Breast Cancer Facts

Breast cancer is cancer that forms in the cells of the breasts. Breast cancer can occur in both men and women, but it’s far more common in women. Substantial support for breast cancer awareness and research funding has helped create advances in the diagnosis and treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining, largely due to factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease.

• Angiosarcoma: rare type of cancer that forms in the lining of the blood vessels and lymph vessels. Your lymph vessels, which are part of your immune system, collect bacteria, viruses and waste products from your body and dispose of them.

• Ductal Carcinoma in Situ (DCIS): the presence of abnormal cells inside a milk duct in the breast. It’s considered the earliest form of breast cancer. DCIS is noninvasive, meaning it hasn’t spread out of the milk duct and has a low risk of becoming invasive.

• Inflammatory Breast Cancer: a rare type of breast cancer that develops rapidly, making the affected breast red, swollen and tender. It occurs when cancer cells block the lymphatic vessels in skin covering the breast, causing the characteristic red, swollen appearance of the breast.

• Invasive Lobular Carcinoma: a type of breast cancer that begins in the milk-producing glands (lobules) of the breast. The terms ‘invasive cancer’ means that the cancer cells have broken out of the lobule where they began and have the potential to spread to the lymph nodes and other areas of the body.

• Male Breast Cancer: Though breast cancer is most commonly thought of as a disease that affects women, breast cancer does occur in men. It’s most common in older men, though it can occur at any age. Men diagnosed with male breast cancer at an early stage have a good chance for a cure and treatment typically involves surgery to remove the breast tissue. Other treatments, such as chemotherapy and radiation therapy, may be recommended based on your particular situation.

• A breast lump or thickening that feels different from the surrounding tissue
• Change in the size, shape or appearance of a breast
• Changes to the skin over the breast, such as dimpling
• A newly inverted nipple
• Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
• Redness or pitting of the skin over your breast, like the skin of an orange

Tests and procedures used to diagnose breast cancer include:

• Breast exam: Your doctor will evaluate both of your breasts and lymph nodes in your armpit, feeling for any lumps or other abnormalities. If you’d like to schedule your checkup, consult our Gynecology experts.

• Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality. For screening procedures, come see us at the San Cristóbal Imaging Center.

• Breast Ultrasound: Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may be used to determine whether a new breast lump is a solid mass or a fluid-filled cyst. Learn more about Ultrasound.

• Biopsy: During a biopsy, the physician uses a specialized needle device guided by X-ray or another imaging test to extract a core of tissue from the suspicious area. Often, a small metal marker is left at the site within your breast so the area can be easily identified on future imaging tests. Biopsy samples are sent to our Clinical Lab for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options.

• Breast magnetic resonance imaging (MRI): An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye. Unlike other types of imaging tests, an MRI doesn’t use radiation to create the images. Learn more about MRI.

• Other tests and procedures may be used depending on your situation.

Once your doctor has diagnosed your breast cancer, he or she works to establish the extent (stage) of your cancer. Your cancer’s stage helps determine your prognosis and the best treatment options. Complete information about your cancer stage may not be available until after you undergo breast cancer surgery. Tests and procedures used to stage breast cancer may include:

• Blood Tests

• Mammogram

• Breast MRI

• Bone Scan

• CT Scan

• PET Scan

Not all women will need all of these tests and procedures. Your doctor selects the appropriate tests based on your specific circumstances and taking into account new symptoms you may be experiencing. Breast cancer stages range from 0 to IV with 0 indicating cancer that is noninvasive or contained within the milk ducts. Stage IV breast cancer, also called metastatic breast cancer, indicates cancer that has spread to other areas of the body. Breast cancer staging also takes into account your cancer’s grade; the presence of tumor markers, such as receptors for estrogen, progesterone, and HER2; and proliferation factors.

