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This section addresses common questions
about breast cancer and breast health. Please visit these
Imaginis sites for frequently asked questions about mammography
and breast cancer treatment.
All women are at risk for breast cancer. Risk factors that may
increase a woman’s risk for breast cancer include: age, family history, genetics, previous breast biopsy showing benign
(non-cancerous) conditions, menstruation beginning at an early age, menstruation
continuing past age 50, not having children, having a first child after age 30, and high
fat diets. However, 80% of women who develop breast cancer have no known risk factors.
Is breast cancer a
genetic disease?
Family history and genetics are only two of the risk factors associated with breast
cancer. Women who carry mutations of certain genes (such as BRCA1, BRCA2, or p53) are
at a higher risk of developing breast cancer than women with no known risk factors. As
stated earlier, 80% of women who develop breast cancer have no known risk factors.
What are the warning
signs of breast cancer?
Any change in the normal appearance or texture of a woman’s breast may be an
indication of breast cancer and should be examined by a physician. Common warning signs of
breast cancer include a lump in the breast, an abnormal thickening of the breast tissue,
or a change in density of the breast. Occasionally, breast cancer may be indicated by a
lump under the arm, a redness of the skin over the breast, a change of the nipple (such as
discharge or inversion), or a dimpling of the breast skin. Note: breast cancer is not
always noticeable by appearance or touch. Women over 40 years of age should have annual
mammograms to help detect breast cancer at an early stage. Women who are at high risk of
breast cancer (such as those who have tested positive for the BRCA1
or BRCA2 genes) or those who have a first-degree (mother or sister) who have/have had
breast cancer should ask their physicians about beginning annual mammograms 10 years prior
to the age of diagnosis of the relative—as early as age 25.
Does nipple discharge
indicate breast cancer?
Most nipple discharges do not indicate a cancerous condition. Up
to 20% of women may experience spontaneous milky, opalescent, or clear fluid nipple
discharge and up to 60% of women experience nipple discharge during breast
self-examination. Usually, if the discharge is milky, yellow, or green, it does not
indicate cancer. However, women should report any worrisome nipple discharges to their
physician for clinical examination. Spontaneous
bloody or watery unilateral discharges are considered abnormal and should be evaluated by
a physician (although only 10% of these abnormalities are usually cancerous).
Does nutrition and diet
affect breast cancer risk?
Nutrition and diet may play a role in breast cancer risk. Studies show that there is a
much higher incidence of breast cancer in areas with high fat diets (such as the United
States) than areas with low-fat diets (such as Japan). In general, women should maintain a
diet rich in fruits and vegetables and low in polyunsaturated fats (such as corn oils, tub
margarine) and saturated fats in meats to reduce their risk of breast cancer. However,
since several other factors such as genetics, socioeconomic status, and environmental
factors are often related to diet, it may be difficult to determine the relative
contributions of each factor to overall risk.
Does breast feeding
increase the risk of breast cancer?
There has been no evidence that breast-feeding causes breast cancer. In fact, some
preliminary studies reveal that breast-feeding may decrease a woman’s risk of
developing breast cancer, though this data has not yet been confirmed. Women who
breast-feed can still get breast cancer, but they are not at any increased risk compared
to women who do not breast-feed.
Does breast size affect
breast cancer risk?
There has been no conclusive evidence that breast size is related to breast cancer risk.
However, radiologists may have a more difficult time reading the mammogram of a woman with
dense breast tissue.
How can women reduce
their risk of breast cancer?
There are many breast cancer risk factors that cannot be controlled such as genetics,
early menstruation and family history. Other aspects such diet, early child-bearing, and
weight can be controlled to help reduce the risk of breast cancer. Women who maintain a
diet rich in fruits and vegetables and low in polyunsaturated fats (such as corn oils, tub
margarine) and saturated fats (such as those found in meats) may help lower their risk of
the disease. Smoking and alcohol consumption have also been linked to higher incidences of
breast cancer. Recently, the U.S. Food and Drug Administration (FDA) has approved the drug
tamoxifen for use in women at high risk of developing breast
cancer. Click here to learn more about the various risk factors
for breast cancer and for information on a new tool to help determine a woman's breast
cancer risk.
Should women performed breast self-exams?
Women may perform breast self exams to help detect changes in their breasts to call to their physicians'
attention. Performing regular breast self exams can help women become familiar with the individual
characteristics of their breasts and notice any changes. Many women find that performing a self
exam a few days to one week after their periods is easiest because the breasts are least tender
and swollen. In recent years, organizations such as the American Cancer Society have changed
their positions, no longer recommending that women perform self exams on a monthly basis. This
decision was made after several studies revealed that the exams do not increase the chances
that women will survive breast cancer. Despite the change in position, the American Cancer
Society and other organizations suggest that self exams can be performed to help detect
changes in the breasts to call to a physician's attention. Women who perform self exams
should consult a healthcare professional to determine how to correctly perform the
exam. If women learn to perform BSE correctly, they can help detect changes and bring them
promptly to a medical professional. Finding a breast cancer tumor when it is smaller
improves the chances of saving a breast by avoiding a mastectomy, and may reduce the need for chemotherapy.
