Breast Cancer Basics

Understanding Signs, Symptoms and Risk Factors

by Tara M. Breslin, MD

October is Breast Cancer Awareness Month and a great time to spread the word about the importance of breast health all year long. Breast cancer is one of the most common forms of cancer diagnosed in the United States, typically in women, but it occurs in men as well. In 2020 alone, an estimated 276,000 women will be diagnosed with breast cancer. Most of these new cases will occur in women older than 50, but 10% will occur in women younger than 45. Recognizing the warning signs of breast cancer and early detection will mean more treatment options and a better chance of being cured.

Be aware of changes in your breasts

  • Lump in the breast or underarm
  • Bloody discharge from the nipple
  • Indentation or retraction of the nipple area
  • Change in breast size
  • Rippling (flattening or indentation) of the skin covering the breast
  • Crustiness or rash of the nipple or areola

What to you do if you notice a new symptom

Stay up-to-date with breast screenings

Regular screening for breast cancer is done before there are any signs or symptoms and is the best way to find cancer early when it’s easier to treat. The first step(s) of screening for breast cancer typically include mammogram and/or a patient’s awareness of changes in their breast.

  • Self-Awareness: Conduct regular and frequent self-exams of your breasts. Become familiar with your breasts, so you aware of, and able to, recognize changes right away.
  • Clinical Breast Exam: This exam is done in a clinical setting, by a physician who will use their hands to look for lumps or changes in your breasts.
  • Mammogram: An x-ray of the breast and the best way to detect cancer early. A screening mammogram is done for asymptomatic women, a diagnostic mammogram is done for women with a new symptom or mammographic abnormality.

A mammogram found something suspicious, now what?

If your doctor finds something concerning on your mammogram, the first step would be diagnostic imaging to further characterize the area.  This may include: diagnostic mammogram, ultrasound, MRI.

  • Biopsy: a small sample of cells or tissue is removed and reviewed under a microscope to determine if cancer is present. There are a variety of ways to perform a biopsy. Talk to your physician about the options available to you, if you require a biopsy.
  • Diagnostic Mammogram: an X-ray test used to diagnose unusual breast changes, such as a lump, pain, nipple discharge, change in breast size or shape or previous breast cancer. If your screening mammogram does show an abnormality, you may need additional imaging like a diagnostic mammogram.
  • Breast Ultrasound: Using sound waves to produce images of the internal structures of the breast, the breast ultrasound can help a physician determine if a mass an abnormality is more likely a solid mass or fluid-filled cyst.
  • MRI: The MRI uses magnets and radio waves to produce images of the breast. These images provide more information and details than other tests. Your physician may recommend a breast MRI for you if your biopsy results were positive for cancer or if you’re considered high risk for breast cancer. The breast MRI is intended to be used along with a mammogram, not as a replacement.

Who would be considered high risk for breast cancer?

As a person ages, their risk of being diagnosed with breast cancer increases, but there are a few other risk factors that you cannot change:

  • Age: Most breast cancers are diagnosed after age 50.
  • Genetics: Inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer.
  • Dense Breasts: Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
  • Personal History of Breast Cancer: Women who have had breast cancer are more likely to get breast cancer a second time. Some non-cancerous breast diseases such as atypical hyperplasia or lobular carcinoma in situ are associated with a higher risk of getting breast cancer.
  • Family History of Breast Cancer: A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast or ovarian cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.

Understanding the signs and symptoms of breast cancer and your risk factors is important for every woman and man. If you have questions or concerns about your breast health, schedule an appointment with an IHA Breast Surgeon.