breast cancer essay outline

Breast Cancer - Free Essay Examples And Topic Ideas

Breast cancer is a type of cancer that develops from breast tissue. Essays on this topic could explore the causes, diagnosis, treatment, and prevention of breast cancer. Additionally, discussions might delve into the psychological and social impact of breast cancer on patients and their families, the ongoing research towards finding a cure, and the broader societal awareness and support systems available for those affected. We have collected a large number of free essay examples about Breast Cancer you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Micro Needle Thermocouple for Detection of Breast Cancer

Hundreds and thousands of people are affected by cancer each year; it is one of the most fatal diseases and a leading cause of death and disability for humans (Iranifam 2014). There are several types of cancer than can affect different areas of the body, some being less life-threatening than others. A vast amount of patients suffer from late diagnosis or recurrence of their disease in spite of all the advances in diagnosis and treatment of breast cancer. Modern cancer […]

The Role of Histology in the Breast Cancer

Breast cancer is an uncontrolled growth of breast cell that can be benign, not dangerous, but it can also metastasize and invade different and distant tissues in our body. Breast Cancer is the most common cancer in female of any age and although the risk increases, as you get older, many different factors affect the chance of a woman to get breast cancer. I chose this specific topic because breast cancer is something that I’ve dealt with in my personal […]

Corporate Social Responsibility against Cancer

Abstract As an assistant manager at Kenta Law Firm, based in Monroe, I intend to collaborate with the Susan B. Komen Foundation a non-organization corporation that is interested in reducing issues of breast cancer among women. Kenta law firm has noted that a significant populace of Monroe’s youth especially women and young children specifically those who are homeless are suffering from breast cancer. In this CSR partnership, our law firm will collaborate with the Susan B. Komen Foundation in addressing […]

We will write an essay sample crafted to your needs.

Why is Screening for Breast Cancer Important

The impact this disease has, on not only the individual but the people around them, is powerful. Even though the tests show cancer, I am thankful that I had the annual test. It is true that stress, anxiety, and money can be saved by waiting until the age of 50 years old because of misinterpretation and overdiagnosis. However, early detection is the key to success in the battle against breast cancer. There are many different options for detection scans that […]

Breast Cancer: Casuses and Treatment

Cancer is defined as “when the body’s cells begin to divide without stopping and spread into surrounding tissues.” (“What is cancer?”, 2017), caused by mutations that lead to the cell cycle to proceed, regardless if the cell is qualified to. The mutations block the use of the G1, G2, and M checkpoints in the cell cycle. These checkpoints are important in “sensing defects that occur during essential processes, and induce a cell cycle arrest in response until the defects are […]

Breast Reconstruction after Mastectomy

Breast cancer is always personal. As a physician who counsels women at different steps during the healing process, I am acutely aware of this undeniable fact. Every decision she makes from the point at which she is diagnosed with breast cancer will require her focused engagement and a physician who is central to understanding her need for clarity of options. It is an intimate relationship where trust is a requirement and every woman faced with the many unknowns ahead will […]

Breast Cancer History Research Paper

Breast cancer is a disease in which most commonly occurs in all women no matter their size, shape, race, or ethnicity. About one in eight women will be diagnosed with breast cancer every year, a fatal disease if not discovered early. Early detection of breast cancer is key so that cancerous cells found in the breast do not spread through other parts of the body. With an increasing prevalence in breast cancer today, the evolution of technology has been improved […]

New Healthcare Inventions on Breast Cancer

Abstract Background: The Ki67 labeling index (LI) for breast carcinoma is essential for therapy. It is determined by visual assessment under a microscope which is subjective, thus has limitations due to inter-observer variability. A standardized method for evaluating Ki67 LI is necessary to reduce subjectivity and improve precision. Therefore, automated Digital Image Analysis (DIA) has been attempted as a potential method for evaluating the Ki67 index. Materials and Method: We included 48 cases of invasive breast carcinoma in this study. […]

Understanding Breast Cancer

This paper will clarify what Breast Cancer is. It will explain the symptoms, treatment options, and other useful information regarding this disease. The first thing to know about Breast Cancer is understanding what it is. According to the Cancer.org website, breast cancer begins when cells in the bosom begin to spread out of control. The tumor that is formed from these cells may be detected on an x-ray or can be felt as a lump. Malignancy can advance into neighboring […]

Breast Cancer in African American Women

Summary Despite the fact that Caucasian women in the United States have a higher incidence rate of breast cancer than any other racial group, African-Americans succumb notably worse to the disease and record the highest mortality rate. To comprehend the barriers and challenges that predispose African-American women to these disparities, this research was conducted to get a better understanding from the perspective of oncologists. With diverse ethnicity and gender representation, the participation of seven medical, surgical and radiation oncologists that […]

Essential Breast Cancer Screening Techniques and their Complements

It is with great distress that each year a large number of females suffer and die from breast cancer. Medicine practitioners and researchers have been striving to save lives from breast cancer, and how they manage to do this includes two major parts—diagnosis and treatment. What comes first on the stage of diagnosis is the detection of tumor. Thus, the development of breast imaging techniques is at the highest priority for diagnosing breast cancer, and individuals’ focus is on earlier […]

Breast Cancer Prevention and Treatment

The human body is made up of cells. When a cell dies the body automatically replaces it with a new healthy cell, but sometimes the cell is not healthy and grows out of control. These cells group together and form a lump that can be seen on an x-ray. Breast cancer is a tumor in the cells of person’s breast. It can spread throughout the breast to the person’s lymph nodes and other parts of the body. Sometimes it occurs […]

Breast Cancer Diagnosis

I. Executive Summary Breast cancer is concerning a large number of female individuals worldwide. This disease comes from abnormally developed breast tissue, which usually begins in either lobules or ducts of the breast. Generally speaking, breast cancer is divided into two types—non-invasive and invasive. The core criteria to distinguish in between these two types of breast cancers is the location of cancer cells. Cancer cells remain on their initial positions for a non-invasive breast cancer, whereas they grow, or “invade”, […]

Understanding a Breast Cancer Diagnosis

Breast cancer is often known as an aggressive cancer. It forms when cells grow uncontrollably in the tissues of the breast, leading to a tumor. Over 190,000 individuals are diagnosed yearly (Cancer Center). Breast cancer is the second leading cause of death, and the rate increases every year in women, and occasionally in men. Over 12 percent of women in the United States of America will face breast cancer in their lifetime. It is the most common cause of death […]

Breast Cancer in the Era of Precision Medicine

Introduction: Precision medicine is concerned with the diagnosis of patients according to their biological, genetic, and molecular status. As cancer is a genetic disease, its treatment comes among the first medical disciplines as an application of precision medicine. Breast cancer is a highly complex, heterogeneous, and multifactorial disease; it is also one of the most common diseases among women in the world. Usually, there are no clear symptoms, so regular screening is important for early detection. Scientists recently started using […]

Exome Sequencing to Identify Rare Mutations Associated with Breast Cancer Susceptibility

Abstract Background - Breast cancer predisposition has been known to be caused by hereditary factors. New techniques particularly exome sequencing have allowed/ helped us to identify new and novel variants that exhibit a phenotype. Method - In this review we discuss the advantages of exome sequencing and how it could help in understanding the familial breast cancer. In particular, we will discuss about the studies by Noh et al.(1), Thompson et al.(2), and Kiiski et al.(3), on how they have […]

A Novel Therapeutic Strategy for HER2 Breast Cancer by Nanoparticles Combined with Macrophages

Abstract:In recent years, the cell membrane bionic nanoparticles as a new drug delivery system is widely used in small molecule drugs, vaccines and targeted delivery of macromolecular drugs, because of its inherited the specific receptors on the cell membrane and membrane proteins can be used to implement specific targeted delivery, and the tumor showed a good treatment effect on the disease such as model, this topic with a huge bite cell membrane of the role of tumor capture, chemical modification, […]

Essays About Breast Cancer Breast Cancer is one of the most common cancers in women and is a disease by which the cells in the breast area grow out of control. Breast cancer tends to begin in the ducts or lobules of a breast and there are different types of cancer. In the US alone 1 in 8 women will develop breast cancer at some stage in their lives. In many academic fields; from science to medicine the study of breast cancer and essays about breast cancer are required as part of the curriculum. An essay on breast cancer can seem daunting due to the amount of research and several varying scientific approaches used to talk about the topic. We offer essay examples, or research paper guidance and free essay samples.  These can be used to gauge how to approach the topic and are an informative look at all factors that contribute to breast cancer and prevention. We also factor breast cancer awareness into our essay samples and ensure essays for both university and college build a strong foundation to understanding the disease, but also draw criticism when necessary and a strong conclusion on whatever element of breast cancer the focus of the essay is on.

1. Tell Us Your Requirements

2. Pick your perfect writer

3. Get Your Paper and Pay

Hi! I'm Amy, your personal assistant!

Don't know where to start? Give me your paper requirements and I connect you to an academic expert.

short deadlines

100% Plagiarism-Free

Certified writers

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Cancers (Basel)

Breast Cancer—Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies—An Updated Review

Sergiusz Łukasiewicz.

1 Department of Surgical Oncology, Center of Oncology of the Lublin Region St. Jana z Dukli, 20-091 Lublin, Poland; lp.lzoc@zciweisakulS (S.Ł.); [email protected] (A.S.)

Marcin Czeczelewski

2 Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; [email protected] (M.C.); lp.teno@amrofa (A.F.)

Alicja Forma

3 Department of Human Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; [email protected]

Robert Sitarz

Andrzej stanisławek.

4 Department of Oncology, Chair of Oncology and Environmental Health, Medical University of Lublin, 20-081 Lublin, Poland

Simple Summary

Breast cancer is the most common cancer among women. It is estimated that 2.3 million new cases of BC are diagnosed globally each year. Based on mRNA gene expression levels, BC can be divided into molecular subtypes that provide insights into new treatment strategies and patient stratifications that impact the management of BC patients. This review addresses the overview on the BC epidemiology, risk factors, classification with an emphasis on molecular types, prognostic biomarkers, as well as possible treatment modalities.

Breast cancer (BC) is the most frequently diagnosed cancer in women worldwide with more than 2 million new cases in 2020. Its incidence and death rates have increased over the last three decades due to the change in risk factor profiles, better cancer registration, and cancer detection. The number of risk factors of BC is significant and includes both the modifiable factors and non-modifiable factors. Currently, about 80% of patients with BC are individuals aged >50. Survival depends on both stage and molecular subtype. Invasive BCs comprise wide spectrum tumors that show a variation concerning their clinical presentation, behavior, and morphology. Based on mRNA gene expression levels, BC can be divided into molecular subtypes (Luminal A, Luminal B, HER2-enriched, and basal-like). The molecular subtypes provide insights into new treatment strategies and patient stratifications that impact the management of BC patients. The eighth edition of TNM classification outlines a new staging system for BC that, in addition to anatomical features, acknowledges biological factors. Treatment of breast cancer is complex and involves a combination of different modalities including surgery, radiotherapy, chemotherapy, hormonal therapy, or biological therapies delivered in diverse sequences.

1. Introduction

Being characterized by six major hallmarks, carcinogenesis might occur in every cell, tissue, and organ, leading to the pathological alternations that result in a vast number of cancers. The major mechanisms that enable its progression include evasion of apoptosis, limitless capacity to divide, enhanced angiogenesis, resistance to anti-growth signals and induction of own growth signals, as well as the capacity to metastasize [ 1 ]. Carcinogenesis is a multifactorial process that is primarily stimulated by both—genetic predispositions and environmental causes. The number of cancer-related deaths is disturbingly increasing every year ranking them as one of the major causes of death worldwide. Even though a significant number of cancers do not always need to result in death, they significantly lower the quality of life and require larger costs in general.

Breast cancer is currently one of the most prevalently diagnosed cancers and the 5th cause of cancer-related deaths with an estimated number of 2.3 million new cases worldwide according to the GLOBOCAN 2020 data [ 2 ]. Deaths due to breast cancer are more prevalently reported (an incidence rate approximately 88% higher) in transitioning countries (Melanesia, Western Africa, Micronesia/Polynesia, and the Caribbean) compared to the transitioned ones (Australia/New Zealand, Western Europe, Northern America, and Northern Europe). Several procedures such as preventive behaviors in general as well as screening programs are crucial regarding a possible minimization of breast cancer incidence rate and the implementation of early treatment. Currently, it is the Breast Health Global Initiative (BHGI) that is responsible for the preparation of proper guidelines and the approaches to provide the most sufficient breast cancer control worldwide [ 3 ]. In this review article, we have focused on the female breast cancer specifically since as abovementioned, it currently constitutes the most prevalent cancer amongst females.

2. Breast Cancer Epidemiology

According to the WHO, malignant neoplasms are the greatest worldwide burden for women, estimated at 107.8 million Disability-Adjusted Life Years (DALYs), of which 19.6 million DALYs are due to breast cancer. [ 4 ]. Breast cancer is the most frequently diagnosed cancer in women worldwide with 2.26 million [95% UI, 2.24–2.79 million] new cases in 2020 [ 5 ]. In the United States, breast cancer alone is expected to account for 29% of all new cancers in women [ 6 ]. The 2018 GLOBOCAN data shows that age-standardized incidence rates (ASIR) of breast cancer are strongly and positively associated with the Human Development Index (HDI) [ 7 ]. According to 2020 data, the ASIR was the highest in very high HDI countries (75.6 per 100,000) while it was more than 200% lower in medium and low HDI countries (27.8 per 100,000 and 36.1 per 100,000 respectively) [ 5 ].

Besides being the most common, breast cancer is also the leading cause of cancer death in women worldwide. Globally, breast cancer was responsible for 684,996 deaths [95% UI, 675,493–694,633] at an age-adjusted rate of 13.6/100,000 [ 5 ]. Although incidence rates were the highest in developed regions, the countries in Asia and Africa shared 63% of total deaths in 2020 [ 5 ]. Most women who develop breast cancer in a high-income country will survive; the opposite is true for women in most low-income and many middle-income countries [ 8 ].

In 2020 breast cancer mortality-to-incidence ratio (MIR) as a representative indicator of 5-year survival rates [ 9 ] was 0.30 globally [ 5 ]. Taking into consideration the clinical extent of breast cancer, in locations with developed health care (Hong-Kong, Singapore, Turkey) the 5-year survival was 89.6% for localized and 75.4% for regional cancer. In less developed countries (Costa Rica, India, Philippines, Saudi Arabia, Thailand) the survival rates were 76.3% and 47.4% for localized and regional breast cancer respectively [ 10 ].

