Breast cancer: Difference between revisions

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{{SI}}
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{{Infobox medical condition
| name            = Breast cancer
| image          = [[File:Breast_Cancer.png|250px]]
| caption        = Micrograph of [[invasive ductal carcinoma]], the most common type of breast cancer
| field          = [[Oncology]]
| symptoms        = [[Lump in the breast]], [[change in breast shape]], [[dimpling of the skin]], [[fluid coming from the nipple]], [[red scaly patch of skin]]
| complications  = [[Metastasis]], [[lymphedema]]
| onset          = Most commonly after age 40
| duration        = Long term
| causes          = [[Genetic mutations]], [[hormonal factors]], [[lifestyle factors]]
| risks          = [[Family history]], [[obesity]], [[alcohol consumption]], [[radiation exposure]]
| diagnosis      = [[Mammography]], [[biopsy]], [[ultrasound]]
| differential    = [[Fibroadenoma]], [[breast cyst]], [[mastitis]]
| prevention      = [[Lifestyle changes]], [[medications]], [[prophylactic surgery]]
| treatment      = [[Surgery]], [[radiation therapy]], [[chemotherapy]], [[hormonal therapy]]
| prognosis      = Varies by stage and type
| frequency      = 2.3 million new cases (2020)
| deaths          = 685,000 (2020)
}}
{{SI}}
{{SI}}
 
{{Short description|A common form of cancer originating in breast tissue}}
<!--T:2-->
{{Infobox medical condition (new)
{| class="videos" style="width: 20em; float:right; font-size:95%" cellspacing="4"
| name = Breast cancer
!<big>'''Breast Cancer'''</big>
| image = MammographyinprocessGraphic.jpg
|-
| caption = Mammogram being performed to detect breast cancer
|  
| synonyms = Breast carcinoma
<YouTube>movie_url=http://www.youtube.com/v/KyeiZJrWrys
| field = [[Oncology]]
embed_source_url=http://www.youtube.com/v/KyeiZJrWrys
| symptoms = [[Breast lump]], [[breast pain]], [[nipple discharge]], changes in [[skin]]
wrap=yes
| complications = [[Metastasis]], [[lymphedema]], [[recurrence]]
width=425
| onset = Variable; more common after age 40
height=355
| causes = Multifactorial: [[genetics]], [[hormonal]], [[environmental factors]]
</YouTube>
| risks = Female sex, age, [[BRCA mutations]], family history, [[hormone therapy]], [[obesity]], alcohol
[http://youtube.com/watch?v=P3wJfzRicR0&rel=1&feature=related Related Videos]
| diagnosis = [[Mammography]], [[ultrasound]], [[biopsy]], [[MRI]]
|-
| treatment = [[Surgery]], [[radiation therapy]], [[chemotherapy]], [[targeted therapy]], [[hormonal therapy]]
|}
| prognosis = Generally good if detected early
 
| frequency = 1 in 8 women (lifetime risk)
<!--T:3-->
}}
'''Breast cancer''' is [[cancer]] of [[breast]] tissue. Worldwide, it is the most common form of cancer in females, affecting approximately one out of twelve to thirteen [[woman|women]] who reach age ninety at some stage of their life in the Western world. It is (after [[lung cancer]]) the second most fatal cancer in women. [http://imaginis.com/breasthealth/statistics.asp] Because the breast is composed of identical tissues in males and females, breast cancer can also occur in males, but here the [[Incidence (epidemiology)|incidence]] is very low, less than 1 percent.
'''Breast cancer''' is a malignant [[tumor]] that originates in the cells of the [[breast]] tissue. It is the most common [[cancer]] among [[women]] worldwide and the second leading cause of cancer-related death in women after [[lung cancer]]. Though rare, it can also affect [[men]]. Early detection, accurate diagnosis, and timely treatment are crucial for improving survival outcomes.
 
