Breast Cancer 101

Breast cancer is the most common type of cancer in women. While it primarily affects people who were assigned female at birth, people assigned male at birth can be diagnosed with breast cancer, too. The majority of breast cancers are ductal cancers, meaning they start in the ducts that carry milk to the nipple. There are also lobular cancers (in the glands that produce breast milk), phyllodes tumors, and angiosarcoma.

GENE MUTATIONS & BREAST CANCER

Within every cell in your body, there are genes that provide instructions to the cells, particularly on how to grow and divide. Occasionally, these genes can be abnormal or mutated, which can lead your cells to grow out of control and result in cancer. In the U.S., approximately 5-10% of breast cancers are related to a gene mutation.

What are the genetic mutations connected with breast cancer?

• BRCA 1 & BRCA 2 – You’ve probably heard of BRCA1 and BRCA2, which are inherited gene mutations that cause Hereditary Breast and Ovarian Cancer (HBOC) Syndrome. If you test positive for HBOC, you are at an increased risk of breast and ovarian cancers. However, it’s important to understand that only about 3% of all breast cancer diagnoses are caused by BRCA1 or BRCA2.

• TP53 – Inherited mutations in the TP53 gene causes Li-Fraumeni Syndrome. If you test positive, you are at an increased risk of a handful of cancers, including breast cancer. If you have Li-Fraumeni syndrome and were assigned female at birth, you have a nearly 100% chance of developing breast cancer.

TREATMENT OPTIONS

Treatment for breast cancer or as a preventative measure due to a genetic mutation and/or family history is very personalized and depends on several factors. You will typically undergo one or more of these treatments.

Surgery

Most people with breast cancer will undergo surgery at some point to remove the cancerous cells from the body or understand how advanced the cancer is. Additionally, for some people who have tested positive for a breast cancer-related genetic mutation or have a personal or family history with breast cancer, their doctor will recommend surgery as a preventative measure. Types of surgery include:

Lumpectomy

A surgeon will remove the cancerous tumor and a little bit of nearby healthy tissue, but not the entire breast. AKA breast-conserving surgery, partial mastectomy, quadrantectomy, segmental mastectomy.

Mastectomy

A surgeon will remove your entire breast. There are different types of mastectomies.

• A total mastectomy removes your entire breast, including the breast tissue, areola, and nipple.
• A skin-sparing mastectomy removes your breast tissue, areola, and nipple, but not your breast skin. If you are undergoing breast reconstruction, it can be performed immediately after a skin-sparing mastectomy.
• A nipple- or areola-sparing mastectomy removes only your breast tissue, sparing the skin, nipple, and areola. If you are undergoing breast reconstruction, it can be performed immediately after a nipple-sparing mastectomy.

Learn about your Post-Mastectomy Options here.

Radiation Therapy

Radiation therapy is usually used as an additional treatment for breast cancer and uses high-energy rays (or particles) to destroy cancer cells.

Chemotherapy

Chemo is an anti-cancer drug that is given orally and/or through an IV so that it can reach cancerous cells throughout the body. With breast cancer, chemo can be used after surgery to kill any remaining cancerous cells, before surgery to shrink the tumor size, or in metastatic breast cancer cases when the cancer has spread beyond the breast and underarm area.

Hormone Therapy

Some breast cancers are impacted by hormones, such as estrogen and progesterone, that allow the cancer to grow. Hormone therapy stops these hormones from attaching to the cancer.

AFTER BREAST CANCER TREATMENT

After breast cancer treatment, there is always a chance of recurrence where your breast cancer can come back, or a second cancer where you are diagnosed later in life with an additional type of cancer. Making healthy lifestyle choices can help prevent a second cancer from developing. Your medical team will provide you with a screening protocol to follow after treatment, which will likely include more frequent screenings to make sure the cancer doesn’t come back.