Breast Cancer
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BRCA Genes and Your Breast Cancer Risk
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Barbara K. Hecht, PhD
BRCA, known as the "breast cancer gene," is one of
several genetic mutations (alterations in the body's genetic material) that have
been associated with the development of breast and ovarian cancer. Changes in two genes, known as BRCA1
and BRCA2 (short
for breast cancer 1 and breast cancer 2), can be inherited and lead to a
markedly increased risk for developing breast cancer and ovarian
cancer.
Only about 5% of women with breast cancer are found to
carry a mutated BRCA gene. Studies have confirmed that women who carry these
BRCA mutations have a high risk for development of breast cancer, up to seven times
that of women who do not have BRCA gene alterations. By the age of 80, women
with BRCA mutations have about an 80% chance of developing breast cancer. Having
a BRCA mutation also predisposes a woman to developing breast cancer at an early
age. The incidence
of BRCA mutation is higher in some ethnic groups, such as people of Ashkenazi
(European) Jewish origin and in some populations in Iceland, the Netherlands, and
the Balkans.
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Breast Cancer Overview
Breast cancer is cancer arising in breast tissue. Cancer is simply a group of abnormal cells that have abnormal growth patterns.
- Although breast cancer is primarily a disease of women, almost 1% of breast
cancers occur in men. In 2007, it is estimated that 2,030 men in the U.S. will
develop invasive breast cancer.
- Breast cancer is the most common type of
cancer in women with the exception of nonmelanoma skin cancers. It is the second
leading cause of death by cancer in women, following only lung cancer.
- In
2007, the American Cancer Society estimated that 178,480 new cases of invasive
breast cancer would be diagnosed among women in the United States, and that a
further 62,030 new cases of in-situ (noninvasive) breast cancer would be
diagnosed.
- A woman has a lifetime risk of developing invasive breast cancer of about
one in eight, or 13%.
- Death rates from breast cancer have been gradually declining and continue
to decline. These decreases are likely due both to increased awareness and
screening and improved treatment methods.
The breasts are made of fat, glands,
and connective (fibrous) tissue. The breast has several lobes, which are divided
into lobules that end in the milk glands. Tiny ducts run from the many tiny
glands, connect together, and end in the nipple.
- These ducts are where 80% of
breast cancers occur. This condition is called ductal cancer.
- Cancer
developing in the lobules is termed lobular cancer. About 10-15% of breast
cancers are of this type.
- Other less common types of breast cancer include
inflammatory breast cancer, medullary cancer, phyllodes tumor, angiosarcoma,
mucinous (colloid) carcinoma, mixed tumors, and a type of cancer involving the
nipple termed Paget's disease.
Precancerous changes, called in situ changes, are
common.
- In situ is Latin for "in place" or "in site" and means that the
changes haven't spread from where they started.
- When these in situ changes occur in the ducts, they are called ductal
carcinoma in situ (DCIS). DCIS may be identified on routine mammography.
- When in-situ changes happen in the lobules, it is called lobular carcinoma
in situ (LCIS).
When cancers spread into the surrounding tissues, they are
termed infiltrating cancers. Cancers spreading from the ducts into adjacent
spaces are termed infiltrating ductal carcinomas. Cancers spreading from the
lobules are infiltrating lobular carcinomas.
The most serious cancers are
metastatic cancers. Metastasis means that the cancer has spread from the place
where it started into other tissues distant from the original tumor site. The
most common place for breast cancer to metastasize is into the lymph nodes under
the arm or above the collarbone on the same side as the cancer. Other common
sites of breast cancer metastasis are the brain, the bones, and the liver.
Next: Breast Cancer Causes »
Last Editorial Review: 4/13/2007