[[File:Early_signs_of_breast_cancer_hariadhi_svg.svg|left|thumb|200px|Diagram of early signs of breast cancer]]
==History of breast cancer== <!--T:4-->
[[File:Mammo_breast_cancer_wArrows.jpg|left|thumb|200px|Mammogram image showing tumor]]
Breast cancer is one of the oldest known forms of cancer tumors. Our oldest description of cancer (although the term cancer was not used) was discovered in Egypt and dates back to approximately 1600 B.C. The [[Edwin Smith Papyrus]], or writing, describes 8 cases of tumors or ulcers of the breast that were treated by cauterization, with a tool called "the fire drill." The writing says about the disease, "There is no treatment." [http://www.cancer.org/docroot/CRI/content/CRI_2_6x_the_history_of_cancer_72.asp?sitearea=CRI] At least one of the described cases is male. This papyrus is 5 meters long and is kept in the New York Historical Society. Scholars believe that the actual document is a copy of an original document from the 30th century before Christ. In any case, for centuries, physicians described similar cases in their practises, with the same sad conclusion. It wasn't until greater understanding of the circulatory system was added to the body of medical knowledge in the 17th century that doctors made the link to the lymph glands in the armpit. The French surgeon [[Jean Louis Petit]] (1674-1750) and later the Scottish surgeon [[Benjamin Bell]] (1749-1806) were the first to remove the lymph nodes, breast tissue, and breast muscle. Their successful work was carried on by [[William Stewart Halsted]] who started performing [[radical mastectomy|mastectomies]] in 1882. He became known for his [[radical mastectomy|Halsted radical mastectomy]], a surgical procedure that remained popular up to the 1970's and was performed on [[Betty Ford]].
== Historical Background ==
 
Breast cancer has been known for millennia. Descriptions of tumors believed to be breast cancer appear in the [[Edwin Smith Papyrus]] from ancient [[Egypt]], dating to around 1600 BCE. Early treatments were mostly surgical, and until the 19th century, options were limited. The modern surgical era began with [[William Stewart Halsted]]'s radical mastectomy technique in the 1880s. Since then, approaches have evolved to include [[lumpectomy]], [[chemotherapy]], [[radiotherapy]], and [[targeted therapy]].
==Types of breast cancer== <!--T:5-->
== Types ==
*[[DCIS]]: Ductal Carcinoma in Situ
Breast cancer can present in different forms. The main types include:
*[[LCIS]]: Lobal Carcinoma in Situ
* '''[[Ductal carcinoma in situ]] (DCIS)''': Non-invasive; confined to milk ducts.
*[[Invasive ductal carcinoma]]
* '''[[Lobular carcinoma in situ]] (LCIS)''': Abnormal cells in the lobules; a marker for increased risk.
*[[Invasive lobal carcinoma]]
* '''[[Invasive ductal carcinoma]]''': Cancer has spread beyond ducts; most common type.
*[[Inflamatory breast cancer]]
* '''[[Invasive lobular carcinoma]]''': Begins in lobules and invades nearby tissue.
*[[Paget's disease]]
* '''[[Inflammatory breast cancer]]''': Rare and aggressive; presents with redness and swelling.
 
* '''[[Paget's disease of the breast]]''': Affects the nipple; often associated with underlying carcinoma.
==Causes== <!--T:6-->
* '''[[Triple-negative breast cancer]]''': Lacks estrogen, progesterone, and HER2 receptors; often more aggressive.
The cause of breast cancer is unknown, but research shows that certain risk factors are associated with the disease.
== Causes and Risk Factors ==
 
The exact cause is unknown, but several risk factors increase the likelihood of developing breast cancer:
==Risk Factors== <!--T:7-->
* [[Female]] gender
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for breast cancer include:
* Age over 50
 
* Family history (especially with [[BRCA1]] or [[BRCA2]] mutations)
<!--T:8-->
* Long-term exposure to estrogen
*Sex: Female, although men can also get breast cancer
* Early menstruation (before age 12) or late menopause (after age 55)
*Age: 50 or older
* Lack of pregnancy or late pregnancy
*Personal history of breast cancer
* Use of [[hormone replacement therapy]]
*Family members with breast cancer
* [[Obesity]] and [[physical inactivity]]
*Changes in breast tissue, such as atypical ductal hyperplasia, radial scar formation, and *lobular carcinoma in situ (LCIS)
* Alcohol consumption
*Changes in certain genes (BRCA1, BRCA2, and others)
* Previous history of breast abnormalities or biopsies
*Race: Caucasian
* [[Radiation]] exposure to the chest
*Increased exposure to estrogen over a lifetime through:
== Symptoms ==
**Early onset of menstruation
Signs of breast cancer may include:
**Late onset of menopause
* A lump or mass in the breast or underarm
**No childbearing or late childbearing
* Change in the size or shape of the breast
**Absence of breastfeeding
* [[Nipple]] retraction, discharge (especially bloody)
**Taking hormone replacement therapy for long periods of time (Prempro for more than four years)
* Skin changes: dimpling, redness, or texture resembling an [[orange]] peel
*Tobacco use
* Pain in the breast or nipple area (less common)
*Increased breast density (more lobular and ductal tissue and less fatty tissue)
These symptoms can also be caused by benign conditions such as [[fibrocystic breast disease]] or [[mastitis]].
*Radiation therapy before the age of 30 years old
== Diagnosis ==
*Overuse of alcohol
Diagnosis involves a combination of clinical and imaging techniques:
 