Breast cancer incidence and death rates have increased over the last three decades. Between 1990 and 2016 breast cancer incidence has more than doubled in 60/102 countries (e.g., Afghanistan, Philippines, Brazil, Argentina), whereas deaths have doubled in 43/102 countries (e.g., Yemen, Paraguay, Libya, Saudi Arabia) [ 11 ]. Current projections indicate that by 2030 the worldwide number of new cases diagnosed reach 2.7 million annually, while the number of deaths 0.87 million [ 12 ]. In low- and medium-income countries, the breast cancer incidence is expected to increase further due to the westernization of lifestyles (e.g., delayed pregnancies, reduced breastfeeding, low age at menarche, lack of physical activity, and poor diet), better cancer registration, and cancer detection [ 13 ].

3. Risk Factors of Breast Cancer

The number of risk factors of breast cancer is significant and includes both modifiable factors and non-modifiable factors ( Table 1 ).

Modifiable and non-modifiable risk factors of breast cancer.

3.1. Non-Modifiable Factors

3.1.1. female sex.

Female sex constitutes one of the major factors associated with an increased risk of breast cancer primarily because of the enhanced hormonal stimulation. Unlike men who present insignificant estrogen levels, women have breast cells which are very vulnerable to hormones (estrogen and progesterone in particular) as well as any disruptions in their balance. Circulating estrogens and androgens are positively associated with an increased risk of breast cancer [ 14 ]. The alternations within the physiological levels of the endogenous levels of sex hormones result in a higher risk of breast cancer in the case of premenopausal and postmenopausal women; these observations were also supported by the Endogenous Hormones and Breast Cancer Collaborative Group [ 15 , 16 , 17 ].

Less than 1% of all breast cancers occur in men. However, breast cancer in men is a rare disease that’s at the time of diagnosis tends to be more advanced than in women. The average age of men at the diagnosis is about 67. The important factors increase a man’s risk of breast cancer are: older age, BRCA2/BRCA1 mutations, increased estrogen levels, Klinefelter syndrome, family history of breast cancer, and radiation exposure [ 18 ].

3.1.2. Older Age

Currently, about 80% of patients with breast cancer are individuals aged >50 while at the same time more than 40% are those more than 65 years old [ 19 , 20 , 21 ]. The risk of developing breast cancer increases as follows—the 1.5% risk at age 40, 3% at age 50, and more than 4% at age 70 [ 22 ]. Interestingly, a relationship between a particular molecular subtype of cancer and a patient’s age was observed –aggressive resistant triple-negative breast cancer subtype is most commonly diagnosed in groups under 40 age, while in patients >70, it is luminal A subtype [ 21 ]. Generally, the occurrence of cancer in older age is not only limited to breast cancer; the accumulation of a vast number of cellular alternations and exposition to potential carcinogens results in an increase of carcinogenesis with time.

3.1.3. Family History

A family history of breast cancer constitutes a major factor significantly associated with an increased risk of breast cancer. Approximately 13–19% of patients diagnosed with breast cancer report a first-degree relative affected by the same condition [ 23 ]. Besides, the risk of breast cancer significantly increases with an increasing number of first-degree relatives affected; the risk might be even higher when the affected relatives are under 50 years old [ 24 , 25 , 26 ]. The incidence rate of breast cancer is significantly higher in all of the patients with a family history despite the age. This association is driven by epigenetic changes as well as environmental factors acting as potential triggers [ 27 ]. A family history of ovarian cancer—especially those characterized by BRCA1 and BRCA2 mutations—might also induce a greater risk of breast cancer [ 28 ].

3.1.4. Genetic Mutations

Several genetic mutations were reported to be highly associated with an increased risk of breast cancer. Two major genes characterized by a high penetrance are BRCA1 (located on chromosome 17) and BRCA2 (located on chromosome 13). They are primarily linked to the increased risk of breast carcinogenesis [ 29 ]. The mutations within the above-mentioned genes are mainly inherited in an autosomal dominant manner, however, sporadic mutations are also commonly reported. Other highly penetrant breast cancer genes include TP53 , CDH1 , PTEN , and STK11 [ 30 , 31 , 32 , 33 , 34 ]. Except for the increased risk of breast cancer, carriers of such mutations are more susceptible to ovarian cancer as well. A significant number of DNA repair genes that can interact with BRCA genes including ATM , PALB2 , BRIP1 , or CHEK2 , were reported to be involved in the induction of breast carcinogenesis; those are however characterized by a lower penetrance (moderate degree) compared to BRCA1 or BRCA2 ( Table 2 ) [ 29 , 35 , 36 , 37 , 38 ]. According to quite recent Polish research, mutations within the XRCC2 gene could also be potentially associated with an increased risk of breast cancer [ 39 ].

Major genes associated with an increased risk of breast cancer occurrence.

3.1.5. Race/Ethnicity

Disparities regarding race and ethnicity remain widely observed among individuals affected by breast cancer; the mechanisms associated with this phenomenon are not yet understood. Generally, the breast cancer incidence rate remains the highest among white non-Hispanic women [ 51 , 52 ]. Contrarily, the mortality rate due to this malignancy is significantly higher among black women; this group is also characterized by the lowest survival rates [ 53 ].

3.1.6. Reproductive History

Numerous studies confirmed a strict relationship between exposure to endogenous hormones—estrogen and progesterone in particular—and excessive risk of breast cancer in females. Therefore, the occurrence of specific events such as pregnancy, breastfeeding, first menstruation, and menopause along with their duration and the concomitant hormonal imbalance, are crucial in terms of a potential induction of the carcinogenic events in the breast microenvironment. The first full-term pregnancy at an early age (especially in the early twenties) along with a subsequently increasing number of births are associated with a reduced risk of breast cancer [ 54 , 55 ]. Besides, the pregnancy itself provides protective effects against potential cancer. However, protection was observed at approximately the 34th pregnancy week and was not confirmed for the pregnancies lasting for 33 weeks or less [ 56 ]. Women with a history of preeclampsia during pregnancy or children born to a preeclamptic pregnancy are at lower risk of developing breast cancer [ 57 ]. No association between the increased breast cancer risk and abortion was stated so far [ 58 ].

The dysregulated hormone levels during preeclampsia including increased progesterone and reduced estrogen levels along with insulin, cortisol, insulin-like growth factor-1, androgens, human chorionic gonadotropin, corticotropin-releasing factor, and IGF-1 binding protein deviating from the physiological ranges, show a protective effect preventing from breast carcinogenesis. The longer duration of the breastfeeding period also reduces the risk of both the ER/PR-positive and -negative cancers [ 59 ]. Early age at menarche is another risk factor of breast cancer; it is possibly also associated with a tumor grade and lymph node involvement [ 60 ]. Besides, the earlier age of the first menstruation could result in an overall poorer prognosis. Contrarily, early menopause despite whether natural or surgical, lowers the breast cancer risk [ 61 ].

3.1.7. Density of Breast Tissue

The density of breast tissue remains inconsistent throughout the lifetime; however, several categories including low-density, high-density, and fatty breasts have been established in clinical practice. Greater density of breasts is observed in females of younger age and lower BMI, who are pregnant or during the breastfeeding period, as well as during the intake of hormonal replacement therapy [ 62 ]. Generally, the greater breast tissue density correlates with the greater breast cancer risk; this trend is observed both in premenopausal and postmenopausal females [ 63 ]. It was proposed that screening of breast tissue density could be a promising, non-invasive, and quick method enabling rational surveillance of females at increased risk of cancer [ 64 ].

3.1.8. History of Breast Cancer and Benign Breast Diseases

Personal history of breast cancer is associated with a greater risk of a renewed cancerous lesions within the breasts [ 65 ]. Besides, a history of any other non-cancerous alternations in breasts such as atypical hyperplasia, carcinoma in situ, or many other proliferative or non-proliferative lesions, also increases the risk significantly [ 66 , 67 , 68 ]. The histologic classification of benign lesions and a family history of breast cancer are two factors that are strongly associated with breast cancer risk [ 66 ].

3.1.9. Previous Radiation Therapy

The risk of secondary malignancies after radiotherapy treatment remains an individual matter that depends on the patient’s characteristics, even though it is a quite frequent phenomenon that arises much clinical concern. Cancer induced by radiation therapy is strictly associated with an individual’s age; patients who receive radiation therapy before the age of 30, are at a greater risk of breast cancer [ 69 ]. The selection of proper radiotherapy technique is crucial in terms of secondary cancer risk—for instance, tangential field IMRT (2F-IMRT) is associated with a significantly lower risk compared to multiple-field IMRT (6F-IMRT) or double partial arcs (VMAT) [ 70 ]. Besides, the family history of breast cancer in patients who receive radiotherapy additionally enhances the risk of cancer occurrence [ 71 ]. However, Bartelink et al. showed that additional radiation (16 Gy) to the tumor bed combined with standard radiotherapy might decrease the risk of local recurrence [ 72 ].

3.2. Modifiable Factors

3.2.1. chosen drugs.

Data from some research indicates that the intake of diethylstilbestrol during pregnancy might be associated with a greater risk of breast cancer in children; this, however, remains inconsistent between studies and requires further evaluation [ 73 , 74 ]. The intake of diethylstilbestrol during pregnancy is associated with an increased risk of breast cancer not only in mothers but also in the offspring [ 75 ]. This relationship is observed despite the expression of neither estrogen nor progesterone receptors and might be associated with every breast cancer histological type. The risk increases with age; women at age of ≥40 years are nearly 1.9 times more susceptible compared to women under 40. Moreover, breast cancer risk increases with greater diethylstilbestrol doses [ 76 ]. Numerous researches indicate that females who use hormonal replacement therapy (HRT) especially longer than 5 or 7 years are also at increased risk of breast cancer [ 77 , 78 ]. Several studies indicated that the intake of chosen antidepressants, mainly paroxetine, tricyclic antidepressants, and selective serotonin reuptake inhibitors might be associated with a greater risk of breast cancer [ 79 , 80 ]. Lawlor et al. showed that similar risk might be achieved due to the prolonged intake of antibiotics; Friedman et al. observed that breast risk is mostly elevated while using tetracyclines [ 81 , 82 ]. Attempts were made to investigate a potential relationship between hypertensive medications, non-steroidal anti-inflammatory drugs, as well as statins, and an elevated risk of breast cancer, however, this data remains highly inconsistent [ 83 , 84 , 85 ].

3.2.2. Physical Activity

Even though the mechanism remains yet undeciphered, regular physical activity is considered to be a protective factor of breast cancer incidence [ 86 , 87 ]. Chen et al. observed that amongst females with a family history of breast cancer, physical activity was associated with a reduced risk of cancer but limited only to the postmenopausal period [ 88 ]. However, physical activity is beneficial not only in females with a family history of breast cancer but also in those without such a history. Contrarily to the above-mentioned study, Thune et al. pointed out more pronounced effects in premenopausal females [ 89 ]. There are several hypotheses aiming to explain the protective role of physical activity in terms of breast cancer incidence; physical activity might prevent cancer by reducing the exposure to the endogenous sex hormones, altering immune system responses or insulin-like growth factor-1 levels [ 88 , 90 , 91 ].

3.2.3. Body Mass Index

According to epidemiological evidence, obesity is associated with a greater probability of breast cancer. This association is mostly intensified in obese post-menopausal females who tend to develop estrogen-receptor-positive breast cancer. Yet, independently to menopausal status, obese women achieve poorer clinical outcomes [ 92 ]. Wang et al. showed that females above 50 years old with greater Body Mass Index (BMI) are at a greater risk of cancer compared to those with low BMI [ 93 ]. Besides, the researchers observed that greater BMI is associated with more aggressive biological features of tumor including a higher percentage of lymph node metastasis and greater size. Obesity might be a reason for greater mortality rates and a higher probability of cancer relapse, especially in premenopausal women [ 94 ]. Increased body fat might enhance the inflammatory state and affects the levels of circulating hormones facilitating pro-carcinogenic events [ 95 ]. Thus, poorer clinical outcomes are primarily observed in females with BMI ≥ 25 kg/m 2 [ 96 ]. Interestingly, postmenopausal women tend to present poorer clinical outcomes despite proper BMI values but namely due to excessive fat volume [ 97 ]. Greater breast cancer risk with regards to BMI also correlates with the concomitant family history of breast cancer [ 98 ].

3.2.4. Alcohol Intake

Numerous evidences confirm that excessive alcohol consumption is a factor that might enhance the risk of malignancies within the gastrointestinal tract; however, it was proved that it is also linked to the risk of breast cancer. Namely, it is not alcohol type but rather the content of alcoholic beverages that mostly affect the risk of cancer. The explanation for this association is the increased levels of estrogens induced by the alcohol intake and thus hormonal imbalance affecting the risk of carcinogenesis within the female organs [ 99 , 100 ]. Besides, alcohol intake often results in excessive fat gain with higher BMI levels, which additionally increases the risk. Other hypotheses include direct and indirect carcinogenic effects of alcohol metabolites and alcohol-related impaired nutrient intake [ 101 ]. Alcohol consumption was observed to increase the risk of estrogen-positive breast cancers in particular [ 102 ]. Consumed before the first pregnancy, it significantly contributes to the induction of morphological alterations of breast tissue, predisposing it to further carcinogenic events [ 103 ].

3.2.5. Smoking

Carcinogens found in tobacco are transported to the breast tissue increasing the plausibility of mutations within oncogenes and suppressor genes ( p53 in particular). Thus, not only active but also passive smoking significantly contributes to the induction of pro-carcinogenic events [ 104 ]. Besides, longer smoking history, as well as smoking before the first full-term pregnancy, are additional risk factors that are additionally pronounced in females with a family history of breast cancer [ 105 , 106 , 107 , 108 ].

3.2.6. Insufficient Vitamin Supplementation

Vitamins exert anticancer properties, which might potentially benefit in the prevention of several malignancies including breast cancer, however, the mechanism is not yet fully understood. Attempts are continually made to analyze the effects of vitamin intake (vitamin C, vitamin E, B-group vitamins, folic acid, multivitamin) on the risk of breast cancer, nevertheless, the data remains inconsistent and not sufficient to compare the results and draw credible data [ 108 ]. In terms of breast cancer, most studies are currently focused on vitamin D supplementation confirming its potentially protective effects [ 109 , 110 , 111 ]. High serum 25-hydroxyvitamin D levels are associated with a lower incidence rate of breast cancer in premenopausal and postmenopausal women [ 110 , 112 ]. Intensified expression of vitamin D receptors was shown to be associated with lower mortality rates due to breast cancer [ 113 ]. Even so, further evaluation is required since data remains inconsistent in this matter [ 108 , 114 ].

