If you, or someone you love, has been diagnosed with cancer, you may not know what to do. Here's a list of tips and ways to cope with a cancer diagnosis.

What is Cancer?

Cancer is the uncontrolled growth of cells within the body. Cells usually reproduce only when necessary to keep the body functioning properly. However, sometimes the mechanism that controls cell growth can stop working because of damage to the cell’s DNA. When the cell-regulating mechanism stops working, the cell begins to divide rapidly, passing on its damaged DNA to the new cells.

Due to the damage to the DNA, the cells don’t die and keep reproducing. This uncontrolled growth leads to the formation of a tumor. Sometimes the tumor is contained, sometimes the cells break off from the tumor and travel to other tissues within the body.  The uncontrolled growth of the abnormal cells and invasion of other tissues are what makes a tumor cancerous (also known as a malignant tumor).

Not all tumors are cancerous. Non-cancerous tumors, known as benign tumors, can grow large, but they cannot invade other tissues nor can they spread throughout the body.

Where the tumor originates defines the type of cancer.

What is Breast Cancer?

If a tumor starts in the breast, the patient is considered to have breast cancer. Breast cancer can start in several different areas of the breast – the ducts (the tubes that carry breast milk to the nipple), the lobules (the glands that produce breast milk), or in the tissue in between.  Both women and men can develop breast cancer, although it is rarer in men.

According to the American Cancer Society (ACS), breast cancer is second only to skin cancer as the most common cancer among American women. Approximately 12% may develop invasive breast cancer at some time in her life.

Breast cancer is the second leading cause of cancer death in women, behind lung cancer. The chance that breast cancer will be the cause of death is about 1 in 35 (3%).  The good news is that, at this time, the ACS estimates there are over 2.5 million breast cancer survivors in the United States (those who are still undergoing treatment as well as those who have completed treatment).

Causes of Breast Cancer:

There is no one known cause for breast cancer. Rather, there are number of risk factors that increase the likelihood of developing breast cancer.

Risk Factors for Breast Cancer:

What we do know is that certain risk factors can increase the likelihood of developing breast cancer.

Although there is no certain way to prevent breast cancer, changing one’s lifestyle risk factors (alcohol intake, obesity, physical activity) along with regular screening (breast self-exams, physical exams by a healthcare professional, and routine mammograms) can lower one’s risk and increase the likelihood of early detection. The earlier a cancer is detected, the easier it is to treat.

These risk factors include (but are not limited to):

  • Gender
  • Age
  • Genetics
  • Family history
  • Race and ethnicity
  • Early onset of menstruation
  • Late onset of menopause
  • Breastfeeding
  • Dense breast tissue
  • Alcohol intake
  • Obesity
  • Physical activity

Symptoms of Breast Cancer:

According to the American Cancer Society, any of the following unusual changes in the breast can be a first sign of breast cancer:

  • Swelling of all or part of the breast
  • Skin irritation or dimpling
  • Breast pain
  • Nipple pain or the nipple turning inward
  • Redness, scaliness, or thickening  of the nipple or breast skin
  • Nipple discharge other than breast milk
  • Lump in the underarm area

Different types of breast cancer may also have additional symptoms.

These are described below in Types of Breast Cancer.

Breast Cancer Diagnosis and Staging

Breast cancer is diagnosed using a combination of procedures:

  • Physical exam
  • Mammography
  • Breast ultrasound
  • Breast MRI
  • Biopsy of the affected tissue
  • Microscopic examination of the discharge (if nipple discharge is present)

How far the cancer has spread from its original site determines its stage (on a scale of 0 to IV).  Stage 0 means that the cancer is non-invasive and remains within the original location.

Cancer staged at Stages I - IV (with I being the earliest stage and IV being the most advanced) indicates that the cancer is invasive and has spread to other tissues and possibly other parts of the body. The stage of the invasive cancer is determined by the following factors: the size of the tumor; whether the cancer has spread to any lymph nodes, and if so, how many; and whether the cancer has spread to other parts of the body.