* '''[[Clinical breast examination]]''' – Manual palpation by a healthcare provider
<!--T:9-->
* '''[[Mammography]]''' – X-ray imaging to detect tumors
Note: Studies show that most women with known risk factors do not get breast cancer. And many women who get breast cancer have none of the risk factors listed above, other than the risk that comes with growing older.
* '''[[Ultrasound]]''' – Useful in distinguishing solid from cystic masses
 
* '''[[MRI]]''' – Used in high-risk women or ambiguous cases
==Symptoms== <!--T:10-->
* '''[[Biopsy]]''' – Definitive diagnosis via fine needle aspiration, core needle biopsy, or surgical excision
When breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause the following changes:
[[File:Needle_Breast_Biopsy.png|left|thumb|Needle biopsy under guidance]]
 
== Staging ==
<!--T:11-->
Breast cancer is staged from 0 to IV using the [[TNM staging system]]:
A lump or thickening in or near the breast or in the underarm area or in the neck
* '''Stage 0''': [[DCIS]] or [[LCIS]]
A change in the size or shape of the breast
* '''Stage I–III''': Local or regional spread
Nipple discharge or tenderness, or the nipple pulled back (inverted) into the breast
* '''Stage IV''': [[Metastatic cancer]]; spread to distant organs such as [[bone]], [[liver]], [[lungs]], or [[brain]]
Ridges or pitting of the breast skin (like the skin of an orange)
[[File:Diagram_showing_stage_T1_breast_cancer_CRUK_244.svg|left|thumb|Stage I]]
A change in the way the skin of the breast, areola, or nipple looks or feels (for example, warm, swollen, red, or scaly)
[[File:Stage_4_of_Breast_Cancer.jpg|left|thumb|Stage IV]]
 
== Treatment ==
<!--T:12-->
Treatment plans depend on the type, stage, hormone receptor status, and patient preferences.
Note: These symptoms may also be caused by other, less serious health conditions. Anyone experiencing these symptoms should see a doctor.
=== Surgical Options ===
 
* '''[[Lumpectomy]]''' – Removal of tumor with margin of normal tissue
==Diagnosis== <!--T:13-->
* '''[[Mastectomy]]''' – Removal of one or both breasts
The doctor will ask about your symptoms and medical history, and perform a physical exam.
* '''[[Sentinel lymph node biopsy]]''' – Identifies first lymph nodes cancer may spread to
 
* '''[[Axillary lymph node dissection]]''' – Removes lymph nodes for staging and treatment
==Tests may include:== <!--T:14-->
[[File:Mastectomie_02.jpg|left|thumb|Post-mastectomy]]
 
[[File:Breast_reconstruction_15.jpg|left|thumb|Post-reconstruction]]
<!--T:15-->
=== Radiation Therapy ===
Clinical Breast Exam–The doctor carefully feels the breast lump and the tissue around it. The doctor examines the size and texture of the lump and determines whether the lump moves easily. The doctor will examine both breasts, since the tissue can be very “lumpy” throughout the breast in some patients.
Usually follows surgery to reduce recurrence:
 
* External beam radiation
<!--T:16-->
* Internal radiation (brachytherapy)
Mammography–x-rays of the breast used to see lumps or other changes in breast tissue
=== Chemotherapy ===
 
Drugs like [[doxorubicin]], [[cyclophosphamide]], [[paclitaxel]] target rapidly dividing cells. Used before (neoadjuvant) or after (adjuvant) surgery.
<!--T:17-->
=== Hormonal Therapy ===
Ultrasonography–the use of high-frequency sound waves to see whether a lump is a fluid-filled cyst (usually not cancer) or a solid mass (which may or may not be cancer)
Used for [[estrogen receptor]] (ER)-positive cancers:
 
* [[Tamoxifen]] – selective estrogen receptor modulator (SERM)
<!--T:18-->
* [[Aromatase inhibitors]] – such as [[letrozole]], [[anastrozole]]
Biopsy–removal of tumor tissue to be tested for cancer cells. Types of biopsies for breast cancer include:
=== Targeted Therapy ===
 
Used in [[HER2-positive]] cancers:
<!--T:19-->
* [[Trastuzumab]] (Herceptin)
Fine-needle aspiration–removal of fluid and/or cells from a breast lump using a thin needle
* [[Pertuzumab]]
Needle biopsy–removal of tissue with a needle from an area that looks suspicious on a mammogram but cannot be felt
* [[T-DM1]]
 
