• An uncontrolled growth of abnormal breast cells.
• Etiology of Breast Cancer
  • Cancer occurs when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all come about because of out-of-control growth of abnormal cells. Different kinds of cancer can behave very differently.
• Types of Breast Cancer
• Ductal Carcinoma in situ (DCIS)
  • Most common type of non-invasive breast cancer.
  • Cancer is only in the ducts and has not spread into the tissue of the breast.
• Lobular carcinoma in situ (LCIS)
  • A condition that begins in the milk-making glands but does not go through the wall of the lobules.  Not a true cancer, but it increases a woman’s risk of getting cancer later.
• Invasive (infiltrating) ductal carcinoma (IDC)
  • Most common breast cancer.
  • Starts in a milk passage or duct, breaks through the wall of the duct, and invades the tissue of the breast.  From there it may be able to spread to other parts of the body.  It accounts for about 8 out of 10 invasive breast cancers.
• Inflammatory Breast Cancer (IBC)
  • An uncommon type of breast cancer which accounts for about 1% to 3% of all breast cancers.
  • Usually there is no single lump or tumor.  Instead, IBC makes the skin of the breast look red and feel warm.  It also gives the skin a thick, pitted appearance that looks a lot like an orange peel.  The affected breast may become larger or firmer, tender, or itchy.
  • IBC is often mistaken for infection in its early stages.  Because there is no defined lump, it may not show up on a mammogram, making it harder to catch early.  IBC usually has a higher chance of spreading and a worse outlook than invasive ductal or lobular cancer.  For more information on IBC, go to the ACS document Inflammatory Breast Cancer, The Inflammatory Breast Cancer Foundation, Inflammatory Breast Cancer Research Foundation, MayoClinic.com, or National Cancer Institute - IBC.


For more information on breast cancer:
American Cancer Society
National Cancer Institute
Susan G. Komen for the Cure

• The risk of breast cancer increases greatly with age.
• Family history, familial cancer syndrome.
• Reproductive and hormonal factors such as early menarche (early onset of menstruation), late menopause, late parity (bearing children late), and nulliparity (not bearing children).
• Certain types of benign breast disease (fibrocystic, fibroadenoma)
• Obesity after menopause.
• Moderate to heavy alcohol consumption (3 or more drinks per day).
• Very high doses of radiation, such as that used in radiation therapy.
• Long-term use of estrogen replacement therapy after menopause.
• Lack of physical activity and a diet high in fat.

  For more information on family history, log onto:
  U.S. Surgeon General’s Family History Initiative

• Tamoxifen- In terms of primary prevention, tamoxifen, a selective estrogen-receptor modulator, has been shown to reduce breast cancer incidence among women at elevated breast cancer risk. Five-year adjuvant treatment of tamoxifen has also been shown to significantly reduce recurrence of secondary malignancies in early stage breast cancer patients.
• Genetic testing- The "breast cancer gene," BRCA1, was identified in 1994 and BRCA2 in 1995. A positive on a mutation test result indicates enhanced breast and ovarian cancer risk - either higher risk of an initial cancer (for unaffected women) or a recurrence or second primary cancer (for women already affected by cancer). Women with BRCA1 or BRCA2 mutations have approximately a 33% to 50% risk of developing breast cancer by age 50.
• Suppression of hormonal factors- Hormones produced by the ovaries appear to increase a woman's risk for developing breast cancer. The removal of one or both ovaries reduces the risk. The use of drugs that suppress the production of estrogen may inhibit tumor cell growth. The use of hormone replacement therapy may be associated with an increased risk of developing breast cancer, mostly in recent users. The use of oral contraceptives may also be associated with a slight increase in breast cancer risk. Beginning to menstruate at an older age and having a full-term pregnancy reduces breast cancer risk. Also, a woman who has her first child before the age of 20 experiences a greater decrease in breast cancer risk than a woman who has never had children or who has her first child after the age of 35. Beginning menopause at a later age increases a woman's risk of developing breast cancer.
• Reducing radiation exposure- The key to preventing breast-cancer is to remove one of the necessary co-actors. Ionizing radiation is a major, proven, preventable cause of this disease. Every reduction in radiation dose is guaranteed to prevent a number of cases, which would otherwise occur.
• Prophylactic mastectomy- Also called preventive mastectomy, it is the surgical removal of one or both breasts to try to prevent or reduce the risk of breast cancer. It involves removal of as much of the at-risk tissue as possible. Prophylactic mastectomy is seen as an option for several reasons.

For more information on prevention:
American Cancer Society
National Cancer Institute
Susan G. Komen for the Cure
      

• Screening for cancer is examination (or testing) of people for early stages in the development of cancer even though they have no symptoms.
  