3.2.7. Exposure to Artificial Light

Artificial light at night (ALAN) has been recently linked to increased breast cancer risk. The probable causation might be a disrupted melatonin rhythm and subsequent epigenetic alterations [ 115 ]. According to the studies conducted so far, increased exposure to ALAN is associated with a significantly greater risk of breast cancer compared to individuals with lowered ALAN exposure [ 116 ]. Nonetheless, data regarding the excessive usage of LED electronic devices and increased risk of breast cancer is insufficient and requires further evaluation as some results are contradictory [ 116 ].

3.2.8. Intake of Processed Food/Diet

According to the World Health Organization (WHO), highly processed meat was classified as a Group 1 carcinogen that might increase the risk of not only gastrointestinal malignancies but also breast cancer. Similar observations were made in terms of an excessive intake of saturated fats [ 117 ]. Ultra-processed food is rich in sodium, fat, and sugar which subsequently predisposes to obesity recognized as another factor of breast cancer risk [ 118 ]. It was observed that a 10% increase of ultra-processed food in the diet is associated with an 11% greater risk of breast cancer [ 118 ]. Contrarily, a diet high in vegetables, fruits, legumes, whole grains, and lean protein is associated with a lowered risk of breast cancer [ 119 ]. Generally, a diet that includes food containing high amounts of n-3 PUFA, vitamin D, fiber, folate, and phytoestrogen might be beneficial as a prevention of breast cancer [ 120 ]. Besides, lower intake of n-6 PUFA and saturated fat is recommended. Several in vitro and in vivo studies also suggest that specific compounds found in green tea might present anti-cancer effects which has also been studied regarding breast cancer [ 121 ]. Similar properties were observed in case of turmeric-derived curcuminoids as well as sulforaphane (SFN) [ 122 , 123 ].

3.2.9. Exposure to Chemical

Chronic exposure to chemicals can promote breast carcinogenesis by affecting the tumor microenvironment subsequently inducing epigenetic alterations along with the induction of pro-carcinogenic events [ 124 ]. Females chronically exposed to chemicals present significantly greater plausibility of breast cancer which is further positively associated with the duration of the exposure [ 125 ]. The number of chemicals proposed to induce breast carcinogenesis is significant; so far, dichlorodiphenyltrichloroethane (DDT) and polychlorinated biphenyl (PCB) are mostly investigated in terms of breast cancer since early exposure to those chemicals disrupts the development of mammary glands [ 126 , 127 ]. A potential relationship was also observed in the case of increased exposure to polycyclic aromatic hydrocarbons (PAH), synthetic fibers, organic solvents, oil mist, and insecticides [ 128 ].

3.2.10. Other Drugs

Other drugs that might constitute potential risk factors for breast cancer include antibiotics, antidepressants, statins, antihypertensive medications (e.g., calcium channel blockers, angiotensin II-converting enzyme inhibitors), as well as NSAIDs (including aspirin, ibuprofen) [ 129 , 130 , 131 , 132 , 133 ].

4. Breast Cancer Classification

4.1. histological classification.

Invasive breast cancers (IBC) comprise wide spectrum tumors that show a variation concerning their clinical presentation, behavior, and morphology. The World Health Organization (WHO) distinguish at least 18 different histological breast cancer types [ 134 ].

Invasive breast cancer of no special type (NST), formerly known as invasive ductal carcinoma is the most frequent subgroup (40–80%) [ 135 ]. This type is diagnosed by default as a tumor that fails to be classified into one of the histological special types [ 134 ]. About 25% of invasive breast cancers present distinctive growth patterns and cytological features, hence, they are recognized as specific subtypes (e.g., invasive lobular carcinoma, tubular, mucinous A, mucinous B, neuroendocrine) [ 136 ].

Molecular classification independently from histological subtypes, invasive breast cancer can be divided into molecular subtypes based on mRNA gene expression levels. In 2000, Perou et al. on a sample of 38 breast cancers identified 4 molecular subtypes from microarray gene expression data: Luminal, HER2-enriched, Basal-like, and Normal Breast-like [ 137 ]. Further studies allowed to divide the Luminal group into two subgroups (Luminal A and B) [ 138 , 139 ]. The normal breast-like subtype has subsequently been omitted, as it is thought to represent sample contamination by normal mammary glands. In the Cancer Genome Atlas Project (TCGA) over 300 primary tumors were thoroughly profiled (at DNA, RNA, and protein levels) and combined in biological homogenous groups of tumors. The consensus clustering confirmed the distinction of four main breast cancer intrinsic subtypes based on mRNA gene expression levels only (Luminal A, Luminal B, HER2-enriched, and basal-like) [ 140 ]. Additionally, the 5th intrinsic subtype—claudin-low breast cancer was discovered in 2007 in an integrated analysis of human and murine mammary tumors [ 141 ].

In 2009, Parker et al. developed a 50-gene signature for subtype assignment, known as PAM50, that could reliably classify particular breast cancer into the main intrinsic subtypes with 93% accuracy [ 142 ]. PAM50 is now clinically implemented worldwide using the NanoString nCounter ® , which is the basis for the Prosigna ® test. The Prosigna ® combines the PAM50 assay as well as clinical information to assess the risk of distant relapse estimation in postmenopausal women with hormone receptor-positive, node-negative, or node-positive early-stage breast cancer patients, and is a daily-used tool assessing the indication of adjuvant chemotherapy [ 143 , 144 , 145 ].

4.2. Luminal Breast Cancer

Luminal breast cancers are ER-positive tumors that comprise almost 70% of all cases of breast cancers in Western populations [ 146 ]. Most commonly Luminal-like cancers present as IBC of no special subtype, but they may infrequently differentiate into invasive lobular, tubular, invasive cribriform, mucinous, and invasive micropapillary carcinomas [ 147 , 148 ]. Two main biological processes: proliferation-related pathways and luminal-regulated pathways distinguish Luminal-like tumors into Luminal A and B subtypes with different clinical outcomes.

Luminal A tumors are characterized by presence of estrogen-receptor (ER) and/or progesterone-receptor (PR) and absence of HER2. In this subtype the ER transcription factors activate genes, the expression of which is characteristic for luminal epithelium lining the mammary ducts [ 149 , 150 ]. It also presents a low expression of genes related to cell proliferation [ 151 ]. Clinically they are low-grade, slow-growing, and tend to have the best prognosis.

In contrast to subtype A, Luminal B tumors are higher grade and has worse prognosis. They are ER positive and may be PR negative and/or HER2 positive. Additionally, it has high expression of proliferation-related genes (e.g., MKI67 and AURKA) [ 152 , 153 , 154 ]. This subtype has lower expression of genes or proteins typical for luminal epithelium such as the PR [ 150 , 155 ] and FOXA1 [ 146 , 156 ], but not the ER [ 157 ]. ER is similarly expressed in both A and B subtypes and is used to distinguish luminal from non-luminal disease.

4.3. HER2-Enriched Breast Cancer

The HER2-enriched group makes up 10–15% of breast cancers. It is characterized by the high expression of the HER2 with the absence of ER and PR. This subtype mainly expresses proliferation—related genes and proteins (e.g., ERBB2/HER2 and GRB7), rather than luminal and basal gene and protein clusters [ 154 , 156 , 157 ]. Additionally, in the HER2-enriched subtype there is evidence of mutagenesis mediated by APOBEC3B. APOBEC3B is a subclass of APOBEC cytidine deaminases, which induce cytosine mutation biases and is a source of mutation clusters [ 158 , 159 , 160 ].

HER2-enriched cancers grow faster than luminal cancers and used to have the worst prognosis of subtypes before the introduction of HER2-targeted therapies. Importantly, the HER2-enriched subtype is not synonymous with clinically HER2-positive breast cancer because many ER-positive/HER2-positive tumors qualify for the luminal B group. Moreover, about 30% of HER2-enriched tumors are classified as clinically HER2-negative based on immunohistochemistry (IHC) and/or fluorescence in situ hybridization (FISH) methods [ 161 ].

4.4. Basal-Like/Triple-Negative Breast Cancer

The Triple-Negative Breast Cancer (TNBC) is a heterogeneous collection of breast cancers characterized as ER-negative, PR-negative, and HER2-negative. They constitute about 20% of all breast cancers. TNBC is more common among women younger than 40 years of age and African-American women [ 161 ]. The majority (approximately 80%) of breast cancers arising in BRCA1 germline mutation are TNBC, while 11–16% of all TNBC harbor BRCA1 or BRCA2 germline mutations. TNBC tends to be biologically aggressive and is often associated with a worse prognosis [ 162 ]. The most common histology seen in TNBC is infiltrating ductal carcinoma, but it may also present as medullary-like cancers with a prominent lymphocytic infiltrate; metaplastic cancers, which may show squamous or spindle cell differentiation; and rare special type cancers like adenoid cystic carcinoma (AdCC) [ 163 , 164 , 165 ].

The terms basal-like and TNBC have been used interchangeably; however, not all TNBC are of the basal type. On gene expression profiling, TNBCs can be subdivided into six subtypes: basal-like (BL1 and BL2), mesenchymal (M), mesenchymal stem-like (MSL), immunomodulatory (IM), and luminal androgen receptor (LAR), as well as an unspecified group (UNS) [ 166 , 167 ]. However, the clinical relevance of the subtyping still unclear, and more research is needed to clarify its impact on TNBC treatment decisions [ 168 ].

4.5. Claudin-Low Breast Cancer

Claudin-low (CL) breast cancers are poor prognosis tumors being mostly ER-negative, PR-negative, and HER2-negative. CL tumors account for 7–14% of all invasive breast cancers [ 147 ]. No differences in survival rates were observed between claudin-low tumors and other poor-prognosis subtypes (Luminal B, HER2-enriched, and Basal-like). CL subtype is characterized by the low expression of genes involved in cell-cell adhesion, including claudins 3, 4, and 7, occludin, and E-cadherin. Besides, these tumors show high expression of epithelial-mesenchymal transition (EMT) genes and stem cell-like gene expression patterns [ 169 , 170 ]. Moreover, CL tumors have marked immune and stromal cell infiltration [ 171 ]. Due to their less differentiated state and a preventive effect of the EMT-related transcription factor, ZEB1 CL tumors are often genomically stable [ 172 , 173 ].

4.6. Surrogate Markers Classification

In clinical practice, the key question is the discrimination between patients who will or will not benefit from particular therapies. By using molecular assays, more patients can be spared adjuvant chemotherapy, but these tests are associated with significant costs. Therefore, surrogate subgroups based on pathological morphology and widely available immunohistochemical (IHC) markers are used as a tool for risk stratification and guidance of adjuvant therapy [ 174 ]. A combination of the routine pathological markers ER, PR, and HER2 is used to classify tumors into intrinsic subtypes [ 175 ]. Semiquantitative evaluation of Ki-67 and PR is helpful for further typing of the Luminal subtype [ 176 , 177 ]. Moreover, evaluation of cytokeratin 5/6 and epidermal growth factor receptor is utilized to identify the Basal-like breast cancer among the TNBC [ 178 ].

In St. Gallen’s 2013 guidelines the IHC-based surrogate subtype classification was recommended for clinical decision making [ 179 ]. However, these IHC-based markers are only a surrogate and cannot establish the intrinsic subtype of any given cancer, with discordance rates between IHC-based markers and gene-based assays as high as 30% [ 180 ].

4.7. American Joint Committee on Cancer Classification

The baseline tool to estimate the likely prognosis of patients with breast cancer is the AJCC staging system that includes grading, immunohistochemistry biomarkers, and anatomical advancement of the disease. Since its inception in 1977, the American Joint Committee on Cancer (AJCC) has published an internationally accepted staging system based on anatomic findings: tumor size (T), nodal status (N), and metastases (M). However, gene expression profiling has identified several molecular subtypes of breast cancer [ 181 ]. The eighth edition of the AJCC staging manual (2018), outlines a new prognostic staging system for breast cancer that, in addition to anatomical features, acknowledges biological factors [ 182 ]. These factors—ER, PR, HER2, grade, and multigene assays—are recommended in practice to define prognosis [ 183 , 184 ].

The most widely used histologic grading system of breast cancer is the Elston-Ellis modification [ 185 ] of Scarff-Bloom-Richardson grading system [ 186 ], also known as the Nottingham grading system. The grade of a tumor is determined by assessing morphologic features: (a) formation of tubules, (b) mitotic count, (c) variability, and the size and shape of cellular nuclei. A score between 1 (most favorable) and 3 (least favorable) is assigned for each feature. Grade 1 corresponds to combined scores between 3 and 5, grade 2 corresponds to a combined score of 6 or 7, and grade 3 corresponds to a combined score of 8 or 9.

In addition to grading and biomarkers, the commercially available multigene assays provide additional prognostic information suitable for incorporation in the AJCC 8th edition. The 21-gene assay Oncotype DX ® assessed by reverse transcription-polymerase chain reaction (RT-PCR) was the only assay sufficiently evaluated and included in the staging system. This assay is valuable in the staging of patients with hormone receptor-positive, HER2-negative, node-negative tumors that are <5 cm. Patients with results of the assay (Recurrence Score) less than 11 had excellent disease-free survival at 6.9 years of 98.6% with endocrine therapy alone [ 187 ]. Hence, adjuvant systemic chemotherapy can be safely omitted in patients with a low-risk multigene assay [ 188 ].

The AJCC staging manual includes a pathological and a clinical-stage group. The clinical prognostic stage group should be utilized in all patients on initial evaluation before any systemic therapy. Clinical staging uses the TNM anatomical information, grading, and expression of these three biomarkers. When patients undergo surgical resection of their primary tumor, the post-resection anatomic information coupled with the pretreatment biomarker findings results in the final Pathologic Prognostic Stage Group.

The recent update of breast cancer staging by the biologic markers improved the outcome prediction in comparison to prior staging based only on anatomical features of the disease. The validation studies involving the reassessment of the Surveillance, Epidemiology, and End Results (SEER) database ( n = 209,304, 2010–2014) and the University of Texas MD Anderson Cancer Center database ( n = 3327, years of treatment 2007–2013) according to 8th edition AJCC manual proved the more accurate prognostic information [ 189 , 190 ].

5. Prognostic Biomarkers

5.1. estrogen receptor.