== Prognosis ==
==Surgical biopsy:== <!--T:20-->
Prognosis varies with the stage and subtype:
Incisional biopsy–cutting out a sample of a lump or suspicious area
* 5-year survival rate:
Excisional biopsy–cutting out all of a lump or suspicious area and an area of healthy tissue around the edges
** Nearly 99% for localized Stage I
 
** Around 28% for metastatic Stage IV
<!--T:21-->
Other factors influencing outcome include tumor size, lymph node involvement, receptor status, and response to treatment.
Hormone Status Evaluation—Breast cancer tissue is tested for the presence of estrogen and progesterone receptors, which are used to help plan therapy.
== Prevention ==
 
There is no sure way to prevent breast cancer, but steps can reduce risk:
==Treatment== <!--T:22-->
* Maintain healthy weight and active lifestyle
Once breast cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what extent.
* Limit alcohol intake
 
* Avoid long-term hormone replacement therapy
<!--T:23-->
* Breastfeed if possible
'''Treatments include:'''
* Regular [[screening mammograms]] beginning at age 40–50
 
* [[Breast self-examination]] and annual [[clinical breast exams]]
<!--T:24-->
* Genetic counseling and testing for high-risk individuals
'''Surgery'''
== Breast Cancer in Men ==
Surgery is the removal of the cancerous tumor and nearby tissues, and possibly nearby lymph nodes. The most common procedures performed today are the lumpectomy (which may be called a tylectomy, segmentectomy, or quadrantectomy) and the modified radical mastectomy.
Though rare, men can develop breast cancer. Risk factors include age, [[Klinefelter syndrome]], [[radiation exposure]], [[BRCA2]] mutations, and [[liver disease]]. Symptoms and treatment are similar to those in women.
 
== Breast Reconstruction ==
<!--T:25-->
Women who undergo mastectomy may choose [[breast reconstruction surgery]] using:
'''Lumpectomy'''–removal of the breast cancer and some normal tissue around it. Often, some of the lymph nodes under the arm are removed.
* [[Breast implants]]
 
* [[Autologous tissue transfer]] (e.g., DIEP flap)
<!--T:26-->
* Combination of both
Segmentectomy–removal of the cancer and a larger area of normal breast tissue around it.
== Support and Resources ==
 
Living with breast cancer can be physically and emotionally challenging. Support groups, counseling, and survivorship programs are essential components of care.
<!--T:27-->
== Glossary of Breast Cancer Terms ==
Simple Mastectomy–removal of the breast, or as much of the breast as possible, without the intentional removal of the lymph nodes.
This glossary provides definitions and descriptions of key terms related to '''breast cancer''', encompassing medical procedures, classifications, therapies, notable people, and research initiatives. Each entry includes an [[internal link]] where applicable.
 
=== A ===
<!--T:28-->
* '''[[Abortion–breast cancer hypothesis]]''': A discredited theory suggesting a link between induced abortion and increased breast cancer risk.
Radical Mastectomy–removal of the breast, both chest muscles, the lymph nodes under the arm, and some additional fat and skin. This procedure is only considered in rare cases if the cancer has spread to the chest muscles, and is rarely performed in the United States at this time.  
* '''[[Alcohol and breast cancer]]''': Refers to the increased risk of '''breast cancer''' associated with [[alcohol]] consumption.
 
* '''[[Antiestrogen withdrawal response]]''': A paradoxical tumor response in some patients where stopping [[antiestrogen]] therapy leads to temporary tumor regression.
<!--T:29-->
=== B ===
Modified Radical Mastectomy–removal of the whole breast, the lymph nodes under the arm and, often, the lining over the chest muscles.
* '''[[Basal-like carcinoma]]''': A subtype of [[triple-negative breast cancer]] lacking [[estrogen receptor]], [[progesterone receptor]], and [[HER2]] expression.
 
* '''[[Before I Say Goodbye]]''': A memoir by Ruth Picardie documenting her battle with '''breast cancer'''.
<!--T:30-->
* '''[[Bovine Meat and Milk Factors]]''': Hypothesized dietary factors from cows potentially linked to cancer development.
Axillary Lymph Node Dissection–removal of the lymph nodes under the arm to help determine whether cancer cells have entered the lymphatic system.
* '''[[BRCA mutation]]''': Genetic mutations in the [[BRCA1]] or [[BRCA2]] genes, associated with a significantly higher risk of [[breast and ovarian cancer]].
 
