The iconic pink ribbon: You would be hard-pressed to find someone who doesn’t know what it symbolizes, and there’s a reason. Aside from skin cancers, breast cancer is the most commonly diagnosed cancer among American women and the most common cancer globally, accounting for 12.5 percent of annual diagnoses. It is a complex disease originating in the breast tissue that occurs when abnormal cells within the breast multiply and grow uncontrollably.

In the United States, it is the second leading cause of cancer death in women, accounting for 1 in 3 of all newly diagnosed women’s cancers annually. Over 43,000 American women are expected to die from the disease each year.

Anatomy of the Breast

The breast comprises three main kinds of tissues: glandular, ductal, and connective. Breasts also contain lymphatic tissue. How breast cancer is categorized depends on where it originated.

The breast is comprised of the following tissues:

• Glandular: This tissue makes up the part of the breast responsible for milk production and secretion. It contains milk-producing structures called lobes, made up of smaller lobules. The lobes connect to the nipples by a series of ducts.
• Ductal: Ductal tissue comprises a tight network of tiny tubes known as ducts. These carry milk from the lobules to the nipple. Due to the highly changeable nature of these cells, it is here that breast cancer often develops.
• Connective: The breast’s connective tissues are the glue that holds everything together. Connective tissue comprises fatty and fibrous components and supports the glandular and ductal tissues.
• Lymphatic: The lymphatic tissue acts as a drainage system that clears waste products and excess fluids from the breast. The lymph nodes located under the arm are critical to diagnosis.

What Are the Common Types of Breast Cancer?

Breast cancer has many different types, but four are the most common. Knowing the differences between types can help individuals and health care professionals come to a diagnosis and outline a treatment plan.

Many types of breast cancer mention “in situ,” which means “in the original place.” Below are some of the most common types of breast cancer:

• Lobular carcinoma in situ (LCIS): This type is not actually cancerous. Instead, it indicates the presence of noninvasive abnormal cells that originated in lobular tissue. LCIS does not typically form a mass of cells or invade surrounding tissues. Having LCIS is considered a risk factor for developing breast cancer in the future.
• Invasive lobular carcinoma (ILC): The second most common type of breast cancer, ILC starts in the lobules and can spread to other tissues. ILC usually grows linearly, and so does not necessarily form a lump, making it harder to detect.
• Ductal carcinoma in situ (DCIS): The most common form of noninvasive breast cancer, DCIS remains confined in the milk ducts. If left untreated, it can progress to invasive ductal carcinoma.
• Invasive ductal carcinoma (IDC): IDC is the most common breast cancer in both women and men. It begins in the milk ducts and then spreads to surrounding breast tissues. There is a high risk of this type of cancer spreading to other areas of the body.

Lesser-known or rare types of breast cancer include:

• Paget’s disease of the breast: This rare form of breast cancer starts in the nipple and typically advances to the areola (the circle of skin around the nipple). It most often results from underlying ductal carcinoma.
• Medullary and mucinous carcinomas: Both of these rare cancers typically form palpable lumps and have a favorable prognosis. While mucinous carcinoma can form anywhere, it most often appears in the breast and is called colloid carcinoma.
• Inflammatory breast cancer: Easily mistaken as a breast infection, this rare type comes on rapidly and makes the breast red, tender, and swollen.

What Are the Symptoms and Early Signs of Breast Cancer?

Early detection of breast cancer significantly improves treatment outcomes. This is why it is so important to know and understand what to look for regarding this disease’s early signs and symptoms.

These early signs include:

• A change in the size, shape, or appearance of the breast.
• Redness of the breast skin.
• Pitting or dimpling of breast tissue, especially around the nipple.
• A lump in the breast, underarm, or collarbone area.
• An inverted nipple where there was none before.
• Changes in the color and consistency of the tissue surrounding the areola or nipple.
• Abnormal nipple discharge.
• Nipple or breast pain.
• Swollen lymph nodes beneath the arm or around the collarbone.

Any changes in one or both breasts warrant visiting your health care provider.

What Causes Breast Cancer?

Though researchers still have more to understand regarding the exact mechanisms behind breast cancer development, a complex link between genetics and environment is thought to be a primary driver. Only about 1 in 10 cases of breast cancer is linked to known inherited genes, but many genes that could also contribute to this disease remain to be discovered.

What Are the Mechanisms Behind Breast Cancer?

The human body is made up of trillions of cells. These cells work together harmoniously to keep the body in homeostasis, or internal balance. Cells age, and old ones naturally die and are replaced by new ones. This is a process known as cellular regeneration.

