Breast Cancer

Condition

If you have breast cancer, you need more than just medical care. You need support and encouragement from health care professionals who understand your fears – and will help you overcome them. Mercy provides seamless breast cancer care in a compassionate environment, helping you on your journey to treatment and healing. Mercy offers a healing environment, providing everything our cancer patients and their families need physically, emotionally and spiritually.

What is Breast Cancer?

Breast cancer is one of the most common cancer in women in the United States and is caused by the abnormal growth of breast cells. Breast cancer can take several forms, and knowing the type of breast cancer you have helps Mercy doctors provide the most effective treatments.  

There are many types of breast cancer. Each one develops differently and responds to treatments differently. Breast cancer can either be categorized as invasive or non-invasive (in situ).

Ductal Carcinoma in Situ (DCIS)

DCIS is non-invasive breast cancer that begins in the cells that line milk ducts, but it’s contained and hasn’t spread to surrounding breast tissue.

Invasive Ductal Carcinoma (IDC)

IDC is the most popular type of breast cancer. It begins in the milk duct lining and spreads to surrounding breast tissue. This type of breast cancer can spread further through the blood and lymph systems.

Lobular Carcinoma in Situ (LCIS)

LCIS begins in the milk glands (lobules) and is noninvasive cancer.

Inflammatory Breast Cancer (IBC)

Inflammatory breast cancer is a fast and aggressive type of breast cancer in which the cells block the lymph vessels. IBC causes breasts to be red, swollen and warm. Breast skin may also be pitted (like an orange). IBC generally grows rapidly and requires aggressive treatment.

Triple-Negative Breast Cancer (TNBC) 

A diagnosis of TNBC means cancer cells lack the three most common receptors known to fuel breast cancer growth:  estrogen, progesterone and human epidermal growth factor receptor 2 (HER2). Without these receptors, common breast cancer treatment methods aren’t as effective. The stage and grade of TNBC will influence treatment plans.

Hormone Receptor-Positive

About 80% of all breast cancer types are hormone receptor-positive, also called ER-positive. ER-positive breast cancer is much more likely to respond to hormone therapy than other types of breast cancer.

HER2-Positive

Breast cancer cells have too many HER2 receptors, making them grow and spread quickly. Treatments may target HER2-positive cells.

Metastatic Breast Cancer

Metastatic breast cancer is that has spread from the place it began in the breast to other parts of the body, usually including the lungs, liver and bones. Metastatic breast cancer is stage 4 cancer.

Male Breast Cancer

Less than 1% of breast cancer cases occur in men. Male breast cancer most often affects men between ages 60-70. Invasive ductal carcinoma is the most common type of male breast cancer while less-common types include ductal carcinoma in situ, inflammatory breast cancer and Paget’s disease of the nipple—rare cancer in the skin of the nipple and areola.

Breast cancer is caused by the damaged of normal breast cells resulting in abnormal cell growth. Some DNA changes are inherited or passed on to you by your parents. But many of the DNA changes linked to breast cancer are acquired, meaning they take place during your life over time. Certain risk factors, such as gender, age and genetics, are strongly linked to breast cancer and women who have them are at higher risk to develop breast cancer. 

Gender & Age

Women are 100 times more likely than men to develop breast cancer. Men can also be diagnosed with breast cancer, but it’s rare. Your risk also increases with age, and breast cancer is more common in women over age 50.

Family History & Genetics

If a close relative had breast, uterine, ovarian or colon cancer, your risk may be increased. Share any family history of cancer with your Mercy doctor. Having certain genes also increases your risk. The two genes most linked to breast cancer are BRCA1 and BRCA2. If you test positive for these genes, you’ll need to be screened for breast cancer more often and at a younger age.

Menstrual History

Women who get their periods at an early age (before age 12) or enter menopause late (after age 55) have an increased breast cancer risk.

Dense Breasts

Women whose breasts have more fibrous than fatty tissue are more prone to breast cancer. And dense breasts can make it hard to see cancer on mammograms.

Lifestyle Habits

Drinking alcohol, being overweight or physically inactive, never having children and using hormone therapy after menopause also affect your breast cancer risk.

Breast cancer affects people differently, and some don’t experience symptoms. Younger women may ignore breast cancer symptoms, believing they’re too young to get breast cancer. Unfortunately, this delays diagnosis and can lead to poorer outcomes. All women should be aware of the warning signs associated with breast cancer. Signs and symptoms can include:

  • A new lump in the breast or armpit
  • Thick or swollen breasts
  • Irritated or dimpled breast skin
  • Red or flaky skin on the breast or nipple
  • Nipple pain or inverted nipple
  • Nipple discharge other than breastmilk (including blood)
  • Changes in breast size or shape
  • Pain anywhere in the breast

Breast Cancer Screening

Screening tests and exams help detect breast cancer earlier when it’s easier to treat. There are several types of breast screening including mammograms, self-exams and clinical breast exams. Beginning at age 19, women should perform regular breast self-exams and have a clinical breast exam by a Mercy doctor or Mercy OB/GYN annually. Clinical breast exams help detect lumps, pain or other changes in the breast and are an important part of early detection.

Breast Cancer Screening Guidelines

The American College of Obstetricians and Gynecologists (ACOG) recommends the following screening guidelines for breast cancer:

  • Annual mammograms are recommended for women between the ages of 40 - 74 and who have no family history of breast cancer.
  • Women with a family history of breast cancer should start screening before age 40.
  • Healthy women ages 75 and older should continue to get mammograms if they’re in good health and are expected to live 10 years or longer.