* '''[[BRCA1]]''': A tumor suppressor gene; mutations are linked to [[hereditary breast–ovarian cancer syndrome]].
<!--T:31-->
* '''[[BRCA2]]''': Another tumor suppressor gene whose mutations increase the risk of '''breast cancer''', especially in [[male breast cancer]].
Sentinel Lymph Node Biopsy–the placement, by the surgeon, of a small amount of blue dye and/or a radioactive tracer in the area where the tumor was located. The dye or tracer is then followed into the armpit and only those lymph nodes picking up the substance are removed. The accuracy rate for this procedure exceeds 95% in experienced hands and reliably identifies those lymph nodes that may contain cancer. Presently, those remaining lymph nodes should be removed if any sentinel nodes contain cancer. This method is usually done in women who do not have lymph nodes that can be felt in the armpit. The potential side effects are far less than seen after a standard lymph node dissection.  
=== C ===
 
* '''[[Clinical Breast Cancer]]''': A peer-reviewed medical journal covering research in the field of '''breast cancer'''.
==Radiation Therapy== <!--T:32-->
* '''[[Comedocarcinoma]]''': A subtype of [[ductal carcinoma in situ]] characterized by necrosis and high-grade cells.
Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. Two main types of radiation may be used:
* '''[[Cancer Diagnostic Probe]]''': A tool developed to enhance accuracy in identifying cancerous tissue.
 
* '''[[Connie Johnson (fundraiser)]]''': Australian cancer advocate and co-founder of the Love Your Sister campaign.
<!--T:33-->
* '''[[Breast cancer chemotherapy]]''': Systemic use of drugs to destroy cancer cells in '''breast cancer'''.
External Radiation Therapy–radiation directed at the breast from a source outside the body.
* '''[[Breast cancer classification]]''': Classification based on histological type, grade, and receptor status (ER, PR, HER2).
 
* '''[[Breast cancer management]]''': Multidisciplinary approach to treatment including surgery, chemotherapy, radiation, and hormone therapy.
<!--T:34-->
* '''[[Breast cancer research stamp]]''': A fundraising initiative by the USPS to support '''breast cancer''' research.
Internal Radiation Therapy–radioactive materials placed into the breast in or near the cancer cells.
=== D ===
 
* '''[[Dressed to Kill (book)]]''': A controversial book claiming links between [[bras]] and '''breast cancer''', not supported by scientific consensus.
==Chemotherapy== <!--T:35-->
* '''[[Ductal carcinoma in situ]] (DCIS)''': A non-invasive '''breast cancer''' confined to the milk ducts.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.
* '''[[Dynamic angiothermography]]''': A non-invasive imaging technique used in [[breast cancer screening]].
 
=== E ===
==Biologic Therapy== <!--T:36-->
* '''[[Epidemiology of breast cancer]]''': The study of the distribution and determinants of '''breast cancer''' in populations.
Biologic therapy is the use of medications or substances made by the body to increase or restore the body's natural defenses against cancer. It is also called biologic response modifier (BRM) therapy.
* '''[[Erin Kennedy]]''': A patient advocate and journalist who chronicled her experiences with '''breast cancer'''.
 
* '''[[Europa Donna]]''': The European Breast Cancer Coalition advocating for improved services and screening.
==Prevention== <!--T:37-->
=== F ===
Because the cause of breast cancer is unknown, finding it early and treating it is the best way to prevent dying from the disease. And because it does not cause symptoms in the early stages, it is important to have screening tests to find the cancer before symptoms appear.  
* '''[[Fluoroestradiol F-18]]''': A radiotracer used in PET scans to assess estrogen receptor expression in '''breast cancer'''.
 
=== G ===
<!--T:38-->
* '''[[Global Pink Hijab Day]]''': An awareness event combining breast cancer awareness with Muslim cultural identity.
Women age 20 or older should perform a breast self-exam (BSE) every month.
=== H ===
Women between the ages of 20-39 should have a clinical breast exam by a health professional every three years. A breast exam should be performed more regularly if there is a family history or there have been previous breast biopsies.
* '''[[HEPACAM]]''': A gene implicated in some cancer pathways, including '''breast cancer'''.
Women age 40 and older should have a screening mammogram every year. Some advocate that a mammogram should be given sooner for patients with a strong family history or whom have had previous breast biopsies performed.
* '''[[HER2]]''': A receptor protein overexpressed in some [[breast cancers]], often targeted with therapies such as [[trastuzumab]].
 
* '''[[Henda's Law]]''': A Texas law requiring women to be informed of their breast tissue density after a mammogram.
<!--T:39-->
* '''[[Hereditary breast–ovarian cancer syndrome]]''': A genetic predisposition caused by [[BRCA1]] and [[BRCA2]] mutations.
After age 40, women should have a breast exam by a healthcare professional every year.
* '''[[Hereditary lobular breast cancer]]''': A rare genetic form of [[lobular carcinoma]] not caused by BRCA mutations.
{{breast cancer types}}
=== I ===
<!--T:40-->
* '''[[Inflammatory breast cancer]]''': A rare, aggressive form of '''breast cancer''' characterized by redness and swelling.
'''RESOURCES:'''
* '''[[Invasive carcinoma of no special type]]''': The most common histological form of [[invasive breast cancer]].
 