It is important to remember that mammography is still the gold standard for early detection of
breast cancer. Many cancer organizations, including the American Cancer Society, recommend that every
woman 40 or older should have a mammogram every year. Unfortunately mammography misses 10% of
cancers. So, it is still important for women to have their breasts examined on a regular basis
by a healthcare professional, and perform monthly breast self-exams.
Click here for more
information on how to perform BSE.
Do young women get
breast cancer?
Though risk increases with age, young women may also get breast cancer. According to the
National Cancer Institute:
- By age 25, 1 in 19,608 women have breast
cancer
- By age 30, 1 in 2,525 women have breast
cancer
- By age 35, 1 in 622 women have breast
cancer
Women over 20 years of age should
practice breast self-examination (BSE) every month. Regardless of age, women should
promptly report any breast abnormalities to their physician. Also, young women at high
risk for breast cancer may wish to ask their physician about beginning mammograms before
age 40.
Can men get breast
cancer?
Men count for approximately 1,300 cases of breast cancer each year. It is estimated that
400 men die from the disease each year. Click here for more
information about breast cancer in men.
How is breast cancer
diagnosed?
The American College of Radiology (ACR) has established the Breast
Imaging Reporting and Database System (BI-RADS) to guide the breast cancer diagnostic
process. Often, breast cancer is first detected by mammogram. If the radiologist notices a
suspicious area on the mammogram, he or she may refer the patient for additional testing
such as diagnostic mammography, special mammography views, breast
ultrasound, MR scan, T-scan, or sestamibi. After further breast imaging, patients with suspicious
lesions may be referred for a breast biopsy to determine whether
breast cancer is present.
How many women develop
breast cancer?
In 2005, the American Cancer Society estimates that 211,240 women in the United States will
be diagnosed with invasive breast cancer. About 40,410 women will die from the disease this year.
How common are breast
lumps?
Many women develop breast lumps. In general, 80% of lumps are caused by benign
(non-cancerous) changes in the breast. This percentage tends to fluctuate with age. For
young women, more than 80% of breast lumps are benign. As a woman ages, her risk for
breast cancer increases. The percentage of benign breast lumps in older women may be much
lower than in younger women. It is still important for women to report any breast
abnormality to their physician, especially if it persists after two or more menstrual
cycles. Click here for to learn more about breast
changes and warning signs for breast cancer.
Who should get a
mammogram?
All women over 40 years of age should have a mammogram each
year. Woman at a very high risk of breast cancer (such as those have tested positive for
the BRCA1 and BRCA2 breast cancer genes) should speak with their physician about beginning
annual mammograms as early as age 25. Click here to view
frequently asked questions about mammography.
What is the difference
between a benign breast condition and breast cancer?
A benign breast condition is any non-cancerous breast abnormality. The most common
benign breast conditions include fibrocystic change, benign breast tumors, and breast
inflammation. Most benign breast conditions such as fibrocystic change or fibroadenomas (small tumors) do not increase a
woman’s risk for breast cancer later in life. However, lobular
carcinoma in situ (LCIS) and atypical hyperplasia (dangerous increase in number of
breast cells) have been identified as markers for breast cancer.
Does taking hormone
replacement therapy after menopause increase the risk of breast cancer?
The link between hormone replacement therapy (HRT) and breast cancer
is controversial. While HRT is highly effective at relieving menopausal symptoms and may
provide protection against conditions such as osteoporosis, there is some evidence that
supports a link between HRT and an increased risk for breast cancer. In July 2002, the
National Institutes of Health halted a large study on HRT, called the Women's
Health Initiative, because the combined estrogen/progestin regimen of the therapy was
found to cause 8 cases of invasive breast cancer for every 10,000 women on
HRT (a 26 percent increase in breast cancer risk compared to women who
do not take HRT). Despite this finding, research on HRT continues to be conflicting.
For most menopausal and post-menopausal women considering HRT, the treatment is a tradeoff between
the proven benefits of relieving menopausal symptoms and preventing diseases such as
osteoporosis versus the possibility of increasing the risk of breast cancer. If a woman
is at high risk of osteoporosis (due to age, family history, small build, etc.) and has
a relatively low risk of breast cancer, then HRT may be an easy choice. If a woman
is already at high risk of breast cancer due to genetic factors, family history, etc. then
the decision to take HRT may be more complicated. At the moment, the best advice experts
can give is for women to discuss the benefits and risks of HRT with their physicians and make informed choices.
Updated: October 30, 2008
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