What is Breast Cancer?
In the U.S., breast cancer is the second most common cancer in women after skin cancer; 1 in 8 women will develop breast cancer in her lifetime. Breast cancer can occur in both men and women, but it is rare in men. Each year there are about 100 times more new cases of breast cancer in women than in men.
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. Ductal carcinoma in situ is a condition in which individual cancer cells are found in the lining of the ducts but they haven’t spread outside the duct.
Breast cancer cells that have clumped together to form a mass is called invasive or infiltrating breast cancer. Invasive breast cancer has the potential to spread, but just because the cancer cells have joined to form a mass does not necessarily mean that it has spread to the lymph nodes or other areas of the body.
Inflammatory breast cancer is a very rare and aggressive form of breast cancer in which the breast looks red and swollen and feels warm because the cancer cells block the lymph vessels in the skin.
Breast Conditions We Treat
Benign Breast Disease
- Paget’s Disease of the Breast
- Ductal Carcinoma In Situ
- Lobular Carcinoma In Situ
- Invasive Ductal Carcinoma
- Invasive Lobular Carcinoma
- Inflammatory Breast Cancer
- Male Breast Cancer
- Genetic Predispositions to Cancer (BRCA+ and others)
- Family History of Breast Cancer
- High Risk Screening
Breast masses or lumps can be caused by many things including cysts, normal dense breast tissue, benign (noncancerous) tumors such as fibroadenomas and most phyllodes tumors, hematomas (or bruising from trauma), and cancers. Since there are so many causes for breast lumps, it is important to check your breasts each month for changes and report any changes to your doctor right away. Often a lump will be checked by physical examination and a mammogram and/or ultrasound. This will help determine the treatment needed.
Breast pain is very common. There are many different causes for breast pain. Most often it is caused by hormonal stimulation of the glandular tissue in the breast. Pain can change over time along with the menstrual cycle (called cyclical pain). Other causes for breast pain include infection, trauma, and less commonly cancer. Common treatments for breast pain include cutting down on caffeine intake, low-fat diet, some herbal supplements, and oral evening primrose oil. Breast pain with redness of the breast and/ or fever, or breast pain that does not go away or is associated with a lump should always be reported to your doctor.
The most common type of nipple discharge is physiologic due to the lining of the milk duct shedding cells, just like our dry skin or hair. Physiologic discharge can be white, yellow, green or black. It is usually from both nipples. Other common causes of nipple discharge include cysts, hormonal imbalance, papillomas (growths in ducts), and ductal carcinoma in situ. New nipple discharge should always be reported to the doctor especially if it is from one side, happens spontaneously, and is clear or bloody. Often the first steps in determining the cause for the discharge include a physical examination and imaging such as a mammogram, ultrasound and possibly MRI. Treatment is based on clinical and imaging findings and can include observation, follow-up imaging, biopsy and in some cases surgery.
Gynecomastia is enlargement of one or both male breasts. This is common and can be seen in up to 66% of elderly men. It can be caused by certain medications, drug use, alcohol use, liver disease, and diseases such as testicular insufficiency as well as renal disease and hyperthyroidism. Sometimes the cause is unknown. Sometimes the swelling of the breast can be painful. Men with new onset gynecomastia should discuss the condition with their doctors to determine if any workup is needed. Sometimes blood work and/or imaging can be done to confirm the diagnosis. Often treatment is symptomatic. If there is significant enlargement of the breast sometimes surgery is indicated.
Fibrocystic breast disease:
Fibrocystic breast disease is a term used to describe dense glandular breasts that have frequent cysts that come and go. It is very common especially in young women. The breasts feel hard and lumpy sometimes like a bag of pebbles. It can cause breast pain or tenderness that changes with the menstrual cycle. It is very important to do self breast exams if you have fibrocystic breast disease because physical examination is difficult. The more familiar you are with your breast, the better you will be able to detect a change. Remember to report all changes to your doctor.
Mastitis is an infection of the breast tissue. It can happen during breast feeding (most commonly). If it happens when the patient is not breast-feeding, we often check for a cause for the mastitis. This is usually done with imaging of the breast such as a mammogram, ultrasound or MRI. The imaging can also check for an abscess (collection of pus) that may need to be drained or aspirated. Often mastitis is treated with antibiotics, warm compresses, support of the breast, and pain medicine as needed. If mastitis happens while breast-feeding, it is important to continue feeding or pumping to empty the milk from the breast.