Discussions on Breast Cancer Risks & Detection

Breast Cancer Diagnostic Tests

If you or a loved one is facing a diagnosis of breast cancer, you need a team of experts to help you through your next steps. Mercy’s multispecialty team of physicians and breast cancer specialists provide advanced diagnostic and treatment services, and a community of support. You may be diagnosed with breast cancer after routine breast screening or you may have symptoms that you've seen your primary care provider about. Whether you've suspected breast cancer because of signs or because a routine breast screening has shown an abnormality, you'll be referred to a specialist for further tests.

Imaging is used to diagnose as well as evaluate the stage and extent of breast cancer. Three imaging methods are used to detect breast cancer:  mammography, ultrasonography and breast magnetic resonance imaging (MRI).

Mammography

In addition to screening mammograms, Mercy provides 3D mammography, which provides more detailed breast images at several angles. It’s especially effective for women with dense breast tissue and other risk factors.

Ultrasonography

Also known as a breast ultrasound, this exam may be used along with mammography or MRI.

Breast MRI

breast MRI is used to help determine the extent of breast cancer. Not every patient diagnosed with breast cancer needs a breast MRI.

breast biopsy is performed when cancer is suspected during a mammogram, clinical breast exam or other imaging tests. Mercy offers several types of biopsy to detect breast cancer.

If you have a strong family history of breast cancer or you’ve been diagnosed yourself, your Mercy doctor may recommend genetic counseling or testing. Breast cancer genetic testing lets you know if you’ve inherited genes linked to breast cancer risk.

Breast Cancer Treatment Options

Mercy physicians and breast cancer specialists treat women and men with all types and stages of breast cancer. Your cancer team may consist of a combination of one, or all, of the following providers as well as a host of support specialists and services to help you through your journey:  a navigator, surgeon, medical oncologist and radiation oncologist.

Our personalized care addresses your needs in body, mind and spirit. Depending on your age, along with the type and stage of your cancer, your breast cancer treatment plan may include one or more of the following treatment options.

Local therapy treats a specific (local) area of breast cancer without affecting the rest of the body. Local treatment for breast cancer typically includes surgery, which is sometimes followed by radiation therapy to the breast and nearby lymph nodes.

Breast Cancer Surgery

The most common form of treatment for breast cancer is surgery. There are two main types of surgery to remove breast cancer breast-conserving surgery and mastectomy. Mercy also offers breast reconstruction procedures that can be performed at the same time as lumpectomy or mastectomy in some cases.

  • Breast-conserving surgery (BCS) - BCS surgery, also referred to as lumpectomy, quadrantectomy, segmental mastectomy or partial mastectomy, involves removing breast cancer while leaving as much healthy breast tissue as possible. This type of surgery is generally followed by radiotherapy and/or other therapies.

  • Mastectomy - is the surgical removal of the breast, including the breast tissue and nearby tissue in some cases. There are several different types of mastectomies that depend on the amount of tissue that is removed and how the surgical approach.

  • Lymph node surgery - is a procedure to remove lymph nodes to determine whether or not cancer has spread beyond the breast, such as to nodes under your arm or around your collarbone and neck. There are two main types of surgery to remove lymph nodes:  sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND).

Radiation therapy

Radiation therapy uses high-energy rays to destroy cancer cells and is used in many different situations for women with breast cancer. There are two main types of radiation often used to treat breast cancer:  external beam radiation therapy (EBRT) and brachytherapy.

Systemic therapies are medicines that travel throughout the body to treat cancer and can be administered orally or directly via the bloodstream. Different types of drug treatment may be used depending on the type of breast cancer. Systemic treatments for breast cancer include chemotherapy, hormone therapy, targeted therapy and immunotherapy. 

Chemotherapy

Chemotherapy is used to treat all stages of breast cancer, including recurrent and metastatic breast cancer. Not all breast cancer patients will benefit from chemo, however, there are several cases when it may be recommended such as before surgery (neoadjuvant chemotherapy), after surgery (adjuvant chemotherapy), and for advanced breast cancer.

Hormone Therapy

Hormone therapy, also known as hormonal therapy, hormone treatment and endocrine therapy, slows or stops the growth of hormone-sensitive cancers. It does by hormone production or interfering with hormone receptors on cancer cells. It is more targeted than chemotherapy. For example, anti-estrogen therapy blocks the estrogen stimulation of cancer cells.

Targeted Cancer Therapies

Targeted cancer therapies are treatments that target and act on specific molecules (molecular targets) that help cancer grow and spread. Targeted therapies are very focused and work differently than chemotherapy treatments for breast cancer. An example of targeted therapies used is anti-HER2 therapies which target the HER2 protein on cancer cells.

Immunotherapy

Immunotherapy also called biologic therapy, is the use of medicine to help the immune system recognize and attack cancer cells. It can work in different ways, either by boosting immunity or changing how it functions. Immunotherapy can be used to treat some types of breast cancer but not all.

Nurse Navigators

At Mercy, you’ll have a breast cancer nurse navigator to guide you throughout your care. Nurse Navigators explain tests and treatments, make referrals to oncology specialists and surgeons, provide educational materials and connect you with support resources.

Discussions on Breast Cancer Treatment

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