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Empower Your Body, Elevate Your Well-Being

October

Breast Cancer Awareness Month 

What is Breast Cancer

Breast cancer occurs almost entirely in women, but men can get breast cancer, too. Cancer starts when cells begin to grow out of control. (To learn more about how cancers start and spread, see What Is Cancer?)

It’s important to understand that most breast lumps are benign and not cancer (malignant)Non-cancer breast tumors are abnormal growths, but they do not spread outside of the breast. They are not life-threatening, but some types of benign breast lumps can increase a woman's risk of getting breast cancer. Any breast lump or change needs to be checked by a healthcare professional to find out if it is benign or malignant (cancer) and if it might affect your future cancer risk. See Non-cancerous Breast Conditions to learn more.

How breast cancer spreads

Breast cancer can spread when the cancer cells get into the blood or lymph system and then are carried to other parts of the body. 

The lymph (or lymphatic) system is a part of your body's immune system. It is a network of lymph nodes (small, bean-sized glands), ducts or vessels, and organs that work together to collect and carry clear lymph fluid through the body tissues to the blood. The clear lymph fluid inside the lymph vessels contains tissue by-products and waste material, as well as immune system cells.

The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into:

  • Lymph nodes under the arm (axillary lymph nodes)

  • Lymph nodes inside the chest near the breastbone (internal mammary lymph nodes)

  • Lymph nodes around the collar bone (supraclavicular [above the collar bone] and infraclavicular [below the collar bone] lymph nodes)

If cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have traveled through the lymph system and spread (metastasized) to other parts of your body. Still, not all women with cancer cells in their lymph nodes develop metastases, and some women with no cancer cells in their lymph nodes might develop metastases later.

Types of breast cancer

There are many different types of breast cancer. The type is determined by the specific kind of cells in the breast that are affected. Most breast cancers are carcinomas. The most common breast cancers such as ductal carcinoma in situ (DCIS) and invasive carcinoma are adenocarcinomas since the cancers start in the gland cells in the milk ducts or the lobules (milk-producing glands). Other kinds of cancers can grow in the breast, like angiosarcoma or sarcoma, but are not considered breast cancer since they start in different cells of the breast.

Breast cancers are also classified by certain types of proteins or genes each cancer might make. After a biopsy is done, breast cancer cells are tested for proteins called estrogen receptors and progesterone receptors, and the HER2 gene or protein. The tumor cells are also closely looked at in the lab to find out what grade it is. The specific proteins found and the tumor grade can help decide the stage of the cancer and treatment options.

To learn more about the specific tests done on breast cancer cells, see Understanding a Breast Cancer Diagnosis.

Where breast cancer starts

Breast cancers can start from different parts of the breast.

The breast has different parts:

  • Lobules are the glands that make breast milk. Cancers that start here are called lobular cancers.

  • Ducts are small canals that come out from the lobules and carry the milk to the nipple. This is the most common place for breast cancer to start. Cancers that start here are called ductal cancers.

  • The nipple is the opening in the skin of the breast where the ducts come together and turn into larger ducts so the milk can leave the breast. A less common type of breast cancer called Paget disease of the breast can start in the nipple.

  • The fat and connective tissue (stroma) surround the ducts and lobules and help keep them in place. A less common type of breast cancer called phyllodes tumor can start in the stroma.

  • Blood vessels and lymph vessels are also found in each breast. Angiosarcoma is a less common type of breast cancer that can start in the lining of these vessels. The lymph system is described below.

A small number of cancers start in other tissues in the breast. These cancers are called sarcomas and lymphomas and are not really thought of as breast cancers.

Risk Factors for Breast Cancer

A risk factor is anything that increases your chances of getting a disease, such as cancer. But having a risk factor, or even many, does not mean that you are sure to get the disease. While you can’t change some breast cancer risk factors—family history and aging, for example—there are some risk factors that you can control.

Breast Cancer Risk Factors You Cannot Change

A risk factor is anything that increases your chances of getting a disease, such as breast cancer. But having a risk factor, or even many, does not mean that you are sure to get the disease.

Some risk factors for breast cancer are things you cannot change, such as getting older or inheriting certain gene changes. These make your risk of breast cancer higher.

