October is Breast Cancer Awareness Month



If you have noticed people wearing the iconic pink ribbon during the month of October, it’s for a very good reason; October is Breast Cancer Awareness Month. As part of our commitment to supporting those fighting cancer, we created the following blog to help educate and inform people about the signs, symptoms, and treatment of breast cancer.

One in every eight women in the U.S. will be affected by breast cancer.

What is Breast Cancer?

Cancer is a group of diseases in which cells change and begin to multiply out of control and invading other tissues. Cancers are named based on the tissues they originate in. Breast cancer then, is a cancer that begins in breast tissues.

The majority of breast cancers arise in either the milk glands or the ducts that connect them to the nipple. Other breast cancers can start in either lymphatic or connective tissues of the breast. And, even though most people think that only women can develop breast cancer, it can occur in men as well.

Although extremely rare, it does happen. The symptoms for breast cancer in males are actually very similar to those in females. Many men who find a lump though, ignore it until the symptoms become much more pronounced, such as bleeding from the nipple or an obvious deformity in the chest. According to the American Cancer Society, roughly 1% of all breast cancers occur in men.

Breast Cancer is Not a Single Disease

Far from being a single form of disease, there are over 21 different breast cancer subtypes, with at least four additional molecular subtypes- all of which carry their own biological markers and risk factors. Breast cancer subtypes not only present differently, they also vary in the way they respond to treatment, which is why it is so important that a given subtype be identified.

Two Main Types of Breast Cancer

Cancers in Situ

The two most common forms of breast cancer are ductal carcinoma in situ and lobular carcinoma in situ. (When a cancer is in situ, it means that it is still in its original place and has not spread into nearby tissues.)

According to American Cancer Society, ductal carcinoma in situ (DCIS) represents 83% of in situ diagnoses. DCIS occurs when normal epithelial cells (which line the inside of breast ducts), become abnormal, often growing and expanding inside the lobules and ducts of the breast.

Ductal Carcinomas in Situ
Ductal carcinomas can grow much more slowly than some other cancers and may be classified as benign. They can, however, become invasive cancers. The American Cancer Society notes that even without treatment, some ductal carcinomas do not affect the woman’s health.

Long term studies though, have shown that 20% - 53% of DCIS go untreated, often because they were misdiagnosed as benign, becoming invasive only after a decade or more without treatment.

Per the Journal of the National Cancer Institute, over 90,000 women with breast cancer are misdiagnosed, delaying treatment and creating poorer outcomes. In many cases, DCIS is curable, especially if caught early and has not become invasive.

Lobular Carcinomas in Situ

13% of breast cancers are known as lobular carcinomas in situ. (Carcinoma means that the cancer started in the soft tissues such as that which surrounds internal organs or within the skin.) Lobular carcinomas in situ arise in the lobules (glands) which produce breast milk. They are usually not considered a precursor of invasive breast cancer, although they do represent a serious risk factor for the later development of invasive breast cancers.

What are Invasive Breast Cancers?
Unfortunately, the vast majority (80%) of all breast cancers are invasive. This means that they infiltrate, or break through, the ducts or glands where they began and start growing into surrounding tissues. According to the center for Disease Control, over 180,000 women are diagnosed each year in the U.S. with invasive ductal carcinoma, or IDC.

Breast Cancer Survival Rates are Rising
At the same time, there is some good news too; new treatments for breast cancer, coupled with earlier detection, are gaining traction AND breast cancer survival rates are rising. Every year, more and more women survive breast cancer and go on to lead long, fulfilling, and active lives. Even so, early detection and treatment are crucial to beating breast cancer.

