Section 1: Breast Cancer, Treatment, and Aftercare

HIGHLIGHTS

  • The goal of this section is to provide you with information that researchers know about breast cancer, treatment and aftercare for young African American breast cancer survivors.

  • Every woman is at some risk of breast cancer, however this risk increases as women get older. Breast cancer risk is considerably lower for women under 40 years of age.

  • However, African American women are more often diagnosed with breast cancer before 45 years of age.

  • Breast cancer develops when cells in your breast change and start dividing and growing, unlike normal cells. Different types of breast cancer need different treatments.

  • The stage of a breast cancer tumor tells you how large the cancer has grown, and whether it has spread to lymph nodes or to other parts of the body. Doctors use these stages to choose the best way to treat breast cancer.

  • Every woman is different and every cancer is different. Treatment removes or kills the cancer cells and keeps new cancer cells from growing.

  • Cancer survivors should do the same things to be healthy as everyone else. There are simple steps you can take to improve and maintain your health, like eating a healthy diet, being physically active, limiting alcohol consumption and not using any tobacco.

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SUMMARY

BREAST CANCER AND YOUNG AFRICAN AMERICAN WOMEN

Every woman is at some risk of breast cancer. Breast cancer is very common among women in the United States. In the United States, one in nine (11%) African American women may get breast cancer during her lifetime. However, when breast cancer strikes women under age 40, African American women have the highest rates of breast cancer of any racial group. It is important to realize that only 5% of breast cancer diagnoses are made in women under age 40. Still, every year in the United States, an average of 1,561 African American women under age 40 get breast cancer. The gap in cancer rates between African American and White women is even greater for breast cancers diagnosed before age 30.

UNDERSTANDING YOUR BREASTS

All breasts are made up of the same basic parts, but there is no “typical” breast. Breasts come in different shapes and sizes. The three main parts of the breast are (1) the glands that make milk when breastfeeding a baby; (2) the ducts that carry milk to the nipple, and (3) connective tissue (fat, skin, and small muscles and ligaments) that holds the breast together.

Many conditions may cause a lump or lumps in your breast. Sometimes a breast lump is cancer, but usually lumps in the breast have less serious causes. The two most common causes of breast lumps are fibrocystic breast condition and cysts. Neither of these conditions are breast cancer.

BREAST CANCER RISK FACTORS AND PROTECTIVE FACTORS

Some risk factors for breast cancer include:

  • Personal history of breast cancer

  • Family history of cancer

  • Previous radiation treatment(s)

  • Dense breast tissue

Some protective factors for breast cancer include:

  • Age at first menstruation period

  • Exercise

  • Age at pregnancy

  • Breastfeeding

TYPES OF BREAST CANCER

Breast cancer happens when cells in the breast change so that they can grow and multiply in an uncontrolled way. Usually the cancer cells form a lump, called a tumor. The two most common kinds of breast cancer are as follows:

  1. Ductal carcinoma is the most common pattern of breast cancer. Ductal carcinomas develop in the lining of the tubes that take milk from milk glands to the nipple. If the cancer cells have grown out of the ducts, and spread to other parts of the breast, then the cancer is called invasive ductal carcinoma.

  2. Lobular carcinoma develops in the glands that make milk, called lobes. When cancer cells begin in these milk-making glands, the cancer is called lobular carcinoma. If the cancer cells have grown out of the lobes, and spread to other parts of the breast, then the cancer is called invasive lobular carcinoma.

FAST-GROWING BREAST CANCER IN AFRICAN AMERICAN WOMEN

African American women are at a higher risk for fast-growing breast cancers, including triple-negative tumors, basal-type tumors, and inflammatory breast cancer. A triple-negative tumor does not have receptors for estrogen or progesterone, and does not have too many HER2 receptors. Basal-type tumors are more common in women who have inherited a mutated BRCA1 gene that increases their risk of breast cancer. Inflammatory breast cancer is the type that spreads the fastest. Inflammatory breast cancer only makes up 5 or fewer cases out of 100, but it is more common in African American women and tends to occur at younger ages than other types of breast cancer.

STAGES OF BREAST CANCER

One of the ways to describe breast cancer is by stage of disease. The stage of a breast cancer tumor tells you if the cancer has spread beyond its first location to other parts of the breast or to other parts of the body. The stages range from Stage 0 to Stage 4. Stage 0 is for carcinoma in situ—this means that the cancer has not invaded into deeper layers of the breast tissue. Stage 4 is used to describe cancer that has spread beyond the breast and lymph nodes to more distant places. Knowing the cancer’s stage helps doctors choose the best treatment method.

HOW BREAST CANCER SPREADS IN THE BODY

Cancer cells spread through the body in three main ways:

  1. They can grow through the tissue into a part of the body next to the tumor.

  2. They can travel in the blood stream to distant parts of the body.

  3. They can travel through the lymph system.

DIAGNOSIS AND TREATMENT FOR BREAST CANCER

Following a breast cancer diagnosis, you will talk with your doctor about test results and treatment options. Breast cancer treatments usually fall into three categories: local, regional, and systemic. The goal of treatment is to remove or kill the cancer cells, and once they are gone, to keep new cancer cells from growing. Every woman is different, and every cancer is different.

BREAST CANCER TREATMENTS

Local therapies are the treatments that focus on getting rid of the cancer in the place where the main tumor is found. Most women who are diagnosed with breast cancer will require surgery, where doctors remove the cancer from the body.

Regional therapy treats or removes lymph nodes (glands) that can drain breast cancers. Most breast cancer patients will need to undergo an axillary surgical procedure to determine whether the cancer has spread to the underarm (axillary) glands. This information helps to determine the stage of cancer and treatment needs.

Systemic therapy to treat their breast cancer affects all of the cells in your body. Chemotherapy, hormone therapy, and targeted therapy are used to kill or weaken cancer cells throughout a woman’s body.

AFTER BREAST CANCER TREATMENT IS COMPLETE

Once you finish your cancer treatment, you must take steps to protect your health. One of the most important things you can do is check in regularly with your doctors, especially your oncologist and your surgeon. Talk to your doctor about developing a survivorship care plan that will help to monitor your health after treatment.


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Section 1: Breast Cancer, Treatment, and Aftercare

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African American YBCS Survivor Quote

“I was diagnosed with invasive ductal carcinoma in my left breast on February 19, 2009. I am 31 years of age and just thought I had a clogged milk duct from breast-feeding. It is now April (2009) and I have just finished my third round of chemo, and I have one more to go before my surgery. The entire process for me has been filled with tears, laughter, and a lot of praying. Life looks completely different for me after this experience. You get to really see what really matters and what does not.”