To determine whether the cancer has spread to the lymph nodes, the physician will remove one or more of the lymph nodes for examination. To determine whether the cancer has spread to other parts of the body, a physical exam, blood tests, and imaging tests (chest x-ray, bone scan, CT, ultrasound, MRI, and/or PET scan) may be ordered.

Treatment of Breast Cancer:

Standard options for treating all types of breast cancer include both localized treatments (surgery and radiation therapy) that focus on the tumor and surrounding areas, along with systemic treatments (chemotherapy, hormonal therapy, targeted therapies) that go throughout the body to destroy the cancer cells that may have left the original tumor and to help reduce the risk of cancer recurrence.

Physicians will use a combination of both localized and systemic treatment options, which are tailored to the individual patient’s needs, depending upon the type and severity of the disease.

Surgical options include:

  • Lumpectomy
  • Mastectomy (partial, total, or modified radical)
  • Sentinel lymph node biopsy
  • Axillary lymph node dissection

Radiation therapy options include:

  • External beam radiation
  • Brachytherapy, also known as internal partial-breast irradiation
  • External partial-breast irradiation

Systemic treatments include:

  • Chemotherapy – anti-cancer medications taken either orally or injected into the vein. A combination of two or more medications is often used at one time.
  • Hormonal therapy – medications designed to lower or eliminate the amount of estrogen in the body; estrogen promotes the growth of breast cancer cells – reducing the amount decreases the likelihood of the cancer returning
  • Targeted therapies – medications designed to interfere with specific processes that breast cancer cells use to grow and thrive.

Types of Breast Cancer

Ductal Carcinoma In Situ (DCIS): This type starts inside the milk ducts and is considered non-invasive because it has not spread beyond the milk duct into any surrounding tissue. Although not life-threatening, having it may increase the risk of developing an invasive breast cancer in the future.

Symptoms of DCIS: There are generally no obvious signs or symptoms of DCIS, although a small number of patients may have a lump in the breast or notice discharge from the nipple.

Invasive Ductal Carcinoma (IDC): Also known as infiltrating ductal carcinoma, IDC is the most common type of breast cancer, accounting for approximately 80% of all cases. It begins in the milk duct, but then it breaks through the wall of the duct and begins invading the surrounding breast tissue. Over time, IDC can spread to the surrounding lymph nodes where it can enter the lymph system and spread to other parts of the body such as the bones, liver, lung, and/or brain. IDC can affect women at any age, but it is more common in women 55 or older.  IDC also affects men.

Symptoms of IDC: In some cases, IDC may not cause any symptoms. It is detected through a screening mammogram, after which the patient is sent for further testing. In other cases, the first sign of IDC is a new lump in the breast.  However, any of the unusual changes in the breast outlined by the American Cancer Society can be a first sign of this type of breast cancer.  (See above, under Symptoms)

Invasive Lobular Carcinoma (ILC): Also known as infiltrating lobular carcinoma, this type of breast cancer starts in the lobule, the gland that produces breast milk and empties into the milk ducts, but then breaks through the wall of the lobule and begins invading the surrounding breast tissue. Over time, ILC can spread to the surrounding lymph nodes where it can enter the lymph system and spread to other parts of the body. ILC can affect women at any age, but it is more common in older women (55 and above).

