How does cancer spread?

Malignant tumors can invade surrounding tissue and destroy it. Cancer cells can also break away from malignant tumors and enter the blood or lymphatic system. This is how cancer spreads in the body.

When breast cancer spreads outside the breast, cancer cells are usually found in the lymph nodes under the arm. Cancer cells may spread outside the breast, such as to other lymph nodes, bones, liver, or lungs. Although this is uncommon, some patients who do not have breast cancer in their armpit lymph nodes may still have cancer cells that have spread to the breast and other parts of the body.

Cancer that has spread to other parts of the body is the same disease and has the same name as the original cancer. When breast cancer spreads, it is called metastatic breast cancer, even if it is found elsewhere in the body. For example, breast cancer that has spread to the bones is called metastatic breast cancer, not bone cancer.

What causes breast cancer?

Medical researchers are learning what happens inside cells that may cause cancer. They have identified changes in certain genes within breast cells that may be associated with an increased risk of breast cancer. Breast cells contain a variety of genes that often work in conjunction with a woman's natural hormones, diet and environment to keep her breasts healthy. Certain genes normally prevent breast cells from dividing and growing out of control and forming tumors. When these genes are altered, changes occur and cells cannot grow properly.

Genetic changes may be inherited from parents, or grandparents may accumulate over a person's lifetime. Breast cancer usually begins in a single cell, which changes from normal to malignant over a period of time.

Currently, no one can accurately predict when cancer will develop or how it will progress. When breast cancer is diagnosed—even in its earliest stages—it is currently impossible to predict which cancer cells will be successfully treated and which will continue to grow and spread rapidly to other parts of the body.

The only way to determine if a breast lump or abnormal tissue is cancer is to have a biopsy. Suspicious tissue removed during a biopsy by a surgeon or radiologist is examined under a microscope by the pathologist who makes the diagnosis. If your biopsy is positive, it means the tumor or tissue in the suspicious area contains cancer and you will need treatment.

Are all breast cancers the same?

Breast cancer is a complex disease. All situations are different. Once breast cancer is found, more tests will be done to find specific patterns in your disease. This important step is called staging . Knowing the exact stage of your disease will help your doctor plan your treatment. Your doctor will want to know:

• The size of the tumor and its exact location in your breast
• If cancer has spread in your breast
• If cancer is in your armpit lymph nodes
• If the cancer is in other parts of your body

American Cancer Society Breast Health Guidelines

The goal of early breast cancer screening is to find cancer before it starts causing symptoms. Breast cancers that are detected because they cause symptoms tend to be relatively large and may have spread beyond the breast. In contrast, breast cancer found during a screening exam is more likely to be small and remain localized to the breast.

The American Cancer Society believes that the use of mammography, clinical breast examinations, and breast self-examinations offer women the best opportunity to reduce breast cancer mortality through early detection. This combined approach is clearly better than either inspection alone. The American Cancer Society does not recommend relying solely on any one of these methods.

American Cancer Society Breast Cancer Early Detection Guidelines

If you are between 20 and 39 years old:

• A clinical breast examination by your healthcare provider at least every three years
• Do a breast self-examination every month

If you are 40 years or older:

• Get a mammogram every year
• Annual clinical breast examination by your healthcare provider
• Do a breast self-examination every month

If there is a history of breast cancer in your family, discuss mammogram guidelines and schedule with your healthcare provider.

Basic facts about breast health:

• anatomy
• breast cancer biology
• breast cancer staging
• American Cancer Society Guidelines
• Breast self-examination
• mammogram
• Lifestyle changes to prevent breast cancer
• Nutrition to prevent breast cancer

Breast self-examination

All women should check their breasts every month for lumps, thickness, and other changes. By checking your breasts regularly, you will learn how your breasts usually feel. If your breasts change, you will be able to recognize them and tell your doctor.

