Presented by: Lillian Erdahl, MD
Learning Objectives What is Breast Cancer Types of Breast Cancer Risk Factors Warning Signs Diagnosis Treatment Options Prognosis
What is Breast Cancer? A disease that causes cells in the breast to grow out of control and create a mass of tissue, a tumor. Most common form of cancer found in women in the United States. Also occurs in men but much less frequently. Different types of breast cancer develop depending on the type of breast cells giving rise to them.
Breast Anatomy Lobules Glands that produce milk. Ducts Tubes that carry milk to the nipple. Connective Tissue Surrounds and holds everything together (fibrous and fatty tissue).
Types of Breast Cancer Invasive Ductal Carcinoma Starts and spreads from the milk duct. Invasive Lobular Carcinoma Starts and spreads from milk-producing lobule. These are most common forms of breast cancer.
Risk Factors for Breast Cancer Age most occur in women over the age of 60 Early menstrual period women who start periods before age 12 due to longer hormone exposure Late or no pregnancy first pregnancy after 30 or never having a full-term pregnancy Starting menopause after age 55 longer exposure to hormones Having dense breast tissue Being obese or overweight
Risk Factors cont. Family history of breast cancer having a first degree relative (mother, sister, daughter) diagnosed with breast cancer doubles your risk Previous treatment using radiation therapy Alcohol use increases with greater weekly intake Combination hormone therapy* taking hormones to replace missing estrogen & progesterone during menopause for more than 5 years Not being physically active
Reduce Risk of Breast Cancer Maintain a healthy weight Exercise regularly Limit alcohol consumption Avoid exposure to carcinogens Limit radiation exposure CT scans, X-rays, PET scans Ask doctor about hormone replacement therapy and birth control risks Breastfeed children if possible
Breast Cancer Warning Signs Lump in breast or underarm Thickening or swelling of part of the breast Irritation or dimpling of breast skin Redness or flaky skin in the nipple area Nipple discharge other than breast milk Any change in breast size or shape Breast pain
Diagnosis Breast Exams Clinical Breast Exam Women in 20s and 30s every 3 years Women 40 and older every year High risk women, every 6 months Breast Self-Exam and Breast Awareness Women should know how their breasts normally look and feel to notice any changes Visual inspection note any changes in contour or texture Manual inspection note any lumps and thickness
Diagnosis Mammograms Effective screening method Low-dose x-rays to take picture of the breast Can help catch breast cancer tumors in early stages Frequency Depends on risk factors
Diagnosis Other Imaging Techniques Magnetic Resonance Imaging (MRI) Performed in addition to mammogram screening For women at high risk Genetic mutations or strong family history of breast cancer Personal history of radiation therapy or high risk lesion Women who have previously had breast cancer in one breast to detect hidden tumors in other breast May be more likely to find benign lesions or false positive Ultrasound Used if mammogram or MRI suggests abnormalities Can help locate a mass in biopsy procedure
Diagnosis Biopsy Performed if something suspicious is found with ultrasound, mammogram, or MRI A small piece of the breast is removed and sent to a laboratory for examination A small clip is left behind to mark the site for future medical care
Treatment 3 main treatments: surgery, radiation, drug therapy Usually use a combination of treatment options Factors determining treatment: Age, menopausal status, cancer stage, location of tumor Local treatment Directly treats the tumor Surgery & radiation Systemic treatment Affects the whole body Drugs: chemotherapy, hormone therapy, targeted therapy
Lumpectomy Surgery to remove the tumor plus small amount of normal tissue surrounding it If cancer is present in surrounding tissue, additional tissue may need to be removed Radiation therapy is usually given during or after surgery to prevent cancer from coming back Best for small tumors or in women with small tumor relative to breast size
Mastectomy Total (simple) Mastectomy Removal of whole breast. Modified Radical Mastectomy Removal of breast and axillary lymph nodes Surgery to remove the entire breast Radical Mastectomy Removal of breast, axillary lymph nodes, and chest wall muscles.
Lymph Node Dissection Surgery to look for spread of cancer to lymph nodes Sentinel Lymph Node Dissection removal of 1 or a few lymph nodes to check for cancer spread Axillary Lymph Node Dissection removal of the lymph nodes under the arm when there is spread of breast cancer
Prognosis New and better treatments are helping people diagnosed live longer More than 2.8 million breast cancer survivors Factors: Stage of cancer Type of breast cancer Rate of cell growth Your age and general health Tumor size and shape Hormone-receptor status of cancer
Thank you! Locations: University of Iowa Hospitals and Clinics UI Health Care Iowa River Landing Schedule an Appointment: Meet your Primary Care Provider Breast Imaging Center (319)356-4369 Cancer Clinic (319)356-4200 Breast Clinic at IRL (319)467-2000