1. MADLANGSAKAY, MICAH LOIS T. CLASS #: 10
BS BIOLOGY 3B DECEMBER 12,2012
Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of
cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the
body. The disease occurs almost entirely in women, but men can get it, too.
Countries with High Risk
Breast cancer is the leading cause of cancer death in women, with proper screening and early
detection many breast cancer deaths can be avoided. Sage is a life saving program in Minnesota that provides
access to the early detection of breast and cervical cancer and treatment for women who lack adequate
health insurance. Since 1991, it has served over 118,722 Minnesota women and detected 11,471 breast and
cervical cancers. Currently in Minnesota, only 3 in 5 women eligible for Sage are getting their mammogram or
The absolute risk of developing breast cancer during a particular decade of life is lower than 1 in 8. The
younger you are, the lower the risk. For example:
From age 30 to 39, absolute risk is 1 in 233, or 0.43%. This means that 1 in 233 women in this age group
can expect to develop breast cancer. Put another way, your odds of developing breast cancer if you are in
this age range are 1 in 233.
From age 40 to 49, absolute risk is 1 in 69, or 1.4%.
From age 50 to 59, absolute risk is 1 in 38, or 2.6%.
From age 60 to 69, absolute risk is 1 in 27, or 3.7%.
2. Diet and Stress
Sept. 24, 2003 (Copenhagen, Denmark) -- As if life isn't stressful enough, Swedish researchers say that
being under stress maydouble a woman's risk of developingbreast cancer.
They based their findings on surveys of more than 1,400 Swedish women in the late 1960s who were
part of a long-term health-care study.
The women, who were reported to be a representative sample of the Swedish population, were asked
to fill out a health survey, which included a question about stress, asking whether at any time in the last five
years they had experienced a feeling of stress for a month or more.
Examples of stressful situations the women might have encountered were tension, fear, anxiety,
or sleep disturbances related to family or work problems. Because the question about stress was only one of
many different questions asked at the time, the researchers felt that their answers would probably have
accurately reflected the way they felt at the time, says OestenHelgesson, MD, a physician in the department of
primary health care at Gothenburg University.
They found that women who reported being under stress had twice the risk of developing breast
cancer as women who managed to stay cool, calm, and collected. This twofold risk held up even when they
took into account other factors that might explain the increased risk for breast cancer, such as family history
of cancer, alcohol use, body weight, smoking, and factors related to reproduction, such as the age when
women first had their periods, the age they were when they had their first baby, and the age they were they
The type of fat one consumes may affect the risk of breast cancer. Some studies have shown that
intake of monounsaturated fats (olive and canola oils) can decrease the risk of breast cancer. Other studies
have shown that teen females that consume a high fat diet have an increased risk of breast cancer when they
become post-menopausal. More studies need to be completed to fully understand the impact that dietary fat
has on the risk of breast cancer development.
Clinical Manifestations (Signs and Symptoms)
Generally, breast cancers are not painful and women do not feel unwell with them.
Breast cancer is now commonly diagnosed by breast screening in women who have no symptoms.
Approximately 6 in every 1000 women between the ages of 50 and 64 who attend for screening will be
found to have breast cancer the first time they attend screening.
A lump in the breast. In many cases, the woman herself will first suspect the disease because she notices
a lump or an area of lumpiness or irregularity in her breast tissue. This may happen when she is
examining her breasts or while washing or applying lotion to her breasts, or the lump may be visible.
Other signs of breast cancer include the following.
3. A change in the skin: there is often dimpling or indentation of the skin with the formation of wrinkles. The
nipple might be pulled in or there may be a discharge from the nipple.
Occasionally the nipple itself changes. A rash can affect the nipple or the nipple may weep.
The breast may swell and become red and inflamed or the skin may change and become like the skin of an
orange. In some breast cancers this is due to a blockage of the drainage of fluid from the breast.
Patients sometimes present with a lump under the arm, which is a sign that the cancer has spread to the
Progression ( Stages)
Stage 0 is used to describe non-invasive breast cancers, such asDCIS (ductal carcinoma in situ). In stage 0,
there is no evidence of cancer cells or non-cancerous abnormal cells breaking out of the part of the breast in
which they started, or getting through to or invading neighboring normal tissue.
Stage I describes invasive breast cancer (cancer cells are breaking through to or invading normal surrounding
breast tissue) Stage I is divided into subcategories known as IA and IB.
Stage IA describes invasive breast cancer in which:
the tumor measures up to 2 cm AND
the cancer has not spread outside the breast; no lymph nodes are involved
Stage IB describes invasive breast cancer in which:
there is no tumor in the breast; instead, small groups of cancer cells – larger than 0.2 millimeter but not
larger than 2 millimeters – are found in the lymph nodes, OR
there is a tumor in the breast that is no larger than 2 centimeters, and there are small groups of cancer
cells – larger than 0.2 millimeter but not larger than 2 millimeters – in the lymph nodes.
Microscopic invasion is possible in stage I breast cancer. In microscopic invasion, the cancer cells have just
started to invade the tissue outside the lining of the duct or lobule, but the invading cancer cells can't measure
more than 1 mm.
Stage II is divided into subcategories known as IIA and IIB.
4. Stage IIA describes invasive breast cancer in which:
no tumor can be found in the breast, but cancer cells are found in the lymph nodes under the arm
the tumor measures 2 cm or smaller and has spread to the axillary lymph nodes OR
the tumor is larger than 2 cm but not larger than 5 cm and has not spread to the axillary lymph nodes
Stage IIB describes invasive breast cancer in which:
the tumor is larger than 2 cm but no larger than 5 cm and has spread to the axillary lymph nodes OR
the tumor is larger than 5 cm but has not spread to the axillary lymph nodes
Stage III is divided into subcategories known as IIIA, IIIB, and IIIC.
