical experience. He earned his medical degree from the University of California, San Francisco (UCSF), and has worked at leading hospitals including St. Mary’s Medical Center. Dr. Parker specializes in patient education and digital health communication. He now focuses on creating clear, accessible, and evidence-based medical content for the public.

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