  Types of Screening

• Breast Self-Examination (BSE) – Some women perform monthly breast self-exams to check for any changes in their breasts. Women who notice anything unusual should contact their health care provider.
• Clinical Breast Examination (CBE) - During a CBE, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes.
• Mammogram - A mammogram is a special x-ray of the breast that can often find tumors that are too small for you or your doctor to feel.
• Ultrasonography - Ultrasound is used to evaluate lumps that have been identified by BSE, CBE, or mammography, however, there is little evidence to support the use of ultrasound for screening the general population.
• Magnetic Resonance Imaging (MRI) - A procedure in which a magnet linked to a computer is used to create detailed pictures of areas inside the body. MRI has been used to evaluate breast masses which can be felt and to discriminate between cancer and scar.  Although studies of screening MRI in women of high genetic risk are ongoing, the American Cancer Society recommends that women at high risk (greater than 20% lifetime risk) get an MRI and a mammogram every year.  Women at moderately increased risk (15% to 20% lifetime risk) should talk to their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram.
  
  For more information on screening services:
  
  New Jersey Cancer Education and Early Detection Services (NJCEED) – Breast Health Care
  
  Office of Cancer Control and Prevention, Cancer Resources Website

• Chemotherapy- Chemotherapy works by interfering with the cells ability to function and reproduce, usually by affecting DNA synthesis and/or function. It may be injected into the blood stream or taken as tablets.
• Hormone Therapy- Hormonal therapy is used to prevent the growth, spread, or recurrence of breast cancer. If lab tests show that your tumor depended on your natural hormones to grow, it will be described as estrogen-positive or progesterone-positive in the lab report. This means that any remaining cancer cells may continue to grow when these hormones are present in your body. Hormonal therapy can block your body's natural hormones from reaching any remaining cancer cells (ex. Tamoxifen).
• Radiation- Therapy that uses high energy rays or particles to treat disease. High doses of radiation can kill cells or keep them from growing and dividing.
• Radiotherapy- The use of x-rays and other forms of radiation in an attempt to destroy malignant cells and tissue. There are various forms or methods, most now conducted with computers.
• Biological Therapy- This treatment uses materials produced by the body or manufactured in a laboratory to boost, direct, or restore your body's natural defenses against disease. One type of biological therapy called biological response modifier (BRM) therapy, or immunotherapy, is sometimes used to treat cancer.
  
  For more information on treatments:
  National Cancer Institute - Breast Cancer: Treatment
  
  To better understand your treatment options and possible side effects:
  American Cancer Society - Breast Cancer Profiler Tool
  
  For information on surgery choices:
  National Cancer Institute – Surgery Choices for Women with Early Stage Breast Cancer [En español]
  
  For information on finding a doctor or treatment facility:
  National Cancer Institute – How to Find a Doctor or Treatment Facility If You Have Cancer
  

• Clinical trials are research studies in which people help doctors find ways to improve health and cancer care. Each study tries to answer scientific questions and to find better ways to prevent, diagnose, or treat cancer.
• A clinical trial is one of the final stages of a long and careful cancer research process. Studies are done with cancer patients to find out whether promising approaches to cancer prevention, diagnosis, and treatment are safe and effective.
• Different types of clinical trials include:
• Treatment trials
• Prevention trials
• Screening trials
• Quality of life trials
  

Source:  National Cancer Institute – What is a Clinical Trial?

For more information on clinical trials:
Coalition of Cancer Cooperative Groups – Cancer Clinical Trials
National Cancer Institute – Clinical Trials
NJ Cancer Trial Connect
NJ Commission on Cancer Research - IMPACT NJ

• Fatigue
• Pain
• Side Effects/ Other Complications
• Nutritional Concerns
• Emotional Concerns
• Treatment Related Issues
• Clinical Trials Information
• Information for Caregivers & Loved Ones
• Survivorship
• End-of-Life Issues

For information on coping with cancer

Palliative Care

Complementary and Alternative Medicine (CAM)

Children Coping with Cancer in the Family

American Cancer Society – Cancer Facts and Figures
CDC - National Center for Health Statistics – Fast Stats
Comprehensive Cancer Control Plan
National Cancer Institute – Cancer Statistics
New Jersey State Cancer Registry
State Cancer Profiles

• American Cancer Society
• Breast Cancer Network of Strength
• Breast Cancer Resource Center
• Cancer Epidemiology Services
• The Cancer Institute of New Jersey
• Centers for Disease Control and Prevention
• Inflammatory Breast Cancer Research Foundation
• National Cancer Institute
• Shirley Mae Breast Cancer Assistance Fund - Financial assistance for breast cancer patients in Southeastern NJ
• South Jersey Breast Cancer Coalition
• Susan G. Komen for the Cure
• womenshealth.gov