BREAST CANCER

Breast cancer, cancer that are malignant -- life-threatening-tumors -- that develop in one or both breasts.

Breast cancer is the illness that many women fear most, though they're more likely to die of cardiovascular disease than they are of all forms of cancer combined. Still, breast cancer is second only to lung cancer as a cause of cancer deaths in American women. Although rare, breast cancer can also occur in men — in the United States, more than 200,000 women and around 1,500 men will develop the disease in 2005.

Yet there's more reason for optimism than ever before. In the last 30 years, doctors have made great strides in diagnosing and treating the disease and in reducing breast cancer deaths. In 1975 a diagnosis of breast cancer usually meant radical mastectomy — removal of the entire breast along with underarm lymph nodes and skin and muscles underneath the breast. Today, radical mastectomy is rarely performed. Instead, there are more and better treatment options, and many women are candidates for breast-sparing operations.

Signs and symptoms

Knowing the signs and symptoms of breast cancer may help save your life. When the disease is discovered early, you have more treatment options and a better chance for long-term recovery.

Most breast lumps aren't cancerous. Yet the most common sign of breast cancer for both men and women is a lump or thickening in the breast. Often, the lump is painless. Other signs of breast cancer include:

• A spontaneous clear or bloody discharge from your nipple
• Retraction or indentation of your nipple
• A change in the size or contours of your breast
• Any flattening or indentation of the skin over your breast
• Redness or pitting of the skin over your breast, like the skin of an orange

A number of factors other than breast cancer can cause your breasts to change in size or feel. In addition to the natural changes that occur during pregnancy and your menstrual cycle, other common noncancerous (benign) breast conditions include:

• Fibrocystic changes. This condition can cause your breasts to feel ropy or granular. Fibrocystic changes are extremely common, occurring in at least half of all women. In most cases the changes are harmless. And they don't mean you're more likely to develop breast cancer. If your breasts are very lumpy, performing a breast self-exam is more challenging. Becoming familiar with what's normal for you through self-exams will help make detecting any new lumps or changes easier.
• Cysts. These are fluid-filled sacs that frequently occur in the breasts of women ages 35 to 50. Cysts can range from very tiny to about the size of an egg. They can increase in size or become more tender just before your menstrual period, and may disappear completely after it. Cysts are less common in postmenopausal women.
• Fibroadenomas. These are solid, noncancerous tumors that often occur in women during their reproductive years. A fibroadenoma is a firm, smooth, rubbery lump with a well-defined shape. It will move under your skin when touched and is usually painless. Over time, fibroadenomas may grow larger or smaller or even disappear completely. Although your doctor can usually identify a fibroadenoma during a clinical exam, a small tissue sample is necessary to confirm the diagnosis.
• Infections. Breast infections (mastitis) are common in women who are breast-feeding or who recently have stopped breast-feeding, although you can also develop mastitis when you're not nursing. Your breast will likely be red, warm, tender and lumpy, and the lymph nodes under your arm may swell. You also feel slightly ill and have a low-grade fever.
• Trauma. Sometimes a blow to your breast or a bruise also can cause a lump. But this doesn't mean you're more likely to get breast cancer.
• Calcium deposits (microcalcifications). These tiny deposits of calcium can appear anywhere in your breast and often show up on a mammogram. Most women have one or more areas of microcalcifications of various sizes. They may be caused by secretions from cells, cellular debris, inflammation, trauma or prior radiation. They're not the result of calcium supplements you take. The majority of calcium deposits are harmless, but a small percentage may be precancerous or cancer. If any appear suspicious, your doctor will likely recommend additional tests and sometimes a biopsy.

If you find a lump or other change in your breast and haven't yet gone through menopause, you may want to wait through one menstrual cycle before seeing your doctor. If the change hasn't gone away after a month, have it evaluated promptly.

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