Symptoms of ILC: In some cases, ILC may not cause any symptoms but is detected through a screening mammogram, after which the patient is sent for further testing. However, due to the nature of ILC, it can be more difficult to detect with a mammogram than IDC. ILC doesn’t tend to form a cohesive lump; rather the cancer cells spread to the surrounding connective tissue in a line formation. Sometimes, the first indication of ILC is a thickening or hardening in the breast that can be felt. Other symptoms may include:

  • An area of fullness in the breast
  • Swelling of all or part of the breast
  • Change in the skin texture of the breast
  • The nipple turning inward

However, any of the unusual changes in the breast outlined by the American Cancer Society can be a first sign of this type of breast cancer. (See above, under Symptoms)

Inflammatory Breast Cancer (IBC): IBC is a rare, aggressive form of breast cancer that grows and spreads quickly. Symptoms can worsen within days or even hours, so it is vitally important to recognize symptoms and seek treatment right away. According to the ACS, it is more common in African American women, and being overweight may be linked to the likelihood of developing IBC. IBC can also affect men.

Symptoms of Inflammatory Breast Cancer: IBC usually begins with a reddening or swelling of the breast instead of a characteristic lump. The breast may feel thick or heavy, and the skin may be inflamed and red. IBC cells grow in layers or sheets of tissue sometimes called “nests”. The swelling and inflammation of the breast occurs because the cancer cells are clogging the lymph vessels. Seek treatment right away if any of the following symptoms appear:

  • Redness involving all or part of the breast; sometimes the redness fades and then returns.
  • Swelling of part or all of the breast; the breast may feel enlarged and hard to the touch.
  • The breast is warm to the touch.
  • Orange peel-appearance – the breast swells and looks like the peel of a navel orange.
  • Other skin changes – the breast may appear pink or bruised, or it may look like there are ridges, welts, or hives on the breast.
  • Swelling of the lymph nodes under the arm or above the collarbone.
  • Flattening or inversion of the nipple.
  • Aching or burning in the breast.

Some of these symptoms can mimic those of mastitis, an infection within the breast that usually occurs in women who are breastfeeding. Symptoms may also mimic cellulitis, a bacterial infection of the breast skin. A patient with a diagnosis of mastitis or cellulitis that is not responding to treatment should be tested for IBC. In addition, any persistent or unusual changes in the breast should be looked at by a breast specialist.

Diagnosis and Staging: IBC is generally diagnosed after the patient or physician sees or feels the breast changes that accompany IBC (redness, swelling, warmth, orange-peel appearance of the skin). In addition to the usual diagnostic tests used for breast cancer, a skin punch biopsy maybe performed. Due to the aggressive nature of IBC, it is usually discovered at a locally advanced stage, when the cancer cells have already spread into the surrounding breast tissue or lymph nodes. Nearly all people with IBC have evidence of cancer in the lymph nodes, and approximately 33% will have evidence of cancer elsewhere in the body.

Male Breast Cancer: Breast cancer in men is rare, accounting for less than 1% of all breast cancer cases. Nearly all men diagnosed with breast cancer will undergo some combination of treatment for the disease. Standard options for treatment are the same as for women and include surgery, radiation, chemotherapy, hormonal therapy, and targeted therapies.

Symptoms of Male Breast Cancer: Any unusual changes in the breast should be reported, but especially the following:

  • Lump felt in the breast
  • Nipple pain
  • Inverted nipple
  • Nipple discharge (clear or bloody)
  • Sores on the nipple and areola (dark circle of skin surrounding the nipple)
  • Enlarged lymph nodes under the arm

Paget’s Disease of the Nipple: A rare form of breast cancer that usually affects the ducts of the nipple first, then spreads to the nipple surface and areola. Although rare, it is important to be aware of the symptoms, as more than 97% of people with Paget’s disease may also have either DCIS or an invasive cancer somewhere else in the breast.  Changes to the nipple and areola are often the first sign that breast cancer is present. Paget’s disease of the nipple affects both women and men.

Symptoms: The first indication of Paget's disease is when the skin on and around the nipple becomes red, sore, flaky, or scaly. These symptoms may appear, disappear, and then reappear over time. As the disease progresses, other symptoms appear and include:

  • Itching, tingling, and/or a burning sensation
  • Pain and sensitivity
  • Scaling and thickening of the skin
  • Flattening of the nipple
  • Yellowish or bloody discharge from the nipple

Paget’s disease can sometimes be mistaken for eczema, infection, injury, or some other skin condition. Patients experiencing any of the above symptoms that do not resolve with treatment should be seen by a breast specialist to determine if Paget’s disease is present.