Stage IIIA describes invasive breast cancer in which either:
no tumor is found, but cancer is found in axillary lymph nodes, which are clumped together or sticking to
other structures, or cancer may have spread to lymph nodes near the breastbone OR
the cancer is any size and has spread to axillary lymph nodes, which are clumped together or sticking to
Stage IIIB describes invasive breast cancer in which:
the cancer may be any size and has spread to the chest wall and/or skin of the breast AND
may have spread to axillary lymph nodes, which are clumped together or sticking to other structures, or
cancer may have spread to lymph nodes near the breastbone
Inflammatory breast cancer is considered at least stage IIIB. Typical features of inflammatory breast cancer
reddening of a large portion of the breast skin
the breast feels warm and may be swollen
cancer cells have spread to the lymph nodes and may be found in the skin
Stage IIIC describes invasive breast cancer in which:
there may be no sign of cancer in the breast or, if there is a tumor, it may be any size and may have
spread to the chest wall and/or the skin of the breast AND
5. the cancer has spread to lymph nodes above or below the collarbone AND
the cancer may have spread to axillary lymph nodes or to lymph nodes near the breastbone
Stage IV describes invasive breast cancer that has spread beyond the breast and nearby lymph nodes to other
organs of the body, such as the lungs, distant lymph nodes, skin, bones, liver, or brain.
You may hear the words “advanced” and “metastatic” used to describe stage IV breast cancer. Cancer may be
stage IV at first diagnosis or it can be a recurrence of a previous breast cancer that has spread to other parts of
Learn about what treatments you can generally expect according to cancer stage in the Options by Cancer
Stage section in Planning Your Treatment.
TNM staging system
TNM (Tumor, Node, Metastasis) is another staging system researchers use to provide more details
about how the cancer looks and behaves. Your doctor might mention the TNM classification for your case, but
he or she is much more likely to use the numerical staging system. Sometimes clinical trials require TNM
information from participants, so talk to your doctor if you are considering participation in a clinical trial.
The TNM system is based on three characteristics:
size (T stands for tumor)
lymph node involvement (N stands for node)
whether the cancer has metastasized (M stands for metastasis), or moved beyond the breast to other
parts of the body.
The T (size) category describes the original (primary) tumor:
TX means the tumor can't be measured or found.
T0 means there isn't any evidence of the primary tumor.
Tis means the cancer is "in situ" (the tumor has not started growing into healthy breast tissue).
T1, T2, T3, T4: These numbers are based on the size of the tumor and the extent to which it has grown
into neighboring breast tissue. The higher the T number, the larger the tumor and/or the more it may
have grown into the breast tissue.
6. The N (lymph node involvement) category describes whether or not the cancer has reached nearby lymph
NX means the nearby lymph nodes can't be measured or found.
N0 means nearby lymph nodes do not contain cancer.
N1, N2, N3: These numbers are based on the number of lymph nodes involved and how much cancer is
found in them. The higher the N number, the greater the extent of the lymph node involvement.
The M (metastasis) category tells whether or not there is evidence that the cancer has traveled to other parts
of the body:
MX means metastasis can't be measured or found.
M0 means there is no distant metastasis.
M1 means that distant metastasis is present.
Once the pathologist knows your T, N, and M characteristics, he or she can use them to assign a stage
to the cancer. For example, a T1 N0 M0 breast cancer would mean that the primary breast tumor is less than 2
centimeters across (T1), has not involved the lymph nodes (N0), and has not spread to distant parts of the
body (M0). This cancer would be grouped as stage I.
Incidence Rates by Race
All Races 124.3 per 100,000 women
White 127.3 per 100,000 women
Black 121.2 per 100,000 women
Asian/Pacific Islander 94.5 per 100,000 women
American Indian/Alaska Native a 80.6 per 100,000 women
Hispanic b 92.7 per 100,000 women
Cure and Prevention
There are two methods of treatment - local and systemic.
Local treatments are used to remove or destroy the cancer cells in a specific
area. Surgery and Radiation therapy are examples of local treatments.
7. Systemic treatments are used to destroy or control cancer cells all over the
body. Chemotherapy and hormonal therapyexamples of systemic treatments.
The right treatment method, however, depends on the size and location of the breast tumor; the
results of the pathologist’ s review of the tumor specimen, the woman's age, menopausal status, and general
health; and the stage of the disease.
Surgery is the most common treatment for breast cancer. There are two types: breast-sparing surgery
and mastectomy. Breast-sparing surgery, also known as lumpectomy or partialmastectomy, removes the
cancerous lump but not the entire breast. The other type of surgery that is commonly performed in breast
cancer is called a mastectomy. In this procedure, the entire breast is removed. Systemic treatments
Local treatments remove cancerous cells from the breast and under arm lymph nodes
There are two primary kinds of adjuvant systemic treatments:
Chemotherapy drugs are medications that kill rapidly growing cells such as cancer cells. These drugs
can be given either by mouth or intravenously. Chemotherapy medications are very powerful and can have
many side effects. In general, chemotherapy is used for large tumors or for cancers that have spread to the
under arm lymph nodes.
Hormone therapy is used to prevent cancer cells from getting the hormones they need to
grow. Prevention of Breast Cancer
Examine Your Breasts Every Month Beginning At Age 20 (see your doctor for self breast exam instructions).
Check for: new lump (painful or not), unusual thickening of tissue, discharge from the nipples, change in the
skin of nipples or breasts, or different breast size or shape than before.
Have Your Doctor Examine Your Breasts Every Year Or Two Beginning At Age 30
Have A Mammogram Every Year After Age 40