* '''[[Invasive cribriform carcinoma of the breast]]''': A rare, low-grade subtype of invasive '''breast cancer'''.
<!--T:41-->
* '''[[Invasive lobular carcinoma]]''': A type of '''breast cancer''' that begins in the milk-producing lobules.
*[http://www.cancer.org American Cancer Society]
* '''[[In the Family (2008 film)]]''': A documentary exploring the impact of BRCA mutations on family members.
 
=== L ===
<!--T:42-->
* '''[[Lobular carcinoma in situ]] (LCIS)''': A non-invasive lesion that indicates increased risk of developing [[invasive breast cancer]].
*[http://www.cancercare.org CancerCare]
* '''[[Lumpectomy]]''': [[Breast-conserving surgery]] to remove a tumor and a small margin of surrounding tissue.
 
* '''[[Living Proof (2008 film)]]''': A film based on the development of [[Herceptin]] for treating HER2+ '''breast cancer'''.
== External links ==
=== M ===
* {{curlie|Health/Conditions_and_Diseases/Cancer/Breast/}}
* '''[[Male breast cancer]]''': A rare form of '''breast cancer''' that affects men.
* '''[[Medullary breast carcinoma]]''': A rare '''breast cancer''' subtype with a better prognosis than other types.
* '''[[Metaplastic carcinoma]]''': A heterogeneous group of [[breast cancers]] containing both glandular and non-glandular elements.
* '''[[Metastatic breast cancer]]''': Stage IV '''breast cancer''' that has spread beyond the breast to other organs.
* '''[[My Left Breast]]''': A documentary chronicling the life of breast cancer survivor Gerry Rogers.
=== N ===
* '''[[Nancy Cappello]]''': Advocate for breast density notification laws after being diagnosed with advanced-stage cancer missed by mammography.
* '''[[Nottingham Prognostic Index]]''': A prognostic tool used to determine survival in patients with '''breast cancer'''.
=== P ===
* '''[[Paget's disease of the breast]]''': A rare form of '''breast cancer''' involving the skin of the nipple.
* '''[[Papillary carcinomas of the breast]]''': Rare forms of '''breast cancer''' characterized by papillary structures.
* '''[[Pink Ribbons, Inc.]]''': A documentary examining the commercialization of breast cancer awareness.
* '''[[Pinkwashing (breast cancer)]]''': The use of [[breast cancer awareness]] campaigns by companies to improve their public image.
* '''[[Preventive mastectomy]]''': Surgical removal of the breast(s) to reduce the risk of developing cancer.
* '''[[Protein-bound paclitaxel]]''': A formulation of paclitaxel used in the treatment of [[metastatic breast cancer]].
* '''[[Pure apocrine carcinoma of the breast]]''': A rare type of '''breast cancer''' characterized by apocrine cell features.
=== Q ===
* '''[[Quadrantectomy]]''': A form of [[breast-conserving surgery]] removing a quarter of the breast tissue.
=== R ===
* '''[[Risk factors for breast cancer]]''': Factors including age, genetics, lifestyle, and reproductive history that influence breast cancer risk.
=== S ===
* '''[[Sentinel lymph node]]''': The first lymph node to which cancer cells are most likely to spread from a primary tumor.
* '''[[Secretory carcinoma]]''': A rare type of '''breast cancer''' with secretory features, often occurring in younger patients.
* '''[[Stewart–Treves syndrome]]''': A rare lymphangiosarcoma arising in chronic lymphedema, often post-mastectomy.
* '''[[Study of Tamoxifen and Raloxifene]]''': A large clinical trial comparing these drugs for prevention in high-risk women.
* '''[[Symphony (Agendia)]]''': A genomic test used to guide treatment decisions in '''breast cancer'''.
=== T ===
* '''[[Targeted intra-operative radiotherapy]]''': A technique delivering radiation during surgery to minimize exposure.
* '''[[Tomosynthesis]]''': A 3D imaging technique used in [[breast cancer screening]].
* '''[[Triple test score]]''': Combines clinical exam, imaging, and biopsy to evaluate a breast lesion.
* '''[[Triple-negative breast cancer]]''': Lacks estrogen, progesterone, and HER2 receptors; more aggressive with fewer treatment options.
* '''[[Tubular carcinoma]]''': A subtype of [[invasive breast cancer]] with tubular structures; often slow-growing.
=== V ===
* '''[[Vacuum-assisted breast biopsy]]''': A minimally invasive technique using suction to obtain breast tissue samples.
== Related Articles ==
* [[Mammography]]
* [[Cancer staging]]
* [[Chemotherapy]]
* [[Oncology]]
* [[Breast reconstruction]]
* [[Genetic testing]]
* [[Lymph nodes]]
* [[Triple-negative breast cancer]]
* [[Hormone therapy]]
* [[HER2]]
== External Links ==
* [https://www.cancer.gov/types/breast National Cancer Institute – Breast Cancer]
* [https://www.breastcancer.org BreastCancer.org]
* [https://www.cancer.org/cancer/breast-cancer.html American Cancer Society – Breast Cancer]
{{Breast cancer types}}
{{Breast cancer types}}
{{Authority control}}
{{endocrine system}}
 
