Breast cancer is a disease in which malignant (cancer) cells
form in the tissues of the breast.
Sometimes breast cancer occurs in women who are
pregnant or have just given birth.
Signs of breast cancer include a lump or change in the breast.
It may be difficult to detect (find) breast cancer early in
pregnant or nursing women.
Breast exams should be part of prenatal and postnatal care.
Tests that examine the breasts are used to detect (find) and diagnose
breast cancer.
If cancer is found, tests are done to study the cancer cells.
Certain factors affect prognosis
(chance of recovery) and treatment options.
Breast cancer is a disease in which malignant (cancer) cells
form in the tissues of the breast.
The breast
is made up of lobes
and ducts. Each breast has 15 to 20 sections called
lobes. Each lobe has many smaller sections called lobules. Lobules end in dozens of tiny bulbs that
can make milk. The lobes, lobules, and bulbs are linked by thin tubes called
ducts. Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.
Each breast also has blood
vessels
and lymph
vessels. The lymph vessels carry an almost colorless fluid
called lymph. Lymph
vessels carry lymph between lymph
nodes. Lymph nodes are small bean-shaped structures that are
found throughout the body. They filter substances in lymph and help fight infection
and disease. Clusters of lymph nodes are found near the breast in the axilla
(under the arm), above the collarbone, and in the chest.
Sometimes breast cancer occurs in women who are
pregnant or have just given birth.
Breast cancer
occurs about once in every 3,000 pregnancies. It occurs most often between the
ages of 32 and 38.
Signs of breast cancer include a lump or change in the breast.
These and other signs
may be caused by breast cancer or by other conditions. Check with your doctor if you have any of the following:
A lump or thickening in or near the breast or in the underarm area.
Fluid, other than breast milk, from the nipple, especially if it's bloody.
Scaly, red, or swollen skin on the breast, nipple, or areola
(the dark area of skin around the nipple).
Dimples in the breast that look like the skin of an orange, called peau
d’orange.
It may be difficult to detect (find) breast cancer early in
pregnant or nursing women.
The breasts usually get larger, tender, or lumpy in women who are pregnant, nursing, or have just given birth. This occurs because of normal hormone
changes that take place during pregnancy. These changes can make small lumps difficult to detect. The breasts may also become denser. It is more difficult to detect breast cancer in women with dense breasts using mammography. Because these breast changes can delay diagnosis, breast cancer is often found at a later stage
in these women.
Breast exams should be part of prenatal and postnatal care.
To detect breast cancer, pregnant and nursing women should examine
their breasts themselves. Women should also receive clinical breast
exams
during their regular prenatal
and postnatal check-ups. Talk to your doctor if you notice any changes in your breasts that you do not expect or that worry you.
Tests that examine the breasts are used to detect (find) and diagnose
breast cancer.
The
following tests and procedures may be used:
Physical exam
and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Clinical breast exam (CBE): An exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.
MRI
(magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of both breasts. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Ultrasound
exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues
or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to look at later.
Mammogram: An x-ray
of the breast. A mammogram can be done with little
risk to the unborn baby. Mammograms in
pregnant women may appear negative
even though cancer is present. Mammography. The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Biopsy: The removal
of cells
or tissues so they can be viewed under a microscope
by a pathologist
to check for signs of cancer. If a lump in the breast is
found, a biopsy may be done.
Estrogen
and progesterone receptor test: A test to measure the amount of estrogen
and progesterone (hormones) receptors
in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer is called estrogen
and/or progesterone receptor positive. This type of breast cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone given after the baby is born may stop the cancer from growing.
Human epidermal growth factor type 2 receptor (HER2/neu) test: A laboratory test
to measure how many HER2/neu genes
there are and how much HER2/neu protein
is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer is called HER2/neu positive. This type of breast cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs
that target the HER2/neu protein, such as trastuzumab
and pertuzumab, after the baby is born.
Multigene tests: Tests in which samples of tissue are studied to look at the activity of many genes at the same time. These tests may help predict whether cancer will spread to other parts of the body or recur (come back).
MammaPrint: This test helps predict whether stage I or stage II breast cancer that is node-negative will spread to other parts of the body. If the risk of the cancer spreading is high, chemotherapy may be given to lower the risk.
Certain factors affect prognosis
(chance of recovery) and treatment options.
The prognosis
(chance of recovery) and treatment options depend on the following:
The stage
of the cancer (the size of the tumor
and whether it is in the breast only or has spread to other parts of the body).