Breast cancer develops during the following process:

1. Genetic change at the cellular level: These mutations can be inherited from one’s parents or occur spontaneously.
2. Rapid cell division: Next, rapid division and growth of damaged cells begin. Changes within the DNA’s structure disrupt the cells’ normal growth constraints, and the division of the defective cells becomes unstoppable.
3. Tumor formation: A tumor composed of damaged cells begins to form and grow within the breast tissue. In breast cancer cases, it is most common for these rapidly growing cells to formulate tumors in lobular or ductal tissues. Breast tumors can also be classified as invasive or noninvasive depending on whether they have spread to surrounding tissues.
4. Invasion of surrounding tissues and metastasis: Invasive breast cancer occurs when cancer cells break through the walls of the lobules or ducts, infiltrating the surrounding tissues. If left untreated, invasive breast cancer has the potential to spread to other areas of the body via the lymphatic system or bloodstream. This is known as metastasis.

What Are the Stages of Breast Cancer?

Breast cancer develops in stages. Knowing these stages is vital in mapping out a treatment plan with your health care providers. Once breast cancer has been diagnosed, the next step is determining how much the cancer has spread. This complex process is known as staging. Factors used in staging include tumor size, lymph node involvement, spread (metastasis to distant sites), hormone receptors of the cells, and appearance (grade) of the individual cells.

Examples of breast cancer staging include:

• Stage 0: The cancer has been detected at its earliest stage. It has stayed where it originated (in situ) and has not yet spread.
• Stage 1: The cancer has broken free from its place of origin to the surrounding tissue or even to a nearby lymph node. A tumor may have started to form, or there may still only be small separate cancer cells. Depending on tumor size and spread, this stage can have substages 1A and 1B.
• Stage 2: The cancer has grown, spread, or both. The existing tumor is between 2 and 5 centimeters, and there may be cancer cells in two or three adjacent lymph nodes. Depending on tumor size and spread, this stage can also have substages 1A and 1B.
• Stage 3: This stage has three distinctions:
  • Stage 3A: The tumor is larger than 5 centimeters, and cancer cells have spread to one to three axillary lymph nodes (in the armpit) near the breast bone. Alternatively, there may be no tumor, but cancer cells present in four to nine axillary lymph nodes or lymph nodes near the breast bone.
  • Stage 3B: The cancer has spread to the chest wall or the skin of the breast.
  • Stage 3C: The tumor may be any size and have spread to the skin of the breast, causing an ulcer or swelling. Cancer may have also spread to the chest wall. The cancer may also be present in 10 or more axillary lymph nodes.
• Stage 4: The cancer has spread outside the breast and has traveled to distant lymph nodes or other parts of the body.

Who Is More Likely to Develop Breast Cancer?

The development of breast cancer is influenced by many different factors, which include:

• Gender: Breast cancer is predominantly found in women.
• Family history: Having a first- or second-degree relative with breast cancer dramatically increases the risk of developing the disease. First-degree relatives include mothers, sisters, and daughters.
• Genetics: According to the American Cancer Society, about 5 to 10 percent of breast cancers can be traced to genetic mutations in BRCA1 and BRCA2 genes. These mutations are passed down from one’s father or mother. About half to 72 percent of women who inherit one of the harmful mutations of these genes will develop breast cancer by their 70s or 80s.
• Hormonal factors: Two of the main female hormones are estrogen and progesterone. These both can significantly contribute to the development of breast cancer when out of balance. Estrogen dominance (when estrogen is found in too high a concentration in the body) elevates a woman’s risk for developing the disease.
• Endocrine-disrupting chemicals (EDCs): These ubiquitous chemicals are known to contribute to breast cancer development. Exposure can occur through contact with cookware, plastics, and everyday hygiene products. Endocrine disruptors block estrogen receptors, increasing free estrogen in the body. Common EDCs include dioxins, plastics, parabens, pesticides, and phthalates.
• Lifestyle and environmental factors: Lack of physical activity, smoking, and high rates of alcohol consumption can all contribute to the development of breast cancer.
• Stress: Stress plays a key role in the development of many disease processes, including breast cancer. Stress causes the body to produce high levels of a hormone called cortisol. When cortisol levels become too high over long periods, it can contribute to a higher risk of developing breast cancer.

Having one or more risk factors does not guarantee the development of breast cancer. In fact, many people live their whole lives with multiple risk factors present and never develop this disease. Continued research is essential for improving early detection methods and subsequent treatments of breast cancer.