Estrogen receptor (ER) is an important diagnostic determinant since approximately 70–75% of invasive breast carcinomas are characterized by significantly enhanced ER expression [ 191 , 192 ]. Current practice requires the measurement of ER expression on both—primary invasive tumors and recurrent lesions. This procedure is mandatory to provide the selection of those patients who will most benefit from the implementation of the endocrine therapy mainly selective estrogen receptor modulators, pure estrogen receptor downregulators, or third-generation aromatase inhibitors [ 193 ]. Even though the diagnosis of altered expression of ER is particularly relevant in terms of the proper therapy selection, ER expression might also constitute a predictive factor—patients with high ER expression usually present significantly better clinical outcomes [ 194 ]. A relationship was observed between ER expression and the family history of breast cancer which further facilitates the utility of ER expression as a diagnostic biomarker of breast cancer especially in cases of familial risk [ 195 ]. Besides, Konan et al. reported that ERα-36 expression could constitute one of the potential targets of PR-positive cancers and a prognostic marker at the same time [ 196 ].

5.2. Progesterone Receptor

PR is highly expressed (>50%) in patients with ER-positive while quite rarely in those with ER-negative breast cancer [ 197 ]. PR expression is regulated by ER therefore, physiological values of PR inform about the functional ER pathway [ 197 ]. However, both ER and PR are abundantly expressed in breast cancer cells and both are considered as diagnostic and prognostic biomarkers of breast cancer (especially ER-positive ones) [ 198 ]. Greater PR expression is positively associated with the overall survival, time to recurrence, and time to either treatment failure or progression while lowered PR levels are usually related to a more aggressive course of the disease as well as poorer recurrence and prognosis [ 199 ]. Thus, favorable management of breast cancer patients highly depends on the assessment of PR expression. Nevertheless, the predictive value of PR expression still remains controversial [ 200 ].

5.3. Human Epidermal Growth Factor Receptor 2

The expression of human epidermal growth factor receptor 2 (HER2) accounts for approximately 15–25% of breast cancers and its status is primarily relevant in the choice of proper management with breast cancer patients; HER2 overexpression is one of the earliest events during breast carcinogenesis [ 201 ]. Besides, HER2 increases the detection rate of metastatic or recurrent breast cancers from 50% to even more than 80% [ 202 ]. Serum HER2 levels are considered to be a promising real-time marker of tumor presence or recurrence [ 203 ]. HER2 amplification leads to further overactivation of the pro-oncogenic signaling pathways leading to uncontrolled growth of cancer cells which corresponds with poorer clinical outcomes in the case of HER2-positive cancers [ 204 ]. Overexpression of HER2 also correlates with a significantly shorter disease-free period [ 205 ] as well as histologic type, pathologic state of cancer, and a number of axillary nodes with metastatic cancerous cells [ 205 ].

5.4. Antigen Ki-67

The Ki-67 protein is a cellular marker of proliferation and the Ki-67 proliferation index is an excellent marker to provide information about the proliferation of cancerous cells particularly in the case of breast cancer. The proliferative activities determined by Ki-67 reflect the aggressiveness of cancer along with the response to treatment and recurrence time [ 206 ]. Thus, Ki-67 is crucial in terms of the choice of the proper treatment therapy and the potential follow-ups due to recurrence. Though, due to several limitations of the analytical validity of Ki-67 immunohistochemistry, Ki-67 expression levels should be considered benevolently in terms of definite treatment decisions. Ki-67 might be considered as a potential prognostic factor as well; according to a meta-analysis of 68 studies involving 12,155 patients, the overexpression of Ki-67 is associated with poorer clinical outcomes of patients [ 207 ]. High expression of Ki-67 also reflects poorer survival rates of breast cancer patients [ 208 ]. There are speculations whether Ki-67 could be considered as a potential predictive marker, however, such data is still limited and contradictory.

Mib1 (antibody against Ki-67) proliferation index remains a reliable diagnostic biomarker of breast cancer, similarly to Ki-67. A decrease in both Mib1 and Ki-67 expression levels is associated with a good response of breast cancer patients to preoperative treatment [ 209 ]. Mib1 levels are significantly greater in patients with concomitant p53 mutations [ 210 ]. Mib1 assessment might be especially useful in cases of biopsy specimens small in size, inappropriate for neither mitotic index nor S-phase fraction evaluation [ 211 ].

5.6. E-Cadherin

E-cadherin is a critical protein in the epithelial-mesenchymal transition (EMT); loss of its expression leads to the gradual transformation into mesenchymal phenotype which is further associated with increased risk of metastasis. The utility of E-cadherin as a breast biomarker is yet questionable, however, some research indicated that its expression is potentially associated with several breast cancer characteristics such as tumor size, TNM stage, or lymph node status [ 212 ]. Low or even total loss of E-cadherin expression might be potentially useful in the determination of histologic subtype of breast cancer [ 213 , 214 ]. E-cadherin levels do not seem to be promising in terms of patients’ survival rates assessment, however, there are some reports indicating that higher levels of E-cadherin were associated with shorter survival rates in patients with invasive breast carcinoma [ 213 , 215 ]. Lowered E-cadherin expression is positively associated with lymph node metastasis [ 216 ].

5.7. Circulating Circular RNA

Circulating circular RNAs (circRNAs) belong to the group of non-coding RNA and were quite recently shown to be crucial in terms of several hallmarks of breast carcinogenesis including apoptosis, enhanced proliferation, or increased metastatic potential [ 217 ]. One of the most comprehensively described circRNAs, mostly specific to breast cancer include circFBXW7—which was proposed as a potential diagnostic biomarker as well as therapeutic tool for patients with triple-negative breast cancer (TNBC), as well as hsa_circ_0072309 which is abundantly expressed in breast cancer patients and usually associated with poorer survival rates [ 218 ]. Has_circ_0001785 is considered to be promising as a diagnostic biomarker of breast cancer [ 219 ]. The number of circRNAs dysregulated during breast carcinogenesis is significant; their expression might be either upregulated (e.g., has_circ_103110, circDENND4C) or downregulated (e.g., has_circ_006054, circ-Foxo3) [ 220 ]. Besides, specific circRNAs have been reported in different types of breast cancer such as TNBC, HER2-positive, and ER-positive [ 221 ]. Recently it was showed that an interaction between circRNAs and micro-RNA—namely in the form of Cx43/has_circ_0077755/miR-182 post-transcriptional axis, might predict breast cancer initiation as well as further prognosis. Cx43 is transmembrane protein responsible for epithelial homeostasis that mediates junction intercellular communication and its loss dysregulates post-transcriptional axes in breast cancer initiation [ 222 ].

Loss-of-function mutations in the TP53 (P53) gene have been found in numerous cancer types including osteosarcomas, leukemia, brain tumors, adrenocortical carcinomas, and breast cancers [ 223 , 224 ]. P53 protein is essential for normal cellular homeostasis and genome maintenance by mediating cellular stress responses including cell cycle arrest, apoptosis, DNA repair, and cellular senescence [ 225 ]. The silencing mutation of the P53 gene is evident at an early stage of cancer progression. In breast cancer, the prevalence of TP53 mutations is present in approximately 80% of patients with the TNBC and 10% of patients with Luminal A disease [ 226 ].

There have been many studies showing the prognostic role of p53 loss-of-function mutation in breast cancer [ 227 , 228 ]. However, the missense mutations may alters p53 properties causing not only a loss of wild-type function, but also acquisition novel activities-gain of function [ 229 ]. The IHC status of p53 has been proposed as a specific prognostic factor in TNBC, and a feature that divides TNBC into 2 distinct subgroups: a p53-negative normal breast-like TN subgroup, and a p53-positive basal-like subgroup with worse overall survival [ 230 , 231 , 232 ]. However, there is not enough evidence to utilize p53 gene mutational status or immunohistochemically measured protein for determining standardized prognosis in patients with breast cancer [ 233 ].

5.9. MicroRNA

MicroRNAs (miRNA) are a major class of endogenous non-coding RNA molecules (19–25 nucleotides) that have regulatory roles in multiple pathways [ 234 ]. Some miRNAs are related to the development, progression, and response of the tumor to therapy [ 235 ]. Several studies have investigated abnormally expressed miRNAs as biomarkers in breast cancer tissue samples. According to meta-analysis by Adhami et al. two miRNAs (miRNA-21 and miRNA-210) were upregulated consistently and six miRNAs (miRNA-145, miRNA-139-5p, miRNA-195, miRNA-99a, miRNA-497, and miRNA-205) were downregulated consistently in at least three studies [ 236 ].

The miRNA-21 overexpression was observed in TNBC tissues and was associated with enhanced invasion and proliferation of TNBC cells as well as downregulation of the PTEN expression [ 237 ]. Similarly, the high expression of miRNA-210 is related to tumor proliferation, invasion, and poor survival rates in breast cancer patients [ 238 , 239 ].

The miRNA-145 is an anti-cancer agent having the property of inhibiting migration and proliferation of breast cancer cells via regulating the TGF-β1 expression [ 240 ]. However, the miRNA-145 is downregulated in both plasma and tumors of breast cancer patients [ 241 ]. Similarly, miRNA-139-5p and miRNA-195 have tumor suppressor activity in various cancers [ 242 , 243 ].

Nevertheless, further clinical researches focusing on these miRNAs are needed to utilize them as reproducible, disease-specific markers that have a high level of specificity and sensitivity.

5.10. Tumor-Associated Macrophages

Macrophages are known for their immunomodulatory effects and they can be divided according to their phenotypes into M1- or M2-like states [ 244 , 245 ]. M1 macrophages secrete IL-12 and tumor necrosis factor with antimicrobial and antitumor effects. M2 macrophages produce cytokines, including IL-10, IL-1 receptor antagonist type II, and IL-1 decoy receptor. Therefore, macrophages with M1-like phenotype have been linked to good disease course while M2-like phenotype has been associated with adverse outcome, potentially through immunosuppression and the promotion of angiogenesis and tumor cell proliferation and invasion [ 246 , 247 ]. In literature, tumor-associated macrophages (TAMs) are associated with M2 macrophages which promote tumor growth and metastasis.

For breast cancer, studies have shown that the density of TAMs is related to hormone receptor status, stage, histologic grade, lymph node metastasis, and vascular invasion [ 248 , 249 , 250 , 251 ]. According to meta-analysis conducted by Zhao et al. high density of TAMs was related to overall survival disease-free survival [ 252 ].

Conversely, M1 polarized macrophages are linked to favorable prognoses in various cancers [ 253 , 254 , 255 ]. In breast cancer, the high density of M1-like macrophages predicted improved survival in patients with HER2+ phenotype and may be a potential prognostic marker [ 256 ].

However, further studies are needed to clarify the influence of macrophages on breast cancer biology as well as investigate the role of their intratumoral distribution and surface marker selection.

5.11. Inflammation-Based Models

The host inflammatory and immune responses in the tumor and its microenvironment are critical components in cancer development and progression [ 257 ]. The tumor-induced systemic inflammatory response leads to alterations of peripheral blood white blood cells [ 258 ]. Therefore, the relationship between peripheral blood inflammatory cells may serve as an accessible and early method of predicting patient prognosis. Recent studies have reported the predictive role of the inflammatory cell ratios: neutrophil-to-lymphocyte ratio, the lymphocyte-to-monocyte ratio, and the platelet-to-lymphocyte ratio for prognosis in different cancers [ 258 , 259 , 260 , 261 ].

5.11.1. The Neutrophil-to-Lymphocyte Ratio (NLR)

In an extensive study on 27,031 cancer patients, Proctor et al. analyzed the prognostic value of NLR and found a significant relationship between NLR and survival in various cancers including breast cancer [ 262 ]. There are pieces of evidence of the role of lymphocytes in breast cancer immunosurveillance [ 263 , 264 ]. Opposingly neutrophils suppress the cytolytic activity of lymphocytes, leading to enhanced angiogenesis and tumor growth and progression [ 265 ].

Azab et al. first reported that NLR before chemotherapy was an independent factor for long-term mortality and related it to age and tumor size in breast cancer [ 266 ]. In a recent meta-analysis by Guo et al., performed on 17,079 individuals, the high NLR level was associated with both poor overall survival as well as disease-free survival for breast cancer patients. Moreover, it was reported that association between NLR and overall survival was stronger in TNBC patients than in HER2-positive ones [ 267 ].

5.11.2. Lymphocyte-to-Monocyte Ratio

The association of the lymphocyte-to-monocyte ratio (LMR) with patients’ prognosis has been reported for several cancers [ 268 , 269 ]. As lymphocytes have an antitumor activity by inducing cytotoxic cell death and inhibiting tumor proliferation [ 270 ], the monocytes are involved in tumorigenesis, including differentiation into TAMs [ 246 , 247 , 271 ]. In the tumor microenvironment, cytokines, and free radicals that are secreted by monocytes and macrophages are associated with angiogenesis, tumor cell invasion, and metastasis [ 271 ].

A meta-analysis investigating the prognostic effect of LMR showed that low LMR levels are associated with shorter overall survival outcomes in Asian populations, TNBC patients, and patients with non-metastatic and mixed stages [ 272 ]. Moreover, high LMR levels are associated with favorable disease-free survival of breast cancer patients under neoadjuvant chemotherapy [ 273 ].

5.11.3. Platelet-to-Lymphocyte Ratio (PLR)

A high platelet count has been associated with poor prognosis in several types of cancers [ 274 , 275 , 276 ]. Platelets contain both pro-inflammatory molecules and cytokines (P-selectin, CD40L, and interleukin (IL)-1, IL-3, and IL-6) and many anti-inflammatory cytokines. Tumor angiogenesis and growth may be stimulated by the secretion of platelet-derived growth factor, vascular endothelial growth factor, transforming growth factor-beta, and platelet factor 4 [ 277 , 278 , 279 ].

A meta-analysis study investigated the prognostic importance of PLR by analyzing 5542 breast cancer patients. High PLR level was associated with poor prognosis (overall survival and disease-free survival), yet, its prognostic value was not determined for molecular subtypes of breast cancer. Nevertheless, an association was found between PLR and clinicopathological features of the tumor, including stage, lymph node metastasis, and distant metastasis [ 280 ]. In the aforementioned meta-analysis, there was a difference in the incidence of high levels of PLR between HER2 statuses [ 280 ], while other studies found a difference between hormone ER or PR statuses [ 281 , 282 ].

6. Treatment Strategies

6.1. surgery.