For information on other known and possible breast cancer risk factors, see:

Inheriting certain gene changes

About 5% to 10% of breast cancer cases are thought to be hereditary, meaning that they result directly from gene changes (mutations) passed on from a parent.

BRCA1 and BRCA2: The most common cause of hereditary breast cancer is an inherited mutation in the BRCA1 or BRCA2 gene. In normal cells, these genes help make proteins that repair damaged DNA. Mutated versions of these genes can lead to abnormal cell growth, which can lead to cancer.

  • If you have inherited a mutated copy of either gene from a parent, you have a higher risk of breast cancer.

  • On average, a woman with a BRCA1 or BRCA2 gene mutation has up to a 7 in 10 chance of getting breast cancer by age 80. This risk is also affected by how many other family members have had breast cancer. (It goes up if more family members are affected.)  

  • Women with one of these mutations are more likely to be diagnosed with breast cancer at a younger age, as well as to have cancer in both breasts.

  • Women with one of these gene changes also have a higher risk of developing ovarian cancer and some other cancers. (Men who inherit one of these gene changes also have a higher risk of breast and some other cancers.)

  • In the United States, BRCA mutations are more common in Jewish people of Ashkenazi (Eastern Europe) origin than in other racial and ethnic groups, but anyone can have them.

Other genes: Other gene mutations can also lead to inherited breast cancers. These gene mutations are much less common, and most of them do not increase the risk of breast cancer as much as the BRCA genes.

  • ATM: The ATM gene normally helps repair damaged DNA (or helps kill the cell if the damage can't be fixed). Inheriting 2 abnormal copies of this gene causes the disease ataxia-telangiectasia. Inheriting one abnormal copy of this gene has been linked to a high rate of breast cancer in some families.

  • PALB2: The PALB2 gene makes a protein that interacts with the protein made by the BRCA2 gene. Mutations in this gene can lead to a higher risk of breast cancer.

  • TP53: The TP53 gene helps stop the growth of cells with damaged DNA. Inherited mutations of this gene cause Li-Fraumeni syndrome. People with this syndrome have an increased risk of breast cancer, as well as some other cancers such as leukemia, brain tumors, and sarcomas (cancers of bones or connective tissue). This mutation is a rare cause of breast cancer.

  • CHEK2: The CHEK2 gene is another gene that normally helps with DNA repair. A CHEK2 mutation increases breast cancer risk.

  • PTEN: The PTEN gene normally helps regulate cell growth. Inherited mutations in this gene can cause Cowden syndrome, a rare disorder that puts people at higher risk for both cancer and benign (non-cancer) tumors in the breasts, as well as growths in the digestive tract, thyroid, uterus, and ovaries.

  • CDH1: Inherited mutations in this gene cause hereditary diffuse gastric cancer, a syndrome in which people develop a rare type of stomach cancer. Women with mutations in this gene also have an increased risk of invasive lobular breast cancer.

  • STK11: Defects in this gene can lead to Peutz-Jeghers syndrome. People affected with this disorder have pigmented spots on their lips and in their mouths, polyps (abnormal growths) in the urinary and digestive tracts, and a higher risk of many types of cancer, including breast cancer.

Inherited mutations in several other genes have also been linked to breast cancer, but these account for only a small number of cases.

Genetic counseling and testing: Genetic testing can be done to look for inherited mutations in the BRCA1 and BRCA2 genes (or less commonly in genes such as PTEN, TP53, or others mentioned above). This might be an option for some women who have been diagnosed with breast cancer, as well as for certain women with factors that put them at higher risk for breast cancer, such as a strong family history. While genetic testing can be helpful in some cases, not every woman needs to be tested, and the pros and cons need to be considered carefully. To learn more, see Genetic Counseling and Testing for Breast Cancer Risk.

Can Breast Cancer Be Prevented?

There is no sure way to prevent breast cancer. But there are things you can do that might lower your risk. This can be especially helpful for women with certain risk factors for breast cancer, such as having a strong family history or certain inherited gene changes.

Being born female

Getting older

As you get older, your risk of breast cancer goes up. Most breast cancers are found in women aged 55 and older.

