Breast cancer is a type of cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk.

Cancers originating from ducts are known as ductal carcinomas, while those originating from lobules are known as lobular carcinomas. While the overwhelming majority of human cases are in women, breast cancer can also occur in men.

The balance of benefits versus harms of breast cancer screening is controversial.

The characteristics of cancer determine the treatment, which may include surgery, medications (hormonal therapy and chemotherapy), radiation and/or immunotherapy.

Surgery provides the single largest benefit, and to increase the likelihood of remission (no further sign of cancer), several chemotherapy regimens are commonly given in addition.

Radiation is used after breast-conserving surgery and substantially improves local relapse rates and in many circumstances also overall survival.

Prognosis and survival rates for breast cancer vary greatly depending on the cancer type, stage, treatment, and geographical location of the patient.

The first noticeable symptom of breast cancer is typically a lump that feels different from the rest of the breast tissue. More than 80% of breast cancer cases are discovered when a woman feels a lump. The earliest breast cancers are detected by a mammogram. Lumps found in lymph nodes located in the armpits can also indicate breast cancer.

Indications of breast cancer other than a lump may include thickening different from the other breast tissue, one breast becoming larger or lower, a nipple changing position or shape or becoming inverted, skin puckering or dimpling, a rash on or around a nipple, discharge from nipple/s, constant pain in part of the breast or armpit, and swelling beneath the armpit or around the collarbone.

Pain (“mastodynia”) is an unreliable tool in determining the presence or absence of breast cancer, but maybe indicative of other breast health issues.

Inflammatory breast cancer is a particular type of breast cancer that can pose a substantial diagnostic challenge.

Symptoms may resemble a breast inflammation and may include itching, pain, swelling, nipple inversion, warmth and redness throughout the breast, as well as an orange-peel texture to the skin referred to as peau d’orange; as inflammatory breast cancer doesn’t show as a lump there’s sometimes a delay in diagnosis.

Another reported symptom complex of breast cancer is Paget’s disease of the breast.

This syndrome presents as skin changes resembling eczemas, such as redness, discoloration, or mild flaking of the nipple skin. As Paget’s disease of the breast advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain.

There may also be discharge from the nipple. Approximately half of women diagnosed with Paget’s disease of the breast also have a lump in the breast.

In rare cases, what initially appears as a fibroadenoma (hard, movable non-cancerous lump) could, in fact, be a phyllodes tumor.

Phyllodes tumors are formed within the stroma (connective tissue) of the breast and contain glandular as well as stromal tissue. Phyllodes tumors are not staged in the usual sense; they are classified on the basis of their appearance under the microscope as benign, borderline, or malignant.

Occasionally, breast cancer presents as a metastatic disease — that is, cancer that has spread beyond the original organ.

The symptoms caused by metastatic breast cancer will depend on the location of metastasis. Common sites of metastasis include bone, liver, lung, and brain. Unexplained weight loss can occasionally herald an occult breast cancer, as can symptoms of fevers or chills.

The management of breast cancer depends on various factors, including the stage of cancer. Increasingly aggressive treatments are employed in accordance with the poorer the patient’s prognosis and the higher the risk of recurrence of cancer following treatment.

Breast cancer is usually treated with surgery, which may be followed by chemotherapy or radiation therapy, or both. A multidisciplinary approach is preferable. Hormone receptor-positive cancers are often treated with hormone-blocking therapy over courses of several years.

Monoclonal antibodies, or other immune-modulating treatments, may be administered in certain cases of metastatic and other advanced stages of breast cancer.

Surgery involves the physical removal of the tumor, typically along with some of the surrounding tissue. One or more lymph nodes may be biopsied during the surgery; increasingly the lymph node sampling is performed by a sentinel lymph node biopsy.

Standard surgeries include:

Mastectomy: Removal of the whole breast.
Quadrantectomy: Removal of one-quarter of the breast.
Lumpectomy: Removal of a small part of the breast.

Once the tumor has been removed, if the patient desires, breast reconstruction surgery, a type of plastic surgery, may then be performed to improve the aesthetic appearance of the treated site.

Alternatively, women use breast prostheses to simulate a breast under clothing or choose a flat chest. Nipple/areola prostheses can be used at any time following the mastectomy.



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