Phyllodes Tumors of the Breast: Rare tumors that grow in a leaf-like pattern, these tumors grow quickly but usually do not spread outside the breast. Most phyllodes tumors are benign (non-cancerous), but some are malignant (cancerous), and some are borderline.  All three grow quickly and require surgery to reduce the risk of recurrence. They can occur at any age but are more frequently seen in women in their 40s. They rarely appear in men.

Symptoms of Phyllodes Tumors: The most common symptom is a breast lump which can be felt during physical exam. Lumps can grow to a size of 2-3 cm or larger in just weeks or months. Although typically not painful, it can create a visible bulge as it pushes against the skin or cause an open wound to form as it breaks through the skin.

Recurrent and Metastatic Breast Cancer : Unfortunately, breast cancer can re-occur or spread to different parts of the body even if it has been successfully treated at first. When it returns, it is likely to appear in specific areas of the body, including:

  • The breast or the area where the breast used to be
  • The chest wall
  • The lymph nodes
  • The bones
  • The lungs or around the lungs
  • The liver
  • The brain

Symptoms are wide-ranging, dependent upon the area affected, and treatment will be tailored as such.  BreastCancer.org provides a comprehensive guide to recurrent and metastatic cancer on its website here.

Additional Breast Cancer Resources:

BreastCancer.Org – a non-profit organization dedicated to providing complete and up-to-date information about all types of breast cancer.   This comprehensive website covers everything from prevention to diagnosis to treatment and its side effects, as well as advice on how to manage the daily details that come with a diagnosis of breast cancer (employment issues, intimacy issues, arm lymphedema,etc).

American Cancer Society – a nationwide, community-based voluntary health organization dedicated to eliminating cancer as a major health problem. The clearinghouse for all cancer-related information, this website provides an excellent, detailed guide to breast cancer in both women and men, covering many topics such as risk factors, prevention, detection, treatment, and resources for post-treatment needs (prosthetics, hair-loss accessories).

National Cancer Institute – Run by the National Institutes of Health, this website provides in-depth information on screening, testing,treatment, research, and on-going clinical trials.

Breast Cancer Patient Organizations:

Y-ME National Breast Cancer Organization – A national non-profit organization that provides a peer support hotline to breast cancer patients and their families.  Called the YourShoes® 24/7 Breast Cancer Support Center, peer-counselor trained breast cancer survivors are on call around the clock, 365 days per year, to provide support to patients and families. Its mission is to ensure that through information, empowerment and peer support, no one faces breast cancer alone.

National Breast Cancer Foundation – A non-profit organization that promotes the importance of early detection, provides mammograms and other diagnostic breast care services to those in need, and provides support services to patients and families.

Love/Avon Army of Women – Along with providing funding to researchers investigating the causes of breast cancer, the goal of this organization is to recruit healthy women volunteers, including breast cancer survivors and those at high-risk for the disease, to directly participate in research aimed at discovering the causes and prevention of breast cancer.

Canadian Breast Cancer Resources:

Willow Breast Cancer Support Canada – A national non-profit organization that provides free information and support to anyone affected by breast cancer.  Services available include peer support, community support, patient education, and interpreter services.

Young Adult Cancer Center– An organization dedicated to empowering young adults diagnosed with cancer by providing information, support, skills and opportunity.

Canadian Breast Cancer Foundation – A national volunteer-based organization that provides funding, support and advocacy  for  breast cancer research, education and awareness programs,  early diagnosis and effective treatment, and positive quality of life for breast cancer patients and their families.

Breast Cancer Society of Canada – A non-profit, charitable organization dedicated to funding research in the detection, prevention, treatment and cure for breast cancer.