Breast Cancer Basics

Women aged 40–64 (sometimes younger), with limited insurance and low/moderate income, may qualify for free mammograms through the HealthyWoman Program and free treatment via the Breast and Cervical Cancer Prevention and Treatment Program. Call 800-215-7494 or visit www.PAHealthyWoman.org to check eligibility.

Inside a woman’s breast are 15 to 20 sections (lobes), each made of many lobules with milk-producing glands. Milk flows from these lobules through ducts to the nipple. Fibrous tissue and fat fill the spaces between lobules and ducts.

Cancer begins when the normal process of cell growth and death malfunctions, leading to new cells forming unnecessarily and old/damaged cells not dying. This builds up into a lump or tumor, which can be benign (not cancer) or malignant (cancerous).

Benign tumors are usually harmless, rarely invade nearby tissues, do not spread, and can often be removed without returning. Malignant tumors can invade nearby tissues/organs, may spread (metastasize) to other body parts, and can be life-threatening.

Breast cancer cells can break away from the original tumor and travel through the blood or lymphatic system to other body parts, forming new tumors (metastases). The new tumor is named and treated based on where it originated (e.g., breast cancer in the lung is still breast cancer).

The most common type is ductal carcinoma (about 70% of cases), which begins in the cells lining a breast duct. The second most common is lobular carcinoma (about 10% of cases), starting in a breast lobule. Other types and mixtures exist but are less common.

Lab tests include hormone receptor tests (to see if the cancer needs estrogen or progesterone to grow) and HER2 tests (to check for excess HER2 protein). The results guide treatment options like hormone therapy or targeted therapy.

Triple-negative breast cancer has cells that lack estrogen receptors, progesterone receptors, and do not overproduce HER2. About 15% of American women with breast cancer fall into this category.

Inflammatory breast cancer is a rare, aggressive form happening in about 1% of invasive breast cancers. The breast appears red and swollen due to cancer cells blocking lymph vessels in the skin. At diagnosis, it is at least Stage IIIB.

Breast cancer stages are described using Roman numerals 0–IV and letters A, B, C. Early-stage is I, the most advanced is IV (cancer has spread to other body parts). Staging depends on tumor size and cancer spread to lymph nodes or other organs.

Treatment options include surgery, radiation therapy, hormone therapy, chemotherapy, and targeted therapy. The best plan depends on cancer stage, hormone receptor and HER2 status, general health, and other factors.

Options include breast-sparing (conserving) surgery like lumpectomy or segmental mastectomy, and mastectomy (removal of the whole breast). Lymph nodes might also be removed. Choice depends on tumor size, location, stage, and patient preference.

Lymphedema is swelling caused by a build-up of lymph fluid, often in the arm, after lymph nodes under the arm are removed or treated with radiation. It can develop soon after surgery or years later and requires protection and care of the affected arm.

Radiation can be given externally via a machine (most common, daily sessions over several weeks) or internally via brachytherapy (radioactive material placed inside the breast for minutes each session). Both methods target the breast area after surgery.

Hormone therapy is used if breast cancer cells have hormone receptors. It blocks or reduces estrogen/progesterone's effect, usually with drugs like tamoxifen, aromatase inhibitors, or ovarian suppression (drugs or surgery), depending on menopausal status.

Chemotherapy uses drugs to kill cancer cells, often given intravenously or as a pill, before or after surgery. Side effects include low blood cell counts (infection risk, weakness), hair loss, nausea, vomiting, diarrhea, mouth sores, tingling/numbness in extremities, and possible effects on fertility and heart function.

Targeted therapy is for cancers with too much HER2 protein. Drugs like trastuzumab block the action of HER2, slowing cancer growth. Side effects include nausea, vomiting, diarrhea, and risks to heart and lung health.

Reconstruction can use breast implants (saline or silicone) or tissue from other body parts. It can be done at the time of mastectomy or later. Alternatives include wearing a breast form, padding, or doing nothing. The choice depends on age, body type, and medical/surgical situation.

Good nutrition provides needed calories and protein, helping maintain strength and weight. Eating can be difficult during treatment due to poor appetite, nausea, or mouth sores, while some women may gain weight. A dietitian can help meet nutrition needs.

Regular checkups (every 3–6 months) help detect cancer recurrence, new cancers, or treatment side effects. These include exams, mammograms, and other imaging or lab tests as needed.

The PA Breast Cancer Coalition offers patient advocacy, insurance help, the Friends like Me Care Package, educational programs, and connects women with support groups and resources. Free mammograms and treatment may be available for eligible women.

Women aged 40–64 (sometimes younger), with limited insurance and low/moderate income, may qualify for free mammograms through the HealthyWoman Program and free treatment via the Breast and Cervical Cancer Prevention and Treatment Program. Call 800-215-7494 or visit www.PAHealthyWoman.org to check eligibility.

Inside a woman’s breast are 15 to 20 sections (lobes), each made of many lobules with milk-producing glands. Milk flows from these lobules through ducts to the nipple. Fibrous tissue and fat fill the spaces between lobules and ducts.