Signs and Symptoms of Breast Cancer

In the early stages, when it also most treatable, breast cancer symptoms be easily overlooked, or may not show up at all. If they are present, breast cancer symptoms may include:

• Changes in the nipple, such as a nipple that turns inwards
• Nipple discharge which may be bloody and start suddenly
• A change in the look or feel of the breast
• Thickening of the skin of the breast
• Changes in the size or shape of a breast
• Dimpling or puckering of the skin of the breast
• An itchy or scaly sore (or rash) on the nipple
• Swelling and or warmth in the breast
• Darkening of the breast
• Lumps or hard knots in the breast or under the armpit
• Pain in one are of the breast that does not go away
• A pulling sensation in the breast or nipple

Breast Self-Exams

Most women know that mammograms save lives, but they may not know that 40% of all breast cancers are detected by women who notice a lump in their breast(s). This is why breast self-exams are so critical. Every woman should conduct at least a monthly self-exam of her breasts.

Many women find that a self-exam in easier to remember and perform when they are in the shower.

Breast Cancer Self-Exam Guide

The National Breast Cancer Foundation has created this helpful guide which explains how to do a simple breast self-examination. Remember, that while breast cancer self-exams are good and should be encouraged, they are not a substitute for regular mammograms and medical checkups.

If You Find a Lump, get it Checked
Although 8 out of 10 lumps are not cancerous, you should make an appointment with your doctor if you do find a lump or notice any other changes such as those listed in the previous section in your breast(s). Even if you are just suspicious that something is not right, you should always see a qualified healthcare provider, and have it checked out.

Breast Cancer Screenings, Tests and Diagnosis

Breast cancer can sometimes be difficult to diagnose. That is why there are many different kinds of imaging tests to help doctors screen and diagnose cancers of the breast. Some forms of breast cancer also show up on mammograms better than others. According to the Susan G. Komen Foundation, 16% of all breast cancers do not show up on mammograms at all.

Mammograms can also give false positives. This is especially true of newer digital imaging scans which are so sensitive that they may pick up harmless anomalies such as scar tissue. If a mammogram comes back as showing an area of concern in one or both breasts, your doctor may request more tests to help make a diagnosis.

This may mean having a follow up mammogram, another imaging study such as an ultrasound, CT scan, PET (positron emission tomography), MRI (magnetic resonance imaging), or a biopsy. A biopsy is one of the most reliable methods of detection.

Staging Breast Cancer

If breast cancer is detected, your doctor will probably begin trying to establish how far it has progressed. This process is known as staging. Staging a cancer may require additional studies such as bone scans, CT scans, a PET scan, blood tests or surgery to determine where the cancer may have spread. Your doctor can advise you about which tests are, or are not, right for your specific needs.

0 to IV
Breast cancers are staged from a scale that runs from 0 to IV. A stage 0 cancer means that is non-invasive or is contained within the milk ducts. A stage IV cancer, on the other hand, means that it has spread to other areas of the body such as the liver, bones, lymph nodes, lungs or brain.

Breast Cancer Treatment

Breast cancer is often very treatable, especially if caught early. Your doctor will work to determine the kind of cancer, as well as which form of treatment is likely to be the most effective for you.

Breast cancer treatments vary. They may include: targeted breast cancer medications which are based on the subtype in question, hormone therapy, radiation, chemotherapy, surgery, or a combination of treatments, as well as other supportive and or palliative care.

Breast Cancer Surgery
If surgery is required it can range from a lumpectomy (also called a breast conserving surgery or wide local incision) which removes only a limited number of lymph nodes, to a full mastectomy. (The removal of one or both breasts.)

Breast Cancer Resources

Below are some helpful links to breast cancer resources. If you, or someone you know, is fighting cancer, we can help. From exceptional cancer medication management, to access to specialized cancer medications and or help finding alternative funding sources to pay for your medications, we are here to support your fight against cancer.

Please help us raise awareness about breast cancer by sharing this blog. Show your strength by wearing pink: click here to find out how to make your own pink breast cancer ribbon lapel pin.

Additional Resources
Cancer Care
Susan G. Komen Foundation
American Cancer Society

ASP Cares: Big Enough to Serve. Small enough to care.

This content does not represent medical advice. It is not meant to diagnose or treat any condition. It is not intended as a substitute for the advice of a qualified medical provider.

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