There are two major types of surgical procedures enabling the removal of breast cancerous tissues and those include (1) breast-conserving surgery (BCS) and (2) mastectomy. BCS—also called partial/segmental mastectomy, lumpectomy, wide local excision, or quadrantectomy—enables the removal of the cancerous tissue with simultaneous preservation of intact breast tissue often combined with plastic surgery technics called oncoplasty. Mastectomy is a complete removal of the breast and is often associated with immediately breast reconstruction. The removal of affected lymph nodes involves sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND). Even though BCS seems to be highly more beneficial for patients, those who were treated with this technique often show a tendency for a further need for a complete mastectomy [ 283 ]. However, usage of BCS is mostly related to significantly better cosmetic outcomes, lowered psychological burden of a patient, as well as reduced number of postoperative complications [ 284 ]. Guidelines of the European Society for Medical Oncology (ESMO) for patients with early breast cancer make the choice of therapy dependent to tumor size, feasibility of surgery, clinical phenotype, and patient’s willingness to preserve the breast [ 285 ].

6.2. Chemotherapy

Chemotherapy is a systemic treatment of BC and might be either neoadjuvant or adjuvant. Choosing the most appropriate one is individualized according to the characteristics of the breast tumor; chemotherapy might also be used in the secondary breast cancer. Neoadjuvant chemotherapy is used for locally advanced BC, inflammatory breast cancers, for downstaging large tumors to allow BCS or in small tumors with worse prognostics molecular subtypes (HER2 or TNBC) which can help to identify prognostics and predictive factors of response and can be provided intravenously or orally. Currently, treatment includes a simultaneous application of schemes 2–3 of the following drugs—carboplatin, cyclophosphamide, 5-fluorouracil/capecitabine, taxanes (paclitaxel, docetaxel), and anthracyclines (doxorubicin, epirubicin). The choice of the proper drug is of major importance since different molecular breast cancer subtypes respond differently to preoperative chemotherapy [ 286 ]. Preoperative chemotherapy is comparably effective to postoperative chemotherapy [ 287 ].

Even though chemotherapy is considered to be effective, its usage very often leads to several side effects including hair loss, nausea/vomiting, diarrhea, mouth sores, fatigue, increased susceptibility to infections, bone marrow supression, combined with leucopenia, anaemia, easier bruising or bleeding; other less frequent side effects include cardiomyopathy, neuropathy, hand-foot syndrome, impaired mental functions. In younger women, disruptions of the menstrual cycle and fertility issues might also appear. Special form of chemotherapy is electrochemotherapy which can be used in patients with breast cancer that has spread to the skin, however, it is still quite uncommon and not available in most clinics.

6.3. Radiation Therapy

Radiotherapy is local treatment of BC, typically provided after surgery and/or chemotherapy. It is performed to ensure that all of the cancerous cells remain destroyed, minimizing the possibility of breast cancer recurrence. Further, radiation therapy is favorable in the case of metastatic or unresectable breast cancer [ 288 ]. Choice of the type of radiation therapy depends on previous type of surgery or specific clinical situation; most common techniques include breast radiotherapy (always applied after BC), chest-wall radiotherapy (usually after mastectomy), and ‘breast boost’ (a boost of high-dose radiotherapy to the place of tumor bed as a complement of breast radiotherapy after BCS). Regarding breast radiotherapy specifically, several types are distinguished including

• (1) intraoperative radiation therapy (IORT)
• (2) 3D-conformal radiotherapy (3D-CRT)
• (3) intensity-modulated radiotherapy (IMRT)
• (4) brachytherapy—which refers to internal radiation in contrast to other above-mentioned techniques.

Irritation and darkening of the skin exposed to radiation, fatigue, and lymphoedema are one of the most common side effects of radiation therapy applied in breast cancer patients. Nonetheless, radiation therapy is significantly associated with the improvement of the overall survival rates of patients and lowered risk of recurrence [ 289 ].

6.4. Endocrinal (Hormonal) Therapy

Endocrinal therapy might be used either as a neoadjuvant or adjuvant therapy in patients with Luminal–molecular subtype of BC; it is effective in cases of breast cancer recurrence or metastasis. Since the expression of ERs, a very frequent phenomenon in breast cancer patients, its blockage via hormonal therapy is commonly used as one of the potential treatment modalities. Endocrinal therapy aims to lower the estrogen levels or prevents breast cancer cells to be stimulated by estrogen. Drugs that block ERs include selective estrogen receptor modulators (SERMs) (tamoxifen, toremifene) and selective estrogen receptor degraders (SERDs) (fulvestrant) while treatments that aim to lower the estrogen levels include aromatase inhibitors (AIs) (letrozole, anastrazole, exemestane) [ 290 , 291 ]. In the case of pre-menopausal women, ovarian suppression induced by oophorectomy, luteinizing hormone-releasing hormone analogs, or several chemotherapy drugs, are also effective in lowering estrogen levels [ 292 ]. However, approximately 50% of hormonoreceptor-positive breast cancer become progressively resistant to hormonal therapy during such treatment [ 293 ]. Endocrinal therapy combined with chemotherapy is associated with the reduction of mortality rates amongst breast cancer patients [ 294 ].

6.5. Biological Therapy

Biological therapy (targeted therapy) can be provided at every stage of breast therapy– before surgery as neoadjuvant therapy or after surgery as adjuvant therapy. Biological therapy is quite common in HER2-positive breast cancer patients; major drugs include trastuzumab, pertuzumab, trastuzumab deruxtecan, lapatinib, and neratinib [ 295 , 296 , 297 , 298 , 299 ]. Further, the efficacy of angiogenesis inhibitors such as a recombinant humanized monoclonal anti-VEGF antibody (rhuMAb VEGF) or bevacizumab are continuously investigated [ 300 ].

In the case of Luminal, HER2-negative breast cancer, pre-menopausal women more often receive everolimus -TOR inhibitor with exemestane while postmenopausal women often receive CDK 4–6 inhibitor palbociclib or ribociclib simultaneously, combined with hormonal therapy [ 301 , 302 , 303 ]. Two penultimate drugs along with abemaciclib and everolimus can also be used in HER2-negative and estrogen-positive breast cancer [ 304 , 305 ]. Atezolizumab is approved in triple-negative breast cancer, while denosumab is approved in case of metastasis to the bones [ 306 , 307 , 308 ].

7. Conclusions

In this review, we aimed to summarize and update the current knowledge about breast cancer with an emphasis on its current epidemiology, risk factors, classification, prognostic biomarkers, and available treatment strategies. Since both the morbidity and mortality rates of breast cancer have significantly increased over the past decades, it is an urgent need to provide the most effective prevention taking into account that modifiable risk factors might be crucial in providing the reduction of breast cancer incidents. So far, mammography and sonography is the most common screening test enabling quite an early detection of breast cancer. The continuous search for prognostic biomarkers and targets for the potential biological therapies has significantly contributed to the improvement of management and clinical outcomes of breast cancer patients.

Author Contributions

Conceptualization, A.F., R.S. and A.S.; critical review of literature, S.Ł., M.C., A.F., J.B., R.S., A.S.; writing—original draft preparation, M.C., A.F.; writing—review and editing, S.Ł., M.C., A.F., J.B., R.S., A.S.; supervision, R.S. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

144 Breast Cancer Essay Topics

🏆 best essay topics on breast cancer, ✍️ breast cancer essay topics for college, 👍 good breast cancer research topics & essay examples, 🎓 most interesting breast cancer research titles, 💡 simple breast cancer essay ideas, ❓ research questions on breast cancer.

• Breast Cancer: The Story of One Patient
• Breast Cancer: Research Review Paper
• Breast Cancer: Literature Review
• Breast Cancer: Analysis and Data Collection
• Disease Research: Breast Cancer
• Breast Cancer and Effective Medical Treatment
• BRCA Gene Mutation and Breast Cancer
• Understanding Epigenetic Mechanisms in Breast Cancer Human cells become cancerous when they undergo genetic modifications that make them acquire growth and multiplication advantages.
• Epidemiology of Breast Cancer in UK As of 2011, the incidences of breast cancer have been increasing continuously over forty years. Also, there was a general reduction in the rate of mortality caused by breast cancer.
• Bilateral Mastectomy for Breast Cancer Prevention One of the options for preventing the development of breast cancer is a bilateral mastectomy. But it may not be a good preventive choice for genetic markers of breast cancer.
• Breast Cancer: Pathophysiology, Types and Treatment Breast cancer is a common malignant neoplastic disease in women and mostly develops in the stage of women postmenopausal.
• Postmenopausal Women with Breast Cancer This research discusses, Experience of adjuvant treatment among postmenopausal women with breast cancer: health-related quality of life, symptom experience, stressful events and coping strategies.
• Breast Cancer: Diagnosis and Treatment Recent efforts from medical professionals and interest groups like Breast Cancer Awareness Month facilitate open discussion around breast cancer.
• Breast Cancer: Diagnostic and Treatment Breast cancer is one of the most common oncology disorders among females. It has a complicated chain of immune reactions and various structures identified histologically.
• Health-Related Misconceptions Regarding Antiperspirants and Breast Cancer There is a myth about the use of antiperspirants, especially aluminum-containing ones, as a risk factor for breast cancer.
• Naturalistic Observation of Couples Coping With Breast Cancer Couples who are suffering with cancer and their spouses’ psychological well-being were explored in study, which focused on the natural setting and substance of dialogues.
• Breast Cancer: Preventive Measures and Support Methods One of the most common types of cancer that women encounter worldwide is breast cancer. This disease was the cause of approximately 570,000 deaths in 2015.
• Health & Medicine: Breast Cancer in XIX Century The disease of breast cancer was a disease of women, which began to be actively noticed from the beginning of the nineteenth century.
• Breast Cancer: Threat to the Patients Cancer is developed from mutations, namely from atypical changes in genes that regulate cell growth and keep them healthy.
• Post-operative Breast Cancer Patients With Depression: Annotated Bibliography This paper is an annotated bibliography about risk reduction strategies at the point of care: Post-operative breast cancer patients who are experiencing depression.
• Herceptin and Breast Cancer Treatment Cancer growth is a series of processes that are driven by alterations of genes that bring about the progressive conversion of usual body cells into extremely malignant imitation.
• Postoperative Breast Cancer Care The chosen for the paper articles support the implementation of risk reduction strategies for depression in post-operative breast cancer patients.
• Breast Cancer and Exercise. Article Summary The research study focused on breast cancer survivors in the Rocky Mountain Cancer Rehabilitation Institute (RMCRI) who had already been treated.
• The Risk Factors of Breast Cancer This paper will throw light upon what breast cancer is all about, the risk factors, the distribution, and determinants of the same.
• Multicausality: Reserpine, Breast Cancer, and Obesity All the factors are not significant in the context of the liability to breast cancer development, though their minor influence is undeniable.
• Breast Cancer: Etiology, Signs and Symptoms Breast cancer is believed to have claimed many human lives in the last four decades, but its prevalence rate has decreased significantly due to improved disease awareness.
• The Epidemiology of Breast Cancer in Young Women The researcher has clearly outlined the essence of the referenced study as aimed at reviewing the epidemiology of breast cancer in young women.
• The Relationship Between Breast Cancer and Genes Cancer, in general, is a disease caused by genes that have mutated or adapted in a different way than was intended.
• Breast Cancer Development and Progression: Understanding Epigenetic Mechanisms The development and progression of breast cancer have been attributed to a series of cellular and molecular events, most of which are not well understood.
• Impact of Alcohol Abuse on Breast Cancer Risk in Women This paper will examine the effects of alcohol abuse on the development of breast cancer in women to uncover its devastating consequences.
• Prophylaxis Breast Cancer This paper examines the majority of the parts in detail and considers every risk linked to the development of this dangerous disease.
• The Disease of Breast Cancer: Definition and Treatment Breast cancer is a serious disease during which the breast cells experience abnormal growth. Females usually have a higher risk of developing the disease.
• Care of Breast Cancer-Related Lymphoedema The lymphoedema’s clinical manifestations include swelling of the upper or lower extremities, violation of skin nutrition, and subcutaneous fat tissue.
• Women’s Disease: Breast Cancer and Its Consequence Breast cancer is one of the most common cancer types worldwide amounting to 25-30% of all cancer cases detected yearly among women.
• Racism in Breast Cancer Treatment Cancer treatment is the least studied field that arises numerous ambiguities and requires a more sophisticated approach in studying.
• Breast Cancer: Discussion of the Problems and Way of Treatment An analytical and evaluative case that is intended to recover fully the problem of breast cancer and explain the ways of its treatment in the context of nursing.
• Breast Cancer Epidemiology and Prevention This paper aims to discuss breast cancer epidemiology and socioeconomic factors with regard to the young, middle, and older adults to identify risks, prevention, and opportunities.
• Miami Breast Cancer Conference: Scholarly Activity Breast cancer is a prominent variation of the condition, as the body part is generally considered to be among the most common targets for the illness.
• Recommendations for Breast Cancer Screening: USPSTF Guidelines This paper aims to give a proper recommendation for breast cancer screening under USPSTF guidelines while considering the differences in patients’ epidemiology.
• Factors Influencing Breast Cancer Screening in Low-Income African Americans in Tennessee This article focuses on understanding the factors that are associated with the decision and obstacles to breast cancer screening in African-American women living in Tennessee.
• “A Culturally Tailored Internet Cancer Support Group for Asian American Breast Cancer Survivors”: Article Analysis Medicine, as a holistic science, recognizes the individual cultural uniqueness of every patient in order to deliver a better quality of care.
• Breast Cancer and Stress Heightening This paper aims to discuss three educational interventions that can help patients to manage their stressful experiences.
• Prevention of Breast Cancer The problem of the study is a major one because it is connected to one of the critical health concerns that affect women worldwide: breast cancer.
• Anthem Blue Cross: Breast Cancer Screenings This paper aims to present a detailed economic report regarding the implementation of breast cancer screenings that Anthem Blue Cross will provide free of charge.
• Women’s Healthcare: Breast Cancer Prevention & Treatment Preventive services for patients who are at risk of breast cancer include medications for risk reduction of the disease and screening for breast cancer using film mammography.
• Breast Cancer Inheritance Biophysical Factors The biophysical factors operating in this situation are the age of the patient and the possible inheritance of breast cancer. The psychological factors are her mental health records.
• Breast Cancer Screening Promotion The article begins with a brief description of the North Carolina Breast Cancer Screening Program. The program included social-ecological and community organizing approaches to health promotion.
• Mammary Cancer: Health Screening Initiative Breast cancer is one of the dangerous conditions, which might lead to lethal consequences. This type of cancer is a malignant tumor of the glandular tissue of the breast.
• Mammography Screening and Breast Cancer Mortality The study has been designed to measure the effectiveness of breast cancer decision aids (DAs) in improving mammography screening intentions in African-American women 65 years and older.
• Breast Cancer Studies: Evaluation and Analysis of Scientific Papers This paper assesses the level of effectiveness and reliability of studies, as well as offer a separate intervention that can help at least partially solve the problem of breast cancer.
• Music Therapy Effects for Breast Cancer Patients The research question for this study is whether mindfulness-based music therapy influences attention and mood in women who receive adjuvant chemotherapy for breast cancer.
• Breast Cancer: Disease Screening and Diagnosis The paper studies the medical case of a female patient with the risk of breast cancer increased by the fact that cancers were recently diagnosed in her family.
• From Breast Cancer to Zika Virus – Nursing Issues The paper studies relations between diabetes type II and oral hygiene, treatment of cardiovascular diseases, vision loss, breast cancer, and preventing Zika virus.
• A Research of Breast Cancer Survival We know the cancer of breast tissue as Breast cancer. It has reported too that breast cancer affects woman ageing of any age at least in the western world.
• Breast Cancer and Its Effects on Society
• The Anatomy and Physiology of Breast Cancer
• Gated Dibh for Left-Sided Breast Cancer Patients
• Nursing Care For the Terminal Breast Cancer Patient Community
• African American Women, Environmental Impacts, and Breast Cancer
• African American Women and Breast Cancer
• New Breast Cancer Screening Guidelines
• Genetic Changes for Breast Cancer
• Early Preterm Delivery and Breast Cancer
• Elderly Lesbians and Breast Cancer
• Breast Cancer Prevention Strategies
• Breast Cancer Awareness and Walks for Leukemia Flood Media
• Hyaluronan, Inflammation, and Breast Cancer Progression
• Breast Cancer Among Women in the United States
• Modified Radical Mastectomy for Contralateral Breast Cancer
• Breast Cancer and the Use of Exercise as Medicine
• Obesity and Breast Cancer: Role of Leptin
• Breast Cancer Causes and Prevention Methods
• Targeted Therapy for Breast Cancer Prevention
• Breast Cancer Risk Factors You Can’t Control
• Chemotherapy and Breast Cancer
• Postoperative Patients With Breast Cancer and Self Image
• Diagnostic Imaging for Breast Cancer Symptoms
• Breast Cancer: Causes, Prevention, and Treatment
• Oral Treatments for Breast Cancer and Health Promotion
• Breast Cancer and Early Detection of Low-Income Minority
• Breast Cancer and Diet
• NFL and Breast Cancer Awareness
• Antiperspirants and Breast Cancer
• Breast Cancer and Pregnancy
• Cervical and Breast Cancer and Nutrition’s Effects
• Breast Cancer and Early Detection
• 2000 Treatment Program for Cervical and Breast Cancer Prevention
• Hormone Replacement Therapy and Breast Cancer
• Coping Strategies and Breast Cancer
• Breast Cancer and Hormone Replacement Therapy
• Abortion and Breast Cancer (ABC) In the United States of America
• Breast Cancer and Its Effects on Women
• Health Concerns Involving Breast Cancer
• Breast Cancer Characteristics and Survival Differences
• Breast Cancer Information and Support
• Applying Medical Procedures for Breast Cancer
• Breast Cancer and Its Effects on the United States
• Breast Cancer Treatment and Therapy With Nanomedicine
• The Second Leading Cause of Death Is the Breast Cancer
• Romania’s Breast Cancer and Healthcare Education
• Cardiovascular Toxicities From Systemic Breast Cancer Therapy
• Moderate Drinking Can Still Lead To Breast Cancer
• Treatments for Hormone Sensitive Breast Cancer
• Intraoperative Radiotherapy for Breast Cancer
• Postmenopausal Women, Breast Cancer Risk, and Raloxifene
• Breast Cancer and the Environment
• Breast Cancer and Cancer Cell Lines
• Group Therapy, Family Options, and Breast Cancer
• Issues Involving Breast Cancer
• Breast Cancer Survivorship, Quality of Life, and Late Toxicities
• Breast Cancer Age Risk Women
• Relationship Between Meat Intake and Breast Cancer Risks
• Breast Cancer Develops From the Breast Tissue
• Breast Cancer and the Medication Tamoxifen
• Which Branch of Science Is Used in Testing Breast Cancer?
• How Does Breast Cancer Affect a Patient’s Health?
• Which of the Lifestyle Choices Reduces the Chances of Developing Breast Cancer?
• What Is the Survival Rate for Inflammatory Breast Cancer?
• How Does Breast Cancer Affect Homeostasis?
• How to Check for Breast Cancer Using Nursing Assessment Techniques?
• Can Breast Cancer Spread to Your Kidneys?
• Why Does Breastfeeding Reduce Breast Cancer Risk?
• How Rare Is Triple Negative Breast Cancer?
• Is Fibrocystic Mastopathy Associated With an Increased Risk of Breast Cancer?
• What Is Papillary Breast Cancer?
• How Fast Does Metastatic Breast Cancer Spread?
• Who Founded the National Breast Cancer Foundation?
• Are Breast Cancer and Ovarian Cancer Linked?
• What Body Systems and Organs Are Affected by Breast Cancer?
• How Many Breast Cancer Deaths Occur per Year?
• How Do They Test for Breast Cancer?
• How Is Group Behavior Influenced Through Breast Cancer Treatment?
• Can Breast Cancer Cause Numbness in Fingers?
• What Are the Primary and Secondary Risk Factors for Breast Cancer?
• What Causes Inflammatory Breast Cancer?
• What Side Effects Are Possible From Radiotherapy for Breast Cancer?
• Are Prostate Cancer and Breast Cancer Related?
• What Percentage of Breast Cancer Is Detected by Mammogram?
• What Information Does a Doctor Need to Assess a Patient’s Breast Cancer Risk?
• Is Abortion Linked to Breast Cancer?
• What Is the Risk of Metastasis for Breast Cancer?
• What Is the Primary Level of Prevention for Breast Cancer?
• What Genes Are Responsible for Autosomal Dominant Breast Cancer?
• What Is the At-Risk Population Regarding Breast Cancer?