Can Men Develop Breast Cancer?

Yes, men can develop breast cancer. Although the risk is significantly lower than in women, it is still essential for men to speak with their health care providers about any changes they may notice in their breast tissue.

The signs, symptoms, and causes of breast cancer in men are the same as in women.

How Is Breast Cancer Diagnosed?

Several tests and procedures can help health care professionals detect abnormalities and determine whether cancer is present. This is why speaking with your health care provider regularly about your breast health is critical.

Detecting breast cancer early makes a world of difference in treatability and outcomes. The following tests can help screen for breast cancer:

• Regular self-examinations: Learning how to do a proper self-breast exam is vital. This involves manually feeling the tissues of each breast while looking for lumps and irregularities. While this is an important screening tool, it should not be the only one used.
• Breast exam by a health care provider: A clinical breast examination should be done by a health care provider regularly. It involves the manual palpation of breast tissue to look for lumps, color and discharge abnormalities, and thickening of tissues.
• Breast thermography: High-resolution, infrared images of the breast can help screen for cancer. However, there is little to no evidence it works to detect cancer early enough when it is most treatable. The U.S. Food and Drug Administration (FDA) warns against using thermography as a mammogram substitute.
• Mammography: This is a standard test involving an X-ray-like image of the tissue of each breast. Other types of mammography include:
  • 2D digital mammography: Also known as full-field digital mammography (FFDM), this test combines X-rays and electric signals to capture breast images.
  • 3D mammography: This test uses low-dose X-ray images specifically angled to give precise images of very thin tissue slices, much like an MRI image. This test is helpful for those with dense breast tissue.
• Breast MRI: This test generates a more detailed image of the breast tissue using frequency and magnetic waves.
• Biopsy: A breast biopsy involves the removal of a small amount of tissue considered abnormal. There are several kinds of biopsies.
• Molecular breast imaging (MBI): This test involves a radioactive tracer injected into your arm that travels to breast tissue. A camera then takes images of the tracer.
• Ultrasound: Though it is not usually used in breast cancer screenings, ultrasound can help detect breast changes and is especially useful in those with dense breast tissue.

What Are the Complications of Breast Cancer?

A breast cancer diagnosis can lead to several complications that can affect physical, mental, and emotional well-being. Complications can vary greatly depending on the stage and type of breast cancer, its location, and how it’s being treated.

Here are some common complications associated with breast cancer and its treatment:

• Increased fatigue: Fatigue is a common and persistent symptom experienced by many with breast cancer. It can be caused by the cancer itself, cancer treatments, hormonal imbalances, stress, and emotional changes.
• Emotional and psychosocial stress: A breast cancer diagnosis can evoke a wide range of emotions. These emotions can change with little notice and become taxing in one’s daily life.
• Lymphedema: This condition can result in localized swelling after the removal of lymph tissues, which causes a blockage in the flow of lymph fluid.
• Menopausal symptoms: These symptoms can occur as a result of hormonal imbalance. They can also occur due to treatments such as chemotherapy and hormonal therapy.
• Bone health issues: Depending on which treatments are called for, bone health can be affected. Hormonal therapies used to treat breast cancer can result in a loss of bone density. This can lead to brittle bones, which break more easily.
• Cardiovascular issues: Certain treatments for breast cancer, such as radiation, can cause damage to nearby tissues, such as those of the heart. Chemotherapy agents can also have cardiotoxic effects.

Physicians must monitor a patient for all these complications during breast cancer treatment.

What Are the Treatments for Breast Cancer?

The treatment for breast cancer depends on several factors. These include the location, type, and stage of the cancer. Personal preferences are also taken into account when developing a plan of care.

Treatments for breast cancer can include:

• Estrogen suppression or blockade if the tumor is known to have estrogen receptors.
• Surgeries such as lumpectomy and mastectomy to remove abnormal cells and tumors.
• A total mastectomy to remove the entire breast and sometimes surrounding tissues, such as lymph nodes.
• Chemotherapy that uses drugs to detect and kill cancer cells.
• Radiation that uses high-energy X-rays to kill cancer cells.
• Targeted therapy to detect specific proteins present in cancer cells.

Treatment plans should be highly individualized to achieve the best possible outcomes.

How Does Mindset Affect Breast Cancer?

Coping strategies for the diagnosis of breast cancer should take into account the mind, body, and spirit. As more and more evidence comes out supporting the profound mind, body, and spirit connection, it is becoming clear that mindset plays a huge role in a patient’s treatment and quality of life after a breast cancer diagnosis.

