Breast Cancer

Information on breast cancer, one of the 15 health conditions covered by the VA for Camp Lejeune victims.  Information is sourced from various outlets, including the National Institutes of Health (NIH), CDC, Mayo Clinic, Johns Hopkins, etc.

What is Breast Cancer?

The breast is made up of glands called lobules that can make milk and thin tubes called ducts that carry the milk from the lobules to the nipple. Breast tissue also contains fat and connective tissue, lymph nodes, and blood vessels.

The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Breast cancer can also begin in the cells of the lobules and in other tissues in the breast. Invasive breast cancer is breast cancer that has spread from where it began in the ducts or lobules to surrounding tissue.

In the U.S., breast cancer is the second most common cancer in women after skin cancer. It can occur in both men and women, but it is very rare in men. Each year there are about 2,300 new cases of breast cancer in men and about 230,000 new cases in women.

Types of Breast Cancer

There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer. Breast cancer can begin in different parts of the breast, like the ducts or the lobe.

• Ductal carcinoma. The most common kind of breast cancer. It begins in the cells that line the milk ducts in the breast, also called the lining of the breast ducts.
  • Ductal carcinoma in situ (DCIS). The abnormal cancer cells are only in the lining of the milk ducts, and have not spread to other tissues in the breast.
  • Invasive ductal carcinoma. The abnormal cancer cells break through the ducts and spread into other parts of the breast tissue. Invasive cancer cells can also spread to other parts of the body.
• Lobular carcinoma. In this kind of breast cancer, the cancer cells begin in the lobes, or lobules, of the breast. Lobules are the glands that make milk.
  • Lobular carcinoma in situ (LCIS). The cancer cells are found only in the breast lobules. Lobular carcinoma in situ, or LCIS, does not spread to other tissues.
  • Invasive lobular carcinoma. Cancer cells spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.

There are several other less common kinds of breast cancer, such as Paget’s disease and inflammatory breast cancer.

Risk Factors

Factors that are associated with an increased risk of breast cancer include:

• Being female
• Increasing age
• A personal history of breast cancer
• A family history of breast cancer
• Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most common gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don’t make cancer inevitable.
• Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased.
• Obesity
• Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
• Beginning menopause at an older age. If you began menopause at an older age, you’re more likely to develop breast cancer.
• Having your first child at an older age. Women who give birth to their first child after age 35 may have an increased risk of breast cancer.
• Having never been pregnant
• Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.
• Drinking alcohol

Early Detection

Seek the advice of an experienced breast specialist if you notice any of the following symptoms:

• Lump in the breast
• Thickening of the breast skin
• Rash or redness of the breast
• Breast swelling
• New onset of breast pain
• Dimpling around the nipple or on the breast skin
• Nipple pain or the nipple turning inward
• Nipple discharge
• Lumps in the underarm area
• Changes in the appearance of the nipple or breast that are different from the normal monthly changes a woman experiences

Diagnosis

Doctors often use additional tests to find or diagnose breast cancer.

• Breast ultrasound. A machine uses sound waves to make detailed pictures, called sonograms, of areas inside the breast.
• Diagnostic mammogram. If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.
• Magnetic resonance imaging (MRI). A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.
• Biopsy. This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies (for example, fine-needle aspiration, core biopsy, or open biopsy).

Treatment

Breast cancer is treated in several ways. It depends on the kind of breast cancer and how far it has spread. People with breast cancer often get more than one kind of treatment.

• Surgery. An operation where doctors cut out cancer tissue.
• Chemotherapy. Using special medicines to shrink or kill the cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.
• Hormonal therapy. Blocks cancer cells from getting the hormones they need to grow.
• Biological therapy. Works with your body’s immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments.
• Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer.

Statistics

In 2011 (the most recent year numbers are available)—

• 220,097 women and 2,078 men in the United States were diagnosed with breast cancer.*†
• 40,931 women and 443 men in the United States died from breast cancer.*†

*Incidence counts cover about 99% of the U.S. population; death counts cover about 100% of the U.S. population. Use caution when comparing incidence and death counts.

†Source: U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2011 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2014.

Additional Information

Camp Lejeune Marines and Breast Cancer: http://www.motherjones.com/environment/2012/05/camp-lejeune-marines-breast-cancer-florence-williams