Community's dedicated breast surgeons
Certified breast surgeons
Four of our breast surgeons—Dr. Goedde, Dr. Goulet, Dr. Kim and Dr. Thepjatri—are MD Anderson Cancer Network™ certified physicians with access to evidence-based guidelines and treatment plans from MD Anderson. Learn more >>
If you have been diagnosed with breast cancer, you will likely need to see a surgeon for further testing or treatment consultation. At Community Health Network, our expert breast surgeons devote their full-time practice to breast health. Learn more >>
Breast health navigators
Whether you have questions about your mammogram or need support following your breast cancer diagnosis, Community's breast health specialists are there for you as a resource and advocate. Learn more >>
About breast cancer
Although breast cancer has been surpassed by lung cancer as the leading cause of cancer deaths among American women, breast cancer remains the leading cause of non-preventable cancer deaths. There is an average risk of developing breast cancer of approximately 1 in 9 for a woman by the age of 85.
Breast cancer is not a single disease process. It has numerous variations. Furthermore, the outcome for an individual is determined not only by the cancer, but by the individual's response to the carcinoma (cancer).
Most breast cancers, about 90%, arise in the ducts. The earliest manifestation is "ductal carcinoma in situ", or DCIS. It is confined to the duct (therefore non-invasive), and can first appear as extremely tiny specks or calcifications on a mammogram. Though the exact numbers are not certain, it is felt that DCIS will progress to invasive cancer in at least 30 to 50% of women.
The only way that breast cancer can kill is though metastasis (spread outside of the breast). It becomes lethal when it gains the capability of breaking out of the duct and invading the surrounding tissue, gaining access to blood and lymphatic systems through which it can spread to other organs and destroy their function. But even invasive breast cancer can be successfully treated, if caught early enough on mammography or by breast exam. Invasive ductal carcinoma can appear as a lump, nodule, ill-defined density, or distortion on mammography, with or without calcifications.
Another less common variety of breast cancer is lobular cancer. These make up less than 10% of all breast cancers. They begin in the lining of breast lobules (glands) that are located at the ends of ducts. Invasive lobular breast cancer is as threatening as invasive duct cancer, but unfortunately it grows in a way that very often does not show up on a mammogram or a breast ultrasound. This is one reason why worrisome findings on breast self-exams or physical exams should not be ignored, in spite of a normal mammogram.
Lobular carcinoma in situ or LCIS is generally not felt to be a pre-invasive cancer. Rather, it is a significant indicator of increased risk for the development of invasive ductal or lobular cancer that can occur in the same or opposite breast. It is usually found incidentally, not because of a physical finding or finding on mammography.
Signs and symptoms of breast cancer
- Feeling a lump in your breast
- Asymmetric appearance of the breast
- Thickening, dimpling, or retraction of the skin
- Nipple retraction or inversion
- Bloody or clear discharge from the nipple
Risk factors for breast cancer
- Family history of developing breast cancer
- A previous breast cancer in the same or opposite breast
- History of abnormal breast cells on previous biopsy
- Starting menstruation early (before 12)
- Late menopause (after 51)
- No children or later in life pregnancy (first child after 35)
- Obesity ("apple-shaped" women)
- High-fat diet
- Alcohol consumption (two or more drinks a day)
- Artificial hormones
Early detection of breast cancer
Discovering breast cancer at a smaller size and earlier stage reduces the number of women who die each year from breast cancer. Three types of screenings are important, working hand in hand together. These are breast self-exam, physical exam by your doctor and mammography. No one method is perfect, and women should not rely on just one, hoping they can skip the others.
- Perform breast self-examinations regularly, usually about 10 days after the onset of a menstrual cycle, when tenderness and fluid retention in the breast is the least. If you are no longer having periods, pick a day you can remember, like the first of each month.
- Make sure that a breast exam done by a physician or nurse practitioner is included in your annual physical exam.
- Follow recommended guidelines for mammography. Women should have a baseline mammogram between the ages of 35-40 and annual mammography after age 40. Women with a family history of pre-menopausal breast cancer in a mother or sister should begin screening mammography at an age 10 years younger than the age of their relative's diagnosis.