Breast cancer - steps to finding breast lumps early.

2015 rev.
The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor.  

What is breast cancer?

Breast cancer begins in breast tissue. Most of the tumours that develop in breast tissue are benign (not cancerous). However, some breast tumours are cancerous but have not yet spread to other parts of the body. This type of breast cancer is called “in situ” and in many cases it can be cured with treatment. The most serious type of breast cancer is “invasive,” meaning that the cancerous tumours have spread to other parts of the body.

Breast cancer is the second-most common cancer among women (after skin cancer). The good news is that the rate of death from breast cancer has declined over the last few years. This is most likely because of regular screening mammograms and breast exams, which can help find breast cancers earlier, when treatment can help the most. Men can also get breast cancer, but it is not common.

What causes breast cancer?

The exact cause of breast cancer is not known. There are certain risk factors that seem to increase a person’s chance of getting the disease. For example, it is estimated that about 10 per cent of breast cancer cases are hereditary (run in the family). In many of these cases, a person has inherited a gene from his or her parents that has mutated (changed from its normal form). This mutated gene makes it more likely for a person to get breast cancer.

What genes can cause breast cancer to be inherited?

Every person has tens of thousands of genes. Two of these genes are called BRCA1 and BRCA2. Normally, these genes help to prevent cancer tumours from growing. However, sometimes a person can inherit a mutated (abnormal) form of BRCA1 or BRCA2 from their family. This person’s chance of getting breast cancer increases. Mutations in these two genes have also been linked to ovarian cancer.

Researchers believe that the mutations of some other genes besides BRCA1 and BRCA2 also play a role in causing breast cancer. Scientists are working to identify these genes.

Breast cancer seems to run in my family. What should I do?

Talk with your doctor about your family history. Your doctor will ask how you are related to your family members who have had breast cancer and how old your relatives were when their cancer was diagnosed, among other questions.

 

Breast cancer in two or more first-degree relatives (parents, siblings, children) is a sign that the mutated form of BRCA1 or BRCA2 might run in your family. Other signs that you might carry a mutated gene are:

  1. If you have a first-degree relative who got breast cancer before the age of 50
  2. If you have a first-degree relative with ovarian cancer

 

Although anyone with first-degree relatives who have had breast cancer is at an increased risk, most people don’t get the inherited kind of breast cancer.

Should I have a test to find out if I carry the breast cancer gene?

If there are signs that you might be at risk for inherited breast cancer, a discussion with your doctor might help you decide if genetic testing is right for you. Your doctor will discuss the benefits, limitations, and risks of taking the test.

Some people want to know whether they have one of the mutated genes, because they feel that knowing will either relieve their mind (if the test is negative) or help them deal with the risk of breast cancer and allow them and their doctors to watch closely for early signs of cancer (if the test is positive). However, other people would rather not know, because they feel that if they found out they had the gene, the knowledge would be too hard to cope with.

For some patients, genetic testing can help to assess the risk of breast cancer. For all patients, there are other steps you can take to care for your breast health.

How can I find breast cancer early?

The best way to find breast lumps that might be cancer is to do two things:

  1. Have regular mammograms
  2. Have your doctor check your breasts every year

Doing both gives you the best chance to find cancer as early as you can. Finding breast cancer early makes treatment much easier and more effective.

What is a mammogram?

A mammogram is the most effective way to find breast cancer early, up to two years before the lump is even large enough to feel. A mammogram is a special kind of x-ray of your breasts. Mammograms are safe because the amount of radiation used in the x-ray is very small.

How is a mammogram performed? Does it hurt?

Your breast will rest on a shelf and the x-ray machine will be slowly pressed against your breast until you feel pressure. This pressure is needed to spread your breast out so that the machine can get a good x-ray of the breast tissue. The pressure can be uncomfortable and lasts just for a few seconds, while each picture is taken.

How often should I get a mammogram?

If you are over the age of 50, you should get a mammogram and have your breasts examined by your family doctor on a regular basis, usually every one to two years. If you have risk factors for breast cancer, such as a family history of breast cancer, your doctor might want you to have mammograms more often or to start having them sooner.

How often should my doctor check my breasts?

You should have a breast examination in addition to a mammogram every one to two years beginning when you are 50 years old. Talk with your doctor if you are under the age of 50 and have a family history of breast cancer. Your doctor might examine you more often or sooner after discussing your risk factors.

Changes to look for in your breasts

If you notice any of the following changes in your breasts, ask your doctor about them right away:

  • Any new lump, which might not be painful or tender
  • Unusual thickening of your breasts
  • Sticky or bloody discharge from your nipples
  • Any changes in the skin of your nipples or breasts, such as puckering or dimpling
  • An unusual increase in the size of one breast
  • One breast unusually lower than the other


This health education material was developed and adapted by The College of Family Physicians of Canada from online materials developed by The American Academy of Family Physicians, with permission. It is regularly reviewed and updated by family physician members of the CFPC Patient Education Committee, who refer to the current evidence-based medical literature. Support for this program has been provided by a grant to the CFPC Research and Education Foundation by Scotiabank.

These pages may be reproduced for not-for-profit educational purposes only. 

 

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Cancer, Patient Education, Women’s Health
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