Cite this post

• Chicago (N-B)
• Chicago (A-D)

StudyCorgi. (2022, March 1). 144 Breast Cancer Essay Topics. https://studycorgi.com/ideas/breast-cancer-essay-topics/

"144 Breast Cancer Essay Topics." StudyCorgi , 1 Mar. 2022, studycorgi.com/ideas/breast-cancer-essay-topics/.

StudyCorgi . (2022) '144 Breast Cancer Essay Topics'. 1 March.

1. StudyCorgi . "144 Breast Cancer Essay Topics." March 1, 2022. https://studycorgi.com/ideas/breast-cancer-essay-topics/.

Bibliography

StudyCorgi . "144 Breast Cancer Essay Topics." March 1, 2022. https://studycorgi.com/ideas/breast-cancer-essay-topics/.

StudyCorgi . 2022. "144 Breast Cancer Essay Topics." March 1, 2022. https://studycorgi.com/ideas/breast-cancer-essay-topics/.

These essay examples and topics on Breast Cancer were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

This essay topic collection was updated on December 27, 2023 .

• Testimonials
• How it works
• Paper Writers Team
• Essay Writing Guide
• Free plagiarism checker
• Essay title generator
• Conclusion Generator
• Citation Generator
• Can ChatGPT Write Essays?
• Types of Essays
• Essay Writing Formats
• Essay Topics
• Best Research Paper Topics
• Essays by Subject
• Breast Cancer Research Paper

A GUIDE TO WRITING A BREAST CANCER RESEARCH PAPER

Table of contents, how to write a breast cancer research paper, your breast cancer research paper thesis, breast cancer outline for research paper, introduction for breast cancer research paper, breast cancer research paper body paragraphs, breast cancer research paper conclusion, breast cancer research paper example and other help.

Breast cancer is a serious public health issue that impacts people from every walk of life. There are very few people who will not have their lives impacted in some way by this disease. Because it is so prevalent, there is much research that has been done and much research that is currently in progress. As a result, breast cancer is a popular topic for students in the medical and healthcare fields. In addition to this, breast cancer is also an appropriate topic for courses in political science, education, even business. This guide will provide you with important advice on writing a research paper on this serious disease.

Once you’ve chosen your topic, and conducted the appropriate research, you’ll need to construct a thesis. This is the statement that you will support in your research paper.

Sample Breast Cancer Research Paper

Writer144311.

Writer144311 has a background in marketing, technology, and business intelligence. S/he enjoys writing about data science, BI, new marketing trends and branding strategies. On TrustMyPaper s/he shares her practical experience through academic writing.

Now that your topic and thesis are in hand, you can begin the process of creating an outline. Think of this as a foundation for your completed paper. It will help you decide on the structure of your paper, and choose the most important points to support your research paper.

Your introduction paragraph should contain the following elements:

• A hook such as an interesting fact about breast cancer
• A few sentences to introduce the specific topic of your paper
• Your thesis

Best breast cancer research paper topics

• The Impact of Pinkwashing on Breast Cancer Research
• The Prevalence of Breast Cancer in Men
• Are Natural Treatments Ever Appropriate for Breast Cancer?
• What is the Role of CBD in Breast Cancer Treatment?
• How to Tell if a Breast Cancer Charity is Legitimate
• Providing Emotional Support to Loved Ones with Breast Cancer
• Breast Cancer in Film and Literature
• New Research in Breast Cancer Immunotherapy
• New Treatment Options for Metastatic Breast Cancer
• Problems with Current Approaches to Breast Cancer Research
• Treatment Options for Patients Who Cannot Receive Chemotherapy

The body paragraphs are the ‘meat’ of your research paper. This is where you will present facts to your readers. Remember to cite your sources , and to rely on data and academic studies to present your case.

Your concluding paragraph should summarize the points made in your research paper. Show the readers how your research comes together to prove your thesis to be correct.

If you need assistance with a research paper on breast cancer, we recommend looking at an example paper. We are happy to provide such a paper to you, or assistance with writing your own research paper on the subject of breast cancer. We have writers, editors, and customer support reps who are available to help you 7 days per week.

External links

• Breast Cancer Research Papers - Academia.edu . (n.d.). Www.Academia.Edu. Retrieved February 19, 2020, from http://www.academia.edu/Documents/in/Breast_Cancer
• Breast Cancer Research Articles . (2019, May 23). National Cancer Institute; Cancer.gov. https://www.cancer.gov/types/breast/research/articles

How ready is your essay?

Don`t have an account?

Password recovery instructions have been sent to your email

Back to Log in

Home — Essay Samples — Nursing & Health — Breast Cancer — The Ways of Raising Awareness about Breast Cancer

The Ways of Raising Awareness About Breast Cancer

• Categories: Awareness Breast Cancer

About this sample

Words: 1131 |

Published: Dec 5, 2018

Words: 1131 | Pages: 2 | 6 min read

Table of contents

Breast cancer speech outline, breast cancer speech example, introduction.

• Brief overview of breast cancer awareness and its goals

Breast Cancer Advocacy and Awareness

• Role of breast cancer advocates in raising funds and lobbying for better care
• The cultural aspect of breast cancer advocacy and pink ribbon culture
• The significance of the pink ribbon symbol and National Breast Cancer Awareness Month

Support Groups

• Types of support groups (informational, emotional)
• The role of support groups in the recovery process
• Differences between formal and informal support groups

Support Group Variability

• Tailoring support groups to specific needs (age, stage of diagnosis)
• The availability of online support groups
• Unique challenges and needs of men with breast cancer

Impact of Support Groups

• Effectiveness of support groups in reducing stress and anxiety
• No proven impact on long-term survival
• Importance of social support from networks and its potential effect on survival

Available Resources

• Free resources for connecting with breast cancer support groups (online and in-person)

Cite this Essay

Let us write you an essay from scratch

• 450+ experts on 30 subjects ready to help
• Custom essay delivered in as few as 3 hours

Get high-quality help

Verified writer

• Expert in: Life Nursing & Health

+ 120 experts online

By clicking “Check Writers’ Offers”, you agree to our terms of service and privacy policy . We’ll occasionally send you promo and account related email

No need to pay just yet!

Related Essays

2 pages / 779 words

2 pages / 844 words

2 pages / 727 words

1 pages / 506 words

Remember! This is just a sample.

You can get your custom paper by one of our expert writers.

121 writers online

Still can’t find what you need?

Browse our vast selection of original essay samples, each expertly formatted and styled

Related Essays on Breast Cancer

Breast cancer is the most common cancer among women worldwide, with an estimated 2.3 million new cases diagnosed in 2020. Understanding the stages of breast cancer is crucial for early detection, treatment planning, and [...]

After my mom had her operation, I would reflect on the profound impact this mutation has had on my family. Recovery was protracted; my mom suffered greatly as a huge part of her femininity has been taken away from her. She also [...]

Many women all over the world have been known to be victims of breast cancer. The seriousness of the disease is known to surpass many diseases known in the history of man. Various remedies have however been sought following [...]

Summary - Breast cancer is a highly common cancer in women, that develops in the breast tissue. This article discusses the treatment of breast cancer and the importance of a good cancer care team for prolong relief. There are [...]

Cancer research in UK found that there is a gene in skin cancers that grows rapidly and heals itself. Scientists say that the skin cancer is mostly caused by a fault in the gene called asTGFBR1. The disease of skin cancer is [...]

There are two laws in Skipper’s laws. The first law states that the doubling time of a tumor is constant. By using a semi-log graph, it plots the growth of cells in a tumor over time to form a straight line. Researchers studied [...]

Related Topics

By clicking “Send”, you agree to our Terms of service and Privacy statement . We will occasionally send you account related emails.

Where do you want us to send this sample?

By clicking “Continue”, you agree to our terms of service and privacy policy.

Be careful. This essay is not unique

This essay was donated by a student and is likely to have been used and submitted before

Download this Sample

Free samples may contain mistakes and not unique parts

Sorry, we could not paraphrase this essay. Our professional writers can rewrite it and get you a unique paper.

Please check your inbox.

We can write you a custom essay that will follow your exact instructions and meet the deadlines. Let's fix your grades together!

Get Your Personalized Essay in 3 Hours or Less!

We use cookies to personalyze your web-site experience. By continuing we’ll assume you board with our cookie policy .

• Instructions Followed To The Letter
• Deadlines Met At Every Stage
• Unique And Plagiarism Free

Risk Factors, Staging, and Treatment of Breast Cancer

Introduction.

Breast cancer is a disease that originates from the breast tissue and the curative time of the patient is dependent on the level of spread and to what organs it has spread to. In the advent of new technology, computer models have been programmed and developed to help in the staging process and determine how long a person is going to live.

With best treatments available, most of the breast cancer patients can survive up to ten years with a 98% to 10% disease free body within this period. On the other hand, it has been discovered that breast cancer is the most common type of cancer especially with women with the total percentage of 10% of all the kinds of cancer.