Having a family history of breast cancer

Having a personal history of breast cancer

Race and ethnicity

Being taller

Having dense breast tissue

Breasts are made up of fatty tissue, fibrous tissue, and glandular tissue. Breasts appear denser on a mammogram when they have more glandular and fibrous tissue and less fatty tissue. Women with dense breasts on mammograms have a higher risk of breast cancer than women with average breast density. Unfortunately, dense breast tissue can also make it harder to see cancers on mammograms.

Several factors can affect breast density, such as age, menopausal status, the use of certain drugs (including menopausal hormone therapy), pregnancy, and genetics.

To learn more, see our information on breast density and mammograms.

Starting menstrual periods early

Going through menopause later

Having radiation to your chest

Exposure to diethylstilbestrol (DES)

From the 1940s through the early 1970s some pregnant women were given an estrogen-like drug called DES because it was thought to lower their chances of losing the baby (miscarriage). These women have a slightly increased risk of developing breast cancer. Women whose mothers took DES while they were pregnant with them may also have a slightly higher risk of breast cancer.

To learn more, see our information about DES exposure.  

Having certain benign breast conditions

Women diagnosed with certain types of benign (non-cancer) breast conditions may have a higher risk of breast cancer. Some of these conditions are more closely linked to breast cancer risk than others. Doctors often divide benign breast conditions into different groups, depending on how they affect this risk.

Non-proliferative lesions: These conditions don’t seem to affect breast cancer risk, or if they do, the increase in risk is very small. They include:

  • Fibrosis and/or simple cysts (sometimes called fibrocystic changes)

  • Mild hyperplasia

  • Adenosis (non-sclerosing)

  • Phyllodes tumor (benign)

  • A single papilloma

  • Fat necrosis

  • Duct ectasia

  • Periductal fibrosis

  • Squamous and apocrine metaplasia

  • Epithelial-related calcifications

  • Other tumors (lipoma, hamartoma, hemangioma, neurofibroma, adenomyoepithelioma)

Mastitis (infection of the breast) is not a tumor and does not increase the risk of breast cancer.

Proliferative lesions without atypia (cell abnormalities): In these conditions, there’s excessive growth of cells in the ducts or lobules of the breast, but the cells don't look very abnormal. These conditions seem to raise a woman’s risk of breast cancer slightly. They include:

  • Usual ductal hyperplasia (without atypia)

  • Fibroadenoma

  • Sclerosing adenosis

  • Several papillomas (called papillomatosis)

  • Radial scar

Proliferative lesions with atypia: In these conditions, the cells in the ducts or lobules of the breast tissue grow excessively, and some of them no longer look normal. These types of lesions include:

Breast cancer risk is about 4 to 5 times higher than normal in women with these changes. If a woman also has a family history of breast cancer and either hyperplasia or atypical hyperplasia, she has an even higher risk of breast cancer.

Lobular carcinoma in situ (LCIS)

In LCIS, cells that look like cancer cells are growing in the lobules of the milk-producing glands of the breast, but they are not growing through the wall of the lobules. LCIS is not considered to be cancer, and it typically does not spread beyond the lobule (that is, it doesn't become invasive breast cancer) if it isn’t treated. But women with LCIS have a 7 to 12 times higher risk of developing breast cancer (which can be in either breast).

For more on these conditions, see Non-cancerous Breast Conditions.

Here's a simple chart summarizing the benefits of the teas mentioned for women with breast cancer:

  • Green tea - May slow cancer cell growth.- Studied for breast cancer prevention.

  • Turmeric Tea - Anti-inflammatory and antioxidant properties.- May help reduce tumor growth and boost immune response.

  • Ginger Tea - Helps manage chemotherapy side effects like nausea.- May have anti-cancer properties.

  • Rooibos Tea - Antioxidants (Aspalathin, Quercetin)- Supports overall health and reduces oxidative stress.- Caffeine-free.

  • Peppermint Tea - Aids in digestion, nausea relief, and fatigue management.- Useful for managing side effects of cancer treatment.

  • Chamomile Tea - Calms anxiety and helps with insomnia.- Anti-inflammatory effects that can help with overall wellness during treatment.