[[Category:Breast cancer]]
[[Category:Breast cancer| ]]
[[Category:Oncology]]
[[Category:Hereditary cancers]]
[[Category:Hereditary cancers]]
[[Category:Human female endocrine system]]
[[Category:Human female endocrine system]]
[[Category:RTT]]
[[Category:Malignant neoplasms]]
<gallery>
[[Category:Hormone-related disorders]]
File:Early_signs_of_breast_cancer_hariadhi_svg.svg|Breast cancer
File:MammographyinprocessGraphic.jpg|Breast cancer
File:Mammo_breast_cancer_wArrows.jpg|Breast cancer
File:Needle_Breast_Biopsy.png|Breast cancer
File:Invasive_Ductal_Carcinoma_40x.jpg|Breast cancer
File:Mamma-CA.jpg|Breast cancer
File:Diagram_showing_stage_T1_breast_cancer_CRUK_244.svg|Breast cancer
File:Diagram_showing_stage_T2_breast_cancer_CRUK_252.svg|Breast cancer
File:Diagram_showing_stage_T3_breast_cancer_CRUK_259.svg|Breast cancer
File:Stage_4_of_Breast_Cancer.jpg|Breast cancer
File:Mastectomie_02.jpg|Breast cancer
File:Breast_reconstruction_15.jpg|Breast cancer
</gallery>

Latest revision as of 19:52, 4 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Breast cancer
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Lump in the breast, change in breast shape, dimpling of the skin, fluid coming from the nipple, red scaly patch of skin
Complications Metastasis, lymphedema
Onset Most commonly after age 40
Duration Long term
Types N/A
Causes Genetic mutations, hormonal factors, lifestyle factors
Risks Family history, obesity, alcohol consumption, radiation exposure
Diagnosis Mammography, biopsy, ultrasound
Differential diagnosis Fibroadenoma, breast cyst, mastitis
Prevention Lifestyle changes, medications, prophylactic surgery
Treatment Surgery, radiation therapy, chemotherapy, hormonal therapy
Medication N/A
Prognosis Varies by stage and type
Frequency 2.3 million new cases (2020)
Deaths 685,000 (2020)


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Obesity, Sleep & Internal medicine
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A common form of cancer originating in breast tissue


Breast cancer
Synonyms Breast carcinoma
Pronounce N/A
Field Oncology
Symptoms Breast lump, breast pain, nipple discharge, changes in skin
Complications Metastasis, lymphedema, recurrence
Onset Variable; more common after age 40
Duration N/A
Types N/A
Causes Multifactorial: genetics, hormonal, environmental factors
Risks Female sex, age, BRCA mutations, family history, hormone therapy, obesity, alcohol
Diagnosis Mammography, ultrasound, biopsy, MRI
Differential diagnosis N/A
Prevention N/A
Treatment Surgery, radiation therapy, chemotherapy, targeted therapy, hormonal therapy
Medication N/A
Prognosis Generally good if detected early
Frequency 1 in 8 women (lifetime risk)
Deaths N/A


Breast cancer is a malignant tumor that originates in the cells of the breast tissue. It is the most common cancer among women worldwide and the second leading cause of cancer-related death in women after lung cancer. Though rare, it can also affect men. Early detection, accurate diagnosis, and timely treatment are crucial for improving survival outcomes.

Diagram of early signs of breast cancer
Mammogram image showing tumor

Historical Background[edit]

Breast cancer has been known for millennia. Descriptions of tumors believed to be breast cancer appear in the Edwin Smith Papyrus from ancient Egypt, dating to around 1600 BCE. Early treatments were mostly surgical, and until the 19th century, options were limited. The modern surgical era began with William Stewart Halsted's radical mastectomy technique in the 1880s. Since then, approaches have evolved to include lumpectomy, chemotherapy, radiotherapy, and targeted therapy.