This does not mean that it does not attack men but the probability is higher in women. If the diagnosis is fast and early, then the spread rate can be stemmed or even eliminated altogether.

This requires the use of trained oncologists with the right equipments to be able to remove it from the stem altogether or if a cure is impossible then the patient’s life can be significantly prolonged with the aid of a cancer drugs.

This is so because huge amounts of resources have been used in the research and the development of the breast cancer drugs that in effect help the body to combat the cancer by providing additional immune to boost the fighting power of the body.

Additionally in the process of research, new methods that are effective the fight against drugs have been experimented and proven to be effective in the fight against the breast cancer. However, breast cancer remains a killer disease and more research needs to be conducted to ensure that its prevalence level is reduced (Hart, 2007).

Age is very instrumental in determining the risk a woman has in getting breast cancer and the risk to get the breast cancer increases significantly as the woman ages. For instance it has been found that a woman living up to the age of 90 years has a risk factor of up to 14% to contact the cancer compared to a middle aged woman. The manner in which cancer attacks the two age’s differences is quite different.

In older women, the cancer spreads slowly and is not as severe but in younger woman it attacks more vigorously and is difficult to control. In addition, it has also been out that in most cases of breast cancer in older people, a higher depression rate among the patients was noted, and this contributes to the faster death as compared to the younger people.

This is because young people have the necessary hope to fight on due to the life before them but the older people have lost hope in life and when they are diagnosed most tends to seclude themselves or live in denial.

This means that in the research for breast cancer apart from trying to develop cures and ways to eliminate the cancer, lots of research should also be done on the psychological support programs to help stem this tide (Hart, 2007).

Men have a lower risk of getting breast cancer compared to women but the risk is appearing to be on the increase in men too. This has been noted especially in the men with prostate cancer and in the case a man is affected the prognosis even in the first stage is very aggressive and worse than in women.

The treatment for the cancer in men is the same as the treatment for an older woman and is a combination of surgery radiation and chemotherapy.

Change or mutations of genes in our bodies can also increase the probability of having cancerous cells in the breasts. This is supported by studies that explicitly show that up to 10% of all breast cancers are hereditary.

This is supported by the fact that women with both hereditary genes of breast cancer gene 1 and breast cancer gene2 have a higher risk of developing breast cancer with women having breast cancer gene 1 accounting for over 5% of all the cancers that occur.

Human epidermal growth receptor 2(HER2) is another gene that is found on the surface on the human skin and can increase the chance or probability of acquiring breast cancer. This is caused by the over production of the HER2 cells when the gene is altered.

If this happens, then aggressive tumor cells develop which account to about 25-30% of all the cancer patients. If the p53 gene undergoes mutation then the risk is even more. This is confirmed by the studies that have shown that women with this mutated gene have a poorer breast cancer outcome than those that do not posses this gene (Ellmann, 2009).

Family history

The family history deeply increases the risk of having breast cancer especially if a close member had the cancer. To the victims whose mother or father had the cancer then the risk doubles. The following people have a risk of having the cancer depending on the background and according to the genetics. These conditions can increase breast cancer

• Having relatives with breast cancer
• Having relatives with two different kinds of cancer
• Having a male relative with case or cases of breast cancer
• .If the same family is of Ashkenazi Jewish heritage then the odds are even more
• A family history that includes history of diseases such as hereditary breast cancer and diseases such as Li-Fraumeni or even Cowdens Syndromes

It has been shown that there are higher rates and incidence of the breast cancer in areas that have high fat yield content in their diet like in the USA compared with the low fat yield places like Japan. However, the link between the two is not straight and is dependent on the type of fats that a woman has.

Monounsaturated fats are linked to low breast cancer risk compared with polyunsaturated fats that have a slightly higher prevalence. A study was conducted in the USA that showed that despite the link between the diet and the cancer, the reduction of fats in the diet does not automatically mean or lead to a reduction in the risk of having the breast cancer.

However, it was found out that there is a 9% reduction rate in the postmenopausal women if they followed a strict low fat diet. In the end, it was decided that the cutting of fats in the diet can cause a reduced rate of risk in some women but they did not have the necessary solid evidence to make conclusions.

Hormone replacement therapy

Recent studies have indicated the use of this kind of therapy can add to the risk of breast cancer. In the year 2002 a study was carried out by the group Women heath initiative and it was found out that in they were eight cases of invasive breast cancer in about 10000 women. This represented an increase of about 26% compared to those who did not have the hormone replacement therapy.

On the same note, it was found out that between the years 2002 and 2003 there was an increase in the prevalence rate of the breast cancer. Although the tests and the results are not conclusive or even solid, this little link has alarmed experts who believe that women seeking hormone replacement therapy should consult an expert on the matter to ensure that they are well informed (Foster, 2008).

It had not been discovered that tobacco smoking could cause an increase of breast cancer until the beginning of the mid 1990’s when a number of studies were conducted on the same topic. The study had disturbing results that predicted a higher risk rate for both active and passive smokers. Based on the epidemiological studies and the mammary carcinogens, the rate had reached 70% by 2005.

In the year 2006, another study was done which pegged the risk rate at a higher rate due to the risk of non-smokers who are passive smokers. This is especially rife in young women who can suffer from an increased risk rate of up to 70% if they are in their primary pre-menopausal stage because at this stage, the breast tissue is sensitive to the carcinogens; they are still young, and not fully developed

Staging of breast cancer

This process is used to determine the level in which the cancer has attacked the body making a diagnosis. Knowing the stage of the cancer is very important since the doctor gets to know the best way on which to offer treatment and how to determine the prognosis of the cancer (Foster, 2008). The staging is done in stages that are:

• Stage 0: This is called the pre-cancerous state because the cancer cells are located in the milk duct and have not yet spread to the breast tissue or have not invaded the nodes or distant sites. Such cancers like lobular carcinoma can be classified as stage 0 cancer.
• Stage 1: The cancer has started spreading to the other parts of the breast and the tumor is less than 2cm long however the cancer cells have not spread to the lymph nodes or even the distant cells.
• Stage II: This stage is divided into two categories namely stageIIA and stageIIB. In stage II, the tumor will be located and restricted to the breast with no further spreading. Finally, the tumor can be more than 2cm but less than 5cm and has not yet spread to the auxiliary nodes or the distant sites.
• StageIIB can involve cancer cells that have a tumor larger the 2cm but being less than 5cm. At this stage, the cancer cells will have spread to auxiliary nodes but the distant cells will be safe. In addition, during the later stages of the stage, the tumor is more than 5cm long but the spread to the chest walls will not have started. This stage also has the cells localized and have not spread to the distant sites
• Stage III has three sub categories that are categorized according to the level of spreading the cancer has undergone. In stageIIIA, the tumor is less than 5cm in diameter and the cells have spread to 4-9 auxiliary nodes but not to the distant sites. The tumor can be larger than 5cm in diameter and the cells having spread to the mammary nodes but the distant sites will still be healthy. In stageIIIB,the tumor can take up any size and the spread will have encroached the chest walls. The spreading of the cancer can be to the auxiliary nodes in the breast themselves or the lymph nodes that are near the breastbones. Finally in stageIIIC the tumor can be of any size and the cancer cells having spread to 10 0r more of the auxiliary cells or even to 1 or more of the regional lymph nodes or even to the internal mammary glands
• StageIV: At this stage, the tumor can take up any size depending on the attack and the cancerous cells might have spread to the lymph nodes that are nearby. In most cases, the cells will have spread to the distant cells (Foster, 2008).

Treatment of cancer

Treatment of breast cancer is dependent on the stage the cancer is and the whether the cells are sensitive to hormones. Personal preferences also come into effect with many people preferring one method of treatment to another because of their own reasons. Overall, these methods are all-effective and are all instrumental in ensuring that all the cells are ejected from the body.

Treatment methods

The most common method is surgery. In surgery, there are many forms all depending on the level of spread and the staging. A lumpectomy is an effective way ot breast cancer treatment because the removes the entire tumor plus some surrounding cell tissues that are healthy. This method is however reserved for the smaller tumors. The entire breast can also be removed (mastectomy).In this method the doctor usually removes all the breast tissue and all the parts that border or are integral with the breast.

The surgery can also be performed by removing one lymph node, this is because the cancer will have spread to that lymph alone and if removed the chance of finding cancer in other cells is very low to the point that the surgeon leaves all the other parts intact. On the other hand, several lymph nodes can also be removed depending on the level of spread (Ellmann, 2009).

Radiation therapy

“This kind of therapy involves the use of high-powered beams of energy to kill the cancer cell” (Ellmann, 2009, p. 49). It is done using a big machine that emits the rays to ensure that all the cancerous cells are killed. In most cases, some doctors will recommend this therapy instead of mastectomy to be able to save the entire breast tissue.

Chemotherapy

“This process involves the use of drugs to destroy the cancer cells” (Connolly, 2008, p. 52). Some doctors can recommend chemotherapy after surgery to avoid the cells forming again and it can be used before surgery to allow the tumor to shrink to a level where it can be safely removed. It is used in women whose breast cancer has spread to the other organs present in the body

Hormone therapy

“This is another of treatment to treat breast cancers especially is the cells are sensitive to hormones” (Backus, 2005, p. 379). It can be used after a surgery to make sure that the cancer does not rejuvenate or it can be used to reduce the size of the tumor before any surgery can be done.

The drugs also prevent the hormones from attaching themselves to the cancer cells or they help to eliminate the production of estrogen especially in menopausal women . One disadvantage of these drugs is that they are only used for postmenopausal women.

Herceptin breast cancer metastatic treatment

Due to the increased level of research and dedication, new methods have been developed to curb the spread of breast cancer. One of this is by the use of herceptin breast cancer metastatic treatment.

This kind of therapy is injected in the body by the use of a needle and can be used together with the other types of breast cancer drugs .It is new and still not in use especially in the developing world but its use is catching on.

Backus, M. (2005). Is there a role for iodine in breast. The Breast, 10 (5), 379–382.

Connolly, T. (2008). Robbins Basic Pathology . Philadelphia: Saunders.

Ellmann, R. (2009). Breast carcinoma in men: a population-based study. Cancer , 101 (1), 51–58.

Foster, J. (2008). Metalloestrogens: an emerging class of inorganic xenoestrogens with potential to add to the oestrogenic burden of the human breast. Journal of Applied Toxicology, 26 (3), 191–198.

Hart, C. (2007). Breast Cancer . London: Faber & Faber.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2018, May 15). Risk Factors, Staging, and Treatment of Breast Cancer. https://ivypanda.com/essays/risk-factors-staging-and-treatment-of-breast-cancer/

"Risk Factors, Staging, and Treatment of Breast Cancer." IvyPanda , 15 May 2018, ivypanda.com/essays/risk-factors-staging-and-treatment-of-breast-cancer/.

IvyPanda . (2018) 'Risk Factors, Staging, and Treatment of Breast Cancer'. 15 May.

IvyPanda . 2018. "Risk Factors, Staging, and Treatment of Breast Cancer." May 15, 2018. https://ivypanda.com/essays/risk-factors-staging-and-treatment-of-breast-cancer/.

1. IvyPanda . "Risk Factors, Staging, and Treatment of Breast Cancer." May 15, 2018. https://ivypanda.com/essays/risk-factors-staging-and-treatment-of-breast-cancer/.

Bibliography

IvyPanda . "Risk Factors, Staging, and Treatment of Breast Cancer." May 15, 2018. https://ivypanda.com/essays/risk-factors-staging-and-treatment-of-breast-cancer/.

• Cancer Terminology and Characteristics
• Aspects of Modal and Auxiliary Verbs
• Clinical Laboratory Science of Breast Cancer
• Maternal Mortality: Situations, Policies and Programs
• Cultural and Racial Inequality in Health Care
• Blood Clot Risk from Stents Seen in African-Americans
• The Major Medical Causes of Maternal Deaths and Ways to Reduce It
• Analysis and Review of the Decisions made in the Simulation of the Lenity Hospital for Advanced Care (LHAC)

Learn how UpToDate can help you.

Select the option that best describes you

• Medical Professional
• Resident, Fellow, or Student
• Hospital or Institution
• Group Practice
• Patient or Caregiver
• Find in topic

RELATED TOPICS

Contributor Disclosures

Please read the Disclaimer at the end of this page.

INTRODUCTION

Breast cancer is the most common female cancer in the United States, the second most common cause of cancer death in women (after lung cancer). When found and treated early, breast cancer is most often curable.

Breast cancer deaths have decreased by one-third or more over the past three decades. This is due in part to increased screening, as well as earlier and improved treatment for breast cancer. Screening usually detects the disease at an earlier stage, when the chances of successful treatment are higher. Early detection and treatment of breast cancer improve survival because the breast tumor can be removed before it has a chance to spread (metastasize). In addition, there are treatments that can be used to prevent cancer cells that have escaped the breast from growing in other organs (see 'Systemic therapy' below). Screening recommendations are discussed in more detail elsewhere. (See "Patient education: Breast cancer screening (Beyond the Basics)" .)

UpToDate contains a number of patient education articles that discuss breast cancer. The purpose of this overview is to provide a guide to the issues and questions that arise in women with newly diagnosed breast cancer. This topic can serve as a "road map" to the patient education articles that are relevant to your particular situation.

This guide will focus only on the diagnosis and treatment of breast cancer. Other articles within UpToDate discuss the risk factors for breast cancer and methods to prevent breast cancer in women who are at high risk. (See "Patient education: Factors that affect breast cancer risk in women (Beyond the Basics)" and "Patient education: Medications for the prevention of breast cancer (Beyond the Basics)" .)

More detailed information about breast cancer, written for health care providers, is available by subscription. (See 'Professional level information' below.)

DIAGNOSING BREAST CANCER

Breast cancer is sometimes found when a person (or their health care provider) notices a lump or other change in the breast or armpit. Other times, cancer is found during a routine screening test, before a lump can be felt.

Abnormal lump  —  In addition to a lump, other abnormal changes may include dimpling of the skin, a change in the size or shape of one breast, retraction (pulling in) of the nipple when it previously pointed outward, bloody nipple discharge, or a discoloration of the skin of the breast not related to infection or skin conditions such as psoriasis or eczema.

To evaluate a breast lump, a mammogram and a breast ultrasound are usually recommended. If suspicious, a breast biopsy may also be recommended (see 'Breast biopsy' below). A suspicious lump should never be ignored, even if a mammogram is negative. Between 5 and 15 percent of new breast cancers are not visible on a mammogram [ 1-3 ].