Research suggests a resilient, positive mindset plays a role in coping with diagnosis and treatment. It also helps with achieving a better quality of life (pdf). Feeling like one has a consistent support system is crucial in cultivating a resilient mindset.

A positive mindset in breast cancer treatment has been linked to the following:

• A reduction in the reporting of pain.
• A decreased occurrence of psychological distress.
• The reduction of reporting depression.
• Overall feelings of greater support.
• Greater adherence to treatment regimens.
• A higher tolerance for the adverse side effects that can come with various treatments.
• Reports of a higher quality of life.

What Are the Natural Approaches to Breast Cancer?

Many people with breast cancer are open to trying alternative remedies beyond the typical treatments recommended by their doctors. These remedies and treatments are gaining more prevalence and popularity as patients become more educated in all areas of their health.

These natural therapies can also be used with Western medical treatments and even help mitigate some of their side effects.

Adjunct Therapies

• Practicing meditation: This and other mind-body techniques, such as yoga, can help promote relaxation, improve mood, and reduce stress. These techniques improve overall quality of life, increasing resilience during breast cancer treatment.
• Eating a whole-food diet: Avoiding processed foods will improve overall health.

Vitamin and mineral supplementation can help keep the body balanced and functioning correctly.

• Regular physical activity: Exercise enhances cardiovascular function and helps improve emotional and physical well-being.
• Aromatherapy: This is a great way to reduce stress and promote relaxation. It can also help reduce treatment side effects like nausea.
• Acupuncture: This traditional Chinese medicine (TCM) practice improves health by removing energetic blockages and stagnancy. It also promotes inner balance and an improved mindset.
• Cognitive behavioral therapy (CBT): This psychotherapy can benefit breast cancer patients’ quality of life.
• Emotional Freedom Technique (EFT): Also known as tapping, EFT offers a way to heal past emotional experiences, allowing a person to move forward and feel more peaceful. It has also been shown to reduce the side effects of some breast cancer treatments.

Herbal Medicine

There are many conventional treatments for breast cancer, such as surgery, chemotherapy, and radiation. Natural treatments, such as herbal medicine, can also help improve symptoms, counteract adverse side effects of treatments, and help improve prognosis and outlook.

Since the dawn of time, herbal remedies have been a part of our approach to treating and preventing disease. Some herbal remedies that support the treatment and healing of breast cancer include:

• Garlic: This herb has a potent sulfuric compound that stimulates macrophages and lymphocytes, which interfere with tumor cell metabolism.
• Green tea: Green tea contains powerful polyphenols that inhibit the growth of tumors.
• Turmeric: This herb contains potent anti-inflammatory compounds.
• Echinacea: Echinacea contains immune-stimulating flavonoids.
• Ginseng: This plant helps to block tumor growth and spread.
• Black cohosh: Black cohosh may lessen the symptoms of chemotherapy and radiation. Discuss the use of this supplement with your oncologist first, as it has had some contradictory results.
• Flaxseed: Flaxseed contains compounds shown to reduce tumor load. Consult your oncologist before supplementing flaxseed.

Working closely with your health care providers to implement the best care plan for your needs is always recommended. These alone are not complete treatments for breast cancer; instead, they are complements to help in the healing and recovery process.

How Can I Prevent Breast Cancer?

While the exact precipitating factor that allows for the generation of cancerous cells is unknown, many things can be done to offset the risk of developing breast cancer.

There are several ways to help reduce your risk of developing breast cancer, including:

• Eating a diet that consists of whole and fresh foods with an emphasis on plant foods like fresh fruits and green leafy vegetables, whole grains, and healthy fats.
• Consuming foods that help remove excess estrogen from the body. These foods include green leafy vegetables, cauliflower, and broccoli.
• Limiting the consumption of processed sugar, alcohol, and saturated fats.
• Exercising regularly, incorporating weight-bearing exercise and cardiovascular exercise equally.
• Obtaining regular breast cancer screenings.
• Maintaining a healthy weight.
• Getting enough vitamin D. Studies show a correlation between vitamin D deficiency and breast cancer.
• Consulting a holistic health care practitioner, such as a naturopath, in addition to a Western medical doctor. This can give you a well-rounded approach to breast cancer prevention strategies.
• Avoiding endocrine-disrupting chemicals found in plastic packaging, plasticizers, bisphenol A (BPA), pesticides, and polychlorinated biphenyls (PCBs).

Medically reviewed by Beverly Timerding, MD.