• Check your breasts about a week after your period. Checking your breasts in the shower is a convenient way to incorporate self-examination into your daily routine.
• Press firmly with your fingertips. Place your left hand in circles on your right breast. Make sure to check thoroughly and include the armpits.
• Now use your right hand to examine your left breast in the same way.
• You should also look at your breasts in the mirror. Look for any changes in the appearance of your breasts.

If you notice any lumps, thickening, or changes, tell your doctor right away. Most breast lumps are not cancer, but if you don't ask, you won't know. If caught early, breast cancer may be successfully treated.

mammogram

Imaging tests are an important part of breast cancer screening. A mammogram is a low-dose X-ray of the breast. While not always reliable, this is still the best test we have for screening women for breast cancer.

A screening mammogram includes two "photos" of each breast. If an area on the mammogram looks suspicious or unclear, additional mammograms with different views may be needed. We recommend that all women over the age of 40 have an annual mammogram.

A diagnostic mammogram is a mammogram used to solve problems rather than to screen. For example, if a patient has a lump in the breast, a directed examination of the area will be performed. This is also done when specific findings in the breast are tracked over time. Diagnostic mammograms are tailored to the patient's condition and carefully monitored by a radiologist, who interprets the images and determines whether further testing is needed.

Lifestyle changes to prevent breast cancer

We are all unique, and staying healthy and preventing disease varies from person to person. Eating healthily, exercising and learning stress-reduction strategies can help most people feel healthier.

Incorporating healthier habits into your life is important, but it can also be difficult. Some people are more successful if they make small changes over a long period of time. Others find that making major changes to their lifestyle is more effective. Generally speaking, the most lasting motivation is to feel better.

There is no clear cause of breast cancer and therefore no proven way to prevent the disease. This can cause uncertainty, fear and anger. It’s this fear of the unknown and people’s passion for finding the cause that drives breast cancer awareness and research.

Although there is no evidence that healthier living can prevent breast cancer, it is believed that reducing exposure to harmful things and increasing healthier practices may reduce the risk. These practices have been shown to help people increase their energy levels, reduce their incidence of other illnesses, and enhance their overall sense of well-being. Research is ongoing to examine the impact of lifestyle changes such as diet, exercise, support and stress management.

Lifestyle changes begin with a personal commitment to feeling and becoming healthier. It’s often hard for us to take care of ourselves because we’re usually taking care of others. The following series of questions may trigger exploration.

Imagine a self-inventory process:

• What are my self-care skills? Am I finally taking care of myself? If I were my best friend, sibling, or child, what advice would I give?
• How am I eating? Am I dieting, feeling deprived, sneaking in junk food, feeling guilty about eating the “wrong” things, confused about the right and wrong foods to eat? Am I drinking enough water?
• Did I sleep well? Can I sleep well? What interrupts my sleep and rest?
• Do I smoke? Am I drinking too much?
• What are the stressors in my life? What can I change? What could I have responded to differently?
• Can I move my body? In which ways do I find the most pleasure in moving? How, when and where do I incorporate it into my life?
• What makes me feel bad? What are the barriers to changing it?
• What do I love? What moves me and gives my life meaning? Do I make space or time for the things that give my life meaning? What inspires my creativity?

Whenever life gets tough, taking care of yourself is both difficult and important. Lifestyle changes are not written prescriptions that will never change. This is a dynamic process. The first and biggest step is caring enough about yourself to go after what you need. This is self-care.

Nutrition to prevent breast cancer

Changing your relationship with food and eating involves significant shifts in thinking, feeling, and behavior. The goal of this transition is lifestyle changes rather than temporary dieting to lose weight.

Choose, prepare and eat food with "Plenty Mode," which includes delicious options, variety of flavors, generous portions, not feeling limited, not counting calories and the joy of eating when you're hungry.

This contrasts with the more common " deprivation model ," in which rules of "don't" and "shouldn't" make us feel bad or guilty about unsatisfied hunger and cravings. Stress- and depression-related eating cycles are common in this model. Moving from "I can't eat without feeling sad and guilty" to "I like lots of healthy, delicious food" generally leads to better nutrition and a healthier self.