Your doctor determines your breast cancer treatment options based on your type of breast cancer, its stage and grade, size, and whether the cancer cells are sensitive to hormones. Your doctor also considers your overall health and your own preferences. Most women undergo surgery for breast cancer and also receive additional treatment before or after surgery, such as chemotherapy, hormone therapy or radiation.
There are many options for breast cancer treatment, and you may feel overwhelmed as you make complex decisions about your treatment. Consider seeking a second opinion from a breast specialist in a breast center or clinic. Talk to other women who have faced the same decision.

Breast cancer surgery: Operations used to treat breast cancer include:

• Lumpectomy: During a lumpectomy, which may be referred to as breast-conserving surgery or wide local excision, the surgeon removes the tumor and a small margin of surrounding healthy tissue. A lumpectomy may be recommended for removing smaller tumors. Some people with larger tumors may undergo chemotherapy before surgery to shrink a tumor and make it possible to remove completely with a lumpectomy procedure.
• Mastectomy: A mastectomy is an operation to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue — the lobules, ducts, fatty tissue and some skin, including the nipple and areola (total or simple mastectomy). Newer surgical techniques may be an option in selected cases in order to improve the appearance of the breast. Skin-sparing mastectomy and nipple-sparing mastectomy are increasingly common operations for breast cancer.
• Sentinel Node Biopsy: To determine whether cancer has spread to your lymph nodes, your surgeon will discuss with you the role of removing the lymph nodes that are the first to receive the lymph drainage from your tumor. If no cancer is found in those lymph nodes, the chance of finding cancer in any of the remaining lymph nodes is small and no other nodes need to be removed.
• Axillary Lymph Node Dissection: If cancer is found in the sentinel lymph nodes, your surgeon will discuss with you the role of removing additional lymph nodes in your armpit.
• Removing Both Breasts: Some women with cancer in one breast may choose to have their other (healthy) breast removed (contralateral prophylactic mastectomy) if they have a very increased risk of cancer in the other breast because of a genetic predisposition or strong family history. Most women with breast cancer in one breast will never develop cancer in the other breast. Discuss your breast cancer risk with your doctor, along with the benefits and risks of this procedure.

Complications of breast cancer surgery depend on the procedures you choose. Breast cancer surgery carries a risk of pain, bleeding, infection and arm swelling (lymphedema). You may choose to have breast reconstruction after surgery. Discuss your options and preferences with our San Cristóbal Surgery Team.

Radiation therapy: Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. Radiation therapy is typically done using a large machine that aims the energy beams at your body (external beam radiation). San Cristóbal has one of the most sophisticated radiotherapy machines in Puerto Rico, which targets radiation efficiently to aggressively treat tumors without damaging surrounding organs. Meanwhile, radiation can also be done by placing radioactive material inside your body through Brachytherapy. External beam radiation of the whole breast is commonly used after a lumpectomy. Breast brachytherapy may be an option after a lumpectomy if you have a low risk of cancer recurrence. Doctors may also recommend radiation therapy to the chest wall after a mastectomy for larger breast cancers or cancers that have spread to the lymph nodes. Breast cancer radiation can last from three days to six weeks, depending on the treatment. Our radiation specialist will determine which treatment is best for you based on your situation, your cancer type and the location of your tumor.

Chemotherapy: Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. If your cancer has a high risk of returning or spreading to another part of your body, your doctor may recommend chemotherapy after suy to decrease the chance that the cancer will recur.

Hormone Therapy: Hormone therapy — perhaps more properly termed hormone-blocking therapy — is often used to treat breast cancers that are sensitive to hormones. Doctors sometimes refer to these cancers as estrogen receptor positive (ER positive) and progesterone receptor positive (PR positive) cancers. Hormone therapy can be used before or after surgery or other treatments to decrease the chance of your cancer returning. If cancer has already spread, hormone therapy may shrink and control it.

Palliative Care: Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy. When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer. Palliative care is provided by our skilled team of doctors, nurses and specially trained professionals, aimed at improving the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving. Learn more about San Cristóbal Palliative Care.

San Cristobal Cancer Institute offers a wide array of options to help our patients feel calm and supported during the process of screening, diagnosis, and treatment, as well as getting back to life after cancer.  Browse our alternatives for patients – including financial aid for those eligible – in our Patient Resources section.