Types[edit]

Breast cancer can present in different forms. The main types include:

Causes and Risk Factors[edit]

The exact cause is unknown, but several risk factors increase the likelihood of developing breast cancer:

  • Female gender
  • Age over 50
  • Family history (especially with BRCA1 or BRCA2 mutations)
  • Long-term exposure to estrogen
  • Early menstruation (before age 12) or late menopause (after age 55)
  • Lack of pregnancy or late pregnancy
  • Use of hormone replacement therapy
  • Obesity and physical inactivity
  • Alcohol consumption
  • Previous history of breast abnormalities or biopsies
  • Radiation exposure to the chest

Symptoms[edit]

Signs of breast cancer may include:

  • A lump or mass in the breast or underarm
  • Change in the size or shape of the breast
  • Nipple retraction, discharge (especially bloody)
  • Skin changes: dimpling, redness, or texture resembling an orange peel
  • Pain in the breast or nipple area (less common)

These symptoms can also be caused by benign conditions such as fibrocystic breast disease or mastitis.

Diagnosis[edit]

Diagnosis involves a combination of clinical and imaging techniques:

  • Clinical breast examination – Manual palpation by a healthcare provider
  • Mammography – X-ray imaging to detect tumors
  • Ultrasound – Useful in distinguishing solid from cystic masses
  • MRI – Used in high-risk women or ambiguous cases
  • Biopsy – Definitive diagnosis via fine needle aspiration, core needle biopsy, or surgical excision
Needle biopsy under guidance

Staging[edit]

Breast cancer is staged from 0 to IV using the TNM staging system:

Stage I
Stage IV

Treatment[edit]

Treatment plans depend on the type, stage, hormone receptor status, and patient preferences.

Surgical Options[edit]

Post-mastectomy
Post-reconstruction

Radiation Therapy[edit]

Usually follows surgery to reduce recurrence:

  • External beam radiation
  • Internal radiation (brachytherapy)

Chemotherapy[edit]

Drugs like doxorubicin, cyclophosphamide, paclitaxel target rapidly dividing cells. Used before (neoadjuvant) or after (adjuvant) surgery.

Hormonal Therapy[edit]

Used for estrogen receptor (ER)-positive cancers:

Targeted Therapy[edit]

Used in HER2-positive cancers:

Prognosis[edit]

Prognosis varies with the stage and subtype:

  • 5-year survival rate:
    • Nearly 99% for localized Stage I
    • Around 28% for metastatic Stage IV

Other factors influencing outcome include tumor size, lymph node involvement, receptor status, and response to treatment.

Prevention[edit]

There is no sure way to prevent breast cancer, but steps can reduce risk:

Breast Cancer in Men[edit]

Though rare, men can develop breast cancer. Risk factors include age, Klinefelter syndrome, radiation exposure, BRCA2 mutations, and liver disease. Symptoms and treatment are similar to those in women.

Breast Reconstruction[edit]

Women who undergo mastectomy may choose breast reconstruction surgery using:

Support and Resources[edit]

Living with breast cancer can be physically and emotionally challenging. Support groups, counseling, and survivorship programs are essential components of care.

Glossary of Breast Cancer Terms[edit]

This glossary provides definitions and descriptions of key terms related to breast cancer, encompassing medical procedures, classifications, therapies, notable people, and research initiatives. Each entry includes an internal link where applicable.

A[edit]

B[edit]

C[edit]

D[edit]

E[edit]

  • Epidemiology of breast cancer: The study of the distribution and determinants of breast cancer in populations.
  • Erin Kennedy: A patient advocate and journalist who chronicled her experiences with breast cancer.
  • Europa Donna: The European Breast Cancer Coalition advocating for improved services and screening.

F[edit]

  • Fluoroestradiol F-18: A radiotracer used in PET scans to assess estrogen receptor expression in breast cancer.

G[edit]

  • Global Pink Hijab Day: An awareness event combining breast cancer awareness with Muslim cultural identity.

H[edit]

I[edit]

L[edit]

M[edit]

N[edit]

  • Nancy Cappello: Advocate for breast density notification laws after being diagnosed with advanced-stage cancer missed by mammography.
  • Nottingham Prognostic Index: A prognostic tool used to determine survival in patients with breast cancer.

P[edit]

Q[edit]

R[edit]

S[edit]

T[edit]

V[edit]

Related Articles[edit]

External Links[edit]

Breast cancer
Types
General
Other



Diseases of the endocrine system (E00–E35, 240–259)
Pancreas/
glucose
metabolism
Hypothalamic/
pituitary axes
Hypothalamus
Pituitary
Thyroid
Parathyroid
Adrenal
Height
Multiple
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