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Breast & Ovarian Cancer Risk

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BREAST & OVARIAN CANCER RISK

What Is Breast Cancer?

Breast cancer is not exclusively a female issue. Men get breast cancer as well, just at a lower frequency. However, understanding what cancer is and what makes someone at high risk for cancer can make it easier for to understand your personal risk and find screening and prevention strategies that are right for you.

Where Does Breast Cancer Begin?

All cancers begin when some cells change and experience out-of-control growth. Eventually, these cells gain the ability to invade surrounding tissues. In the case of breast cancer, this change can occur in any of the tissues that make up the breasts.

Even before breast cancer develops, a number of noncancerous changes can occur to cells that may increase a woman's chances of developing breast cancer. These are called "marker" conditions because they mark a location that may become cancerous in the future.

Different Types of Breast Cancer

Breast cancers are not all alike. They can start in any tissue of the breast, and each type of breast cancer has distinct symptoms and prognosis.

Most types of breast cancer start in the ducts, but a smaller percentage start in the lobules and even fewer start in other tissues of the breast.

Breast cancers are named after their unique characteristics. For example, breast cancers that arise from epithelial cells are called carcinomas. Cancers arising from the stroma (supporting fibrous breast tissue) are called sarcomas.

Some types of breast cancer are named based on where the disease began, such as invasive ductal carcinoma. Others are named for their appearance under a microscope. For example, tubular carcinoma appears as tube-shaped cells under the microscope.

Invasive (or infiltrating) ductal carcinoma. This accounts for 70 percent of all breast cancers. It is the most common type of breast cancer. It begins inside the duct, then penetrates the duct's wall to reach the fatty tissue of the breast. From there, it has the potential to spread (or metastasize) to other parts of the body through the lymphatic system and bloodstream.

Invasive (or infiltrating) lobular carcinoma. This is the second-most common breast cancer. It accounts for 9 to 10 percent of all breast cancers. It begins in the terminal ducts of the milk-producing glands.

Medullary carcinoma. While these account for only 3 to 6 percent of all breast cancers, medullary carcinomas are more common in women with a genetic predisposition to breast cancer. In fact, studies have found that they account for 13 and 19 percent of all cancers in women who carry a BRCA1 mutation. In BRCA2 mutation carriers, 3 percent of the breast cancers are medullary carcinomas. In this type of cancer, the border between the cancer tissue and the normal tissues is relatively well-defined. Generally, the prognosis for women with medullary carcinoma is better than for women with other types of invasive ductal or lobular carcinoma.

Paget's disease. This unique cancer accounts for only 3 percent of all breast cancers. It involves the nipple and areola, and is often associated with abnormal scaling and redness of the skin in these areas. Women may also have burning or itching. Paget's disease may be associated with in situ or invasive cancer. If a biopsy shows there is no lump or evidence of ductal carcinoma in situ, the prognosis for this cancer is very good.

Inflammatory breast cancer accounts for approximately 1 percent of all breast cancers. It is named after its characteristic initial symptoms, which include redness, warmth, and swelling of the skin of the breast—often without a distinctive lump. These symptoms,have the appearance of an infection or inflammation but are caused by cancer cells blocking lymph vessels or channels in the skin over the breast.

Other rare forms of cancer and variants of invasive ductal carcinoma. Mucinous, or colloid, carcinoma accounts for 3 percent of breast cancers and is more common among older women. Tubular carcinoma and papillary carcinoma each represent around 1 percent of breast cancer diagnoses. Both mucinous and tubular carcinomas have a better prognosis than the more common type of invasive ductal or lobular breast cancer. Adenocystic breast cancer and carcinosarcoma breast cancer are even more rare form of cancers, accounting for 0.4 percent and 0.1 percent of all cases, respectively.