Mammogram  —  Breast cancer is most often diagnosed with a routine "screening" mammogram, before a lump or other change in the breast develops.

A mammogram is a very low-dose X-ray of the breast. The breast tissue is compressed for the X-ray, which decreases the thickness of the tissue and holds the breast in position so the radiologist can find abnormalities more accurately. Each breast is compressed between two panels and X-rayed from two directions (top-down and side-to-side) to make sure all the tissue is examined. Mammograms are currently the best screening method to detect breast cancer. Some mammograms capture images digitally, offering better clarity, the ability to adjust the image, and a decreased likelihood of needing to return on a different day for repeat pictures.

3D tomosynthesis is a type of improved digital mammogram that captures multiple pictures of the breast while the breast is compressed in the two directions (top-down and side-to-side) instead of just one picture. This technology allows the radiologist to examine multiple pictures of each breast. This can help the radiologist see abnormalities that may be concealed by overlapping tissue. Additionally, finer detail is seen, which is helpful in determining which lumps are benign (not cancer) and which need further investigation with additional pictures [ 4-6 ].

Breast ultrasound  —  An ultrasound uses sound waves to look at breast tissue and can tell if a lump is a fluid-filled cyst or a solid lump. An ultrasound is only used to examine a limited area of the breast and is not routinely used as a screening test in place of a mammogram.

Breast MRI  —  Magnetic resonance imaging (MRI) uses a strong magnet to create a detailed image of a part of the body. It does not use X-rays or radiation but does require injection of a contrast agent (a material that shows up on imaging) into a vein.

Breast MRI is not usually used to screen for breast cancer but can aid in the diagnosis of breast cancer in select situations. As examples:

● Breast cancer screening for people who have an increased risk of breast cancer (eg, mutations in the BRCA1 or BRCA2 genes). (See "Patient education: Genetic testing for hereditary breast, ovarian, prostate, and pancreatic cancer (Beyond the Basics)" .)

● Evaluation for breast cancer in a woman who is diagnosed with cancer of the lymph nodes (glands) under the arm but who has no sign of breast cancer on physical examination or mammogram of the breast on that side. Sometimes the breast MRI can be used to determine if the cancer first developed in the breast, and its location.

● Evaluation of a woman with newly diagnosed breast cancer with dense breasts on mammograms, because the density of the breast tissue makes the mammograms difficult to interpret.

Breast biopsy  —  If breast cancer is suspected, the next step is to sample the abnormal area to confirm the diagnosis. Regardless of whether the lump can be felt or not, the sample should be obtained using a needle biopsy with the help of an imaging study (such as mammography, ultrasound, or MRI).

A fine needle aspiration may be sufficient to establish a diagnosis of breast cancer, though a core needle biopsy, which utilizes a larger needle, is often preferable as it provides a larger sample to better characterize certain features of the cancer. (See 'Hormone receptors' below and 'HER2' below.)

Core needle biopsies are performed with local anesthesia and do not require sedation. The area biopsied is preferably marked with a clip or another method to mark the location. This can help facilitate surgical removal if the biopsy shows cancer or allow follow-up if the results are benign (not cancer).

Types of breast cancer  —  Although there are several different types of breast cancer, they are treated similarly, with some exceptions ( figure 1 ).

In situ breast cancer  —  The earliest breast cancers are called "in situ" cancers.

Ductal carcinoma in situ  —  If cancers arise in the ducts of the breast (the tubes that carry milk to the nipple when a woman is breastfeeding) and do not grow outside of the ducts, the tumor is called "ductal carcinoma in situ" (DCIS). DCIS cancers do not spread beyond the breast tissue. However, DCIS can progress into invasive cancer if not treated.

The best treatment for DCIS will depend on the size of the area of disease relative to the size of the breast, the grade of the disease, hormone receptor status, and the woman's overall health:

● Most women can be treated with removal of the cancerous area (breast-conserving therapy, also known as lumpectomy) followed by radiation therapy. Surgical removal of the cancerous area without radiation may be an option, particularly for older women with a very small area of hormone receptor positive, low-grade disease that is completely removed. Women with DCIS who are being treated with lumpectomy do not need their lymph nodes checked for spread of tumor.

● Women with extensive DCIS may need a mastectomy, which may be done with or without reconstruction. A sentinel lymph node biopsy, a special technique to identify and remove only the most important lymph nodes in the armpit, is usually performed at the time of mastectomy for DCIS. Large areas of DCIS have an increased chance of being associated with hidden invasive cancer. If the lymph nodes are involved by this hidden invasive cancer, this will affect treatment decisions. It is not possible to reliably perform sentinel node biopsy after a mastectomy. (See "Patient education: Surgical procedures for breast cancer — Mastectomy and breast-conserving therapy (Beyond the Basics)" .)

● Chemotherapy is not necessary for women with DCIS. Endocrine treatment (also called hormonal therapy) may be recommended for prevention of recurrence, particularly if the DCIS tests positive for responsiveness to estrogen (called "estrogen receptor positive" or "hormone receptor positive" cancer) and the woman did not have a mastectomy. The drug most often used for endocrine treatment is tamoxifen. Other drugs, anastrozole or exemestane, may also be effective in postmenopausal women treated for DCIS. Endocrine treatment reduces the chances that the cancer will come back in the treated breast; it also decreases the chances of developing a new breast cancer in the other breast.

Invasive breast cancer  —  The majority of breast cancers are referred to as invasive breast cancers because they have grown or "invaded" beyond the ducts or lobules of the breast into the surrounding breast tissue ( figure 1 ). Several varieties of invasive breast cancers are possible.

Features of a breast cancer that influence the choice of treatment  —  At the time breast cancer is diagnosed and/or treated, the cancer should be studied for the presence of two types of proteins:

● Hormone receptors (estrogen and progesterone receptors)

● HER2 (for invasive cancers)

These proteins are important for selecting the appropriate medical treatment. These tests are performed by a pathologist, the doctor responsible for examining the breast cancer tissue under the microscope and making the diagnosis. The pathologist will also "grade" the cancer.

Grade  —  A tumor's grade describes how aggressively it grows, although this cannot be translated into a specific timeframe such as a month, a year, etc. Tumors are graded on a scale of 1 to 3, where 1 is the slowest and 3 is the fastest growing type of tumor. Tumors with higher grades are more likely to need chemotherapy.

Hormone receptors  —  More than one-half of breast cancers require the female hormone estrogen to grow, while other breast cancers are able to grow without estrogen. Estrogen-dependent breast cancer cells produce proteins called hormone receptors, which can be estrogen receptors (ER), progesterone receptors (PR), or both.

If hormone receptors are present within a woman's breast cancer, she is likely to benefit from treatments that lower estrogen levels or block the actions of estrogen. These treatments are referred to as endocrine or hormone therapies, and such tumors are referred to as hormone-responsive or hormone receptor positive.

In contrast, women whose tumors do not contain any ER or PR do not benefit from endocrine therapy, and it is not recommended. (See "Patient education: Treatment of early-stage, hormone-responsive breast cancer in premenopausal women (Beyond the Basics)" .)

HER2  —  HER2 is a protein that is present in about 15 to 20 percent of invasive breast cancers [ 7 ]. The presence of HER2 in the breast cancer identifies women who might benefit from treatments directed against the HER2 protein. Drugs that target the HER2 protein include trastuzumab (brand name: Herceptin), pertuzumab (brand name: Perjeta), ado-trastuzumab emtansine (brand name: Kadcyla), and fam-trastuzumab deruxtecan (brand name: Enhertu). (See "Patient education: Treatment of early HER2-positive breast cancer (Beyond the Basics)" .)

If the cancer is HER2 negative as well as hormone receptor negative, this is called "triple negative" disease.

HAS THE BREAST CANCER SPREAD?

Once a diagnosis of breast cancer is established, the next important questions are the following:

● How extensive is the cancer involvement within the breast?

● Is there evidence that the tumor has moved to areas outside of the breast (metastasized)?

The extent of cancer involvement within the breast is usually determined by the findings on the biopsy, the results of the mammogram, ultrasound, and, in some cases, the results of the breast MRI scan.

Although by definition breast cancer starts within the breast, tiny cells or pieces of the cancer may break off from the breast tumor at any point and travel to other places through the bloodstream or the lymph channels. This process is called metastasis ( figure 1 ).

When these stray tumor cells lodge themselves in a lymph node (gland) or an organ such as the liver or the bones, they grow, eventually producing a mass or lump that can sometimes be felt (eg, if it involves the skin or the lymph nodes in the armpit). In other cases, metastases may only be evident because they cause symptoms such as bone pain and can be seen on an imaging test such as a computed tomography (CT) scan, a bone scan, or a positron emission tomography (PET) scan. The use of these studies is discussed below. (See 'Staging and the staging workup' below.)

The importance of the axillary lymph nodes  —  One of the first sites of breast cancer spread is to the lymph nodes located in the armpit (axilla). These nodes (referred to as "axillary lymph nodes") can become enlarged and can sometimes be felt during a breast examination. Other times, they are found on the mammogram or MRI, leading to an ultrasound of the armpit. However, even if the lymph nodes are enlarged, the only way to determine if they truly contain cancer is to examine a sample of the tissue under the microscope.

The presence or absence of lymph node involvement is one of the most important factors in determining the long-term outcome of the cancer (prognosis), and it often guides decisions about treatment.

● If the axillary lymph nodes contain cancer (positive nodes), there is a higher chance that cancer cells have spread elsewhere, and most of these women are advised to have adjuvant systemic therapy.

● Systemic therapy, especially chemotherapy, is recommended less often for women who have no cancer cells detected in the axillary lymph nodes (node-negative breast cancer), particularly if the tumor is small or other prognostic factors (such as estrogen receptor [ER] positivity) are all favorable. Adjuvant endocrine therapy is usually recommended to all people with ER-positive breast cancer, even if the lymph nodes are negative, because it generally has less toxicity than chemotherapy and lowers the chances of recurrences and developing a second breast cancer in the future.

Examination of the axillary lymph nodes  —  The axillary lymph nodes should be examined for tumor spread. This is done first by physical examination and sometimes with ultrasound. If a suspicious lymph node is found, then a needle biopsy to obtain a tissue sample is performed. If there is cancerous involvement of the axillary lymph nodes, a surgical procedure called axillary lymph node dissection is performed at the time of the breast surgery to remove all the nodes from the axilla.

In people with early-stage breast cancer who do not have obvious involvement of the axillary lymph nodes, a surgical procedure called a "sentinel lymph node biopsy" is often performed. In this procedure, two tracers are used to mark the lymph nodes that the cancer would go to first (these are called "sentinel" nodes). These lymph nodes, which are usually under the armpit, are then removed for analysis. Older women with small hormone receptor positive invasive cancer may not need a sentinel lymph node biopsy.

The major benefit of the sentinel lymph node procedure is that it provides important staging information while causing fewer problems such as arm swelling (also called lymphedema) than a more extensive axillary lymph node dissection. (See "Patient education: Lymphedema after cancer surgery (Beyond the Basics)" .)

Most people do not have cancer in their sentinel lymph nodes and will not need additional surgery. Some studies have shown that there are select people for whom an axillary lymph node dissection is not necessary even if one or two of the sentinel lymph node(s) are positive. People who have three or more positive sentinel nodes, however, will require dissection of the remaining axillary lymph nodes, in case there are additional cancer-containing nodes. (See "Patient education: Surgical procedures for breast cancer — Mastectomy and breast-conserving therapy (Beyond the Basics)", section on 'Management of axillary lymph nodes' .)

Staging and the staging workup  —  Oncologists (doctors who care for people with cancer) use a standard set of abbreviations, called the TNM staging system, to describe the stage of individual cancers. The "T" stands for the primary tumor, the "N" stands for the status of the regional lymph nodes, and the "M" stands for the presence or absence of metastases to other organs. The T, N, and M designations are then grouped together to form the stage grouping of a breast cancer, which ranges from stage I (least advanced) to IV (most advanced). Stage 0 cancer is the categorization for people with DCIS alone. The "stage" of the cancer is an indication of whether and how far it has spread.

People sometimes confuse stage and grade, but they are not the same thing. (See 'Grade' above.)

Tumor size (T) and nodes (N)  —  To establish the stage of a breast cancer, the first step is to evaluate the size of the tumor (T) and establish whether the lymph nodes have cancer in them or not (N). This is accomplished with:

● A complete physical, including careful examination of the breast and lymph nodes

● Mammogram (and sometimes other types of breast imaging such as ultrasound or breast MRI)

● Pathologic examination of the cancer and lymph nodes

Metastases (M)  —  If any cancer is detectable outside of the breast, these deposits are called metastases (M).

Several "staging" imaging studies may be done to help determine if the cancer has spread beyond the breast and axillary lymph nodes. These may include:

● Bone scan

● CT scan of the chest

● CT scan of the abdomen and pelvis

Not all of these studies will be recommended during the staging process. Indeed, for most women (including those who have no suspicious symptoms and who have small tumors with negative or only a few positive lymph nodes) nothing is needed for staging beyond the physical examination and breast imaging. The components of the staging evaluation are covered in more detail elsewhere. (See "Patient education: Surgical procedures for breast cancer — Mastectomy and breast-conserving therapy (Beyond the Basics)" .)

Stage I and II breast cancer  —  Women with stage I or II breast cancers are said to have "early-stage" localized breast cancer. In general, stage I breast cancer refers to a tumor less than 2 cm (0.8 inches) in size that is node negative.

In general, stage II tumors are those with spread to the axillary lymph nodes and/or a tumor size larger than 2 cm but smaller than 5 cm (about 2 inches).

Stage III breast cancers  —  Women with stage III tumors are referred to as having locally advanced breast cancer. These consist of large breast tumors (greater than 5 cm, or about 2 inches, across), those with extensive axillary nodal involvement (more than 10 lymph nodes with cancer), nodal involvement of both axillary and internal mammary nodes (behind the ribs of the breast with cancer) at diagnosis, or nodal involvement of the soft tissues above or below the collarbone (called the supraclavicular and infraclavicular lymph nodes, respectively).

A tumor is also designated as stage III if it extends to underlying muscles of the chest wall or the overlying skin. Inflammatory breast cancer, a rapidly growing form of cancer that makes the breast appear red and swollen, is at least stage III, even if it is small and does not involve lymph nodes.

Stage IV breast cancer  —  Stage IV breast cancer refers to tumors that have metastasized to areas outside the breast and lymph nodes to the bones, lungs, liver, or other organs. The primary tumor may be any size, and there may be any number of affected lymph nodes. This is referred to as "metastatic" breast cancer.

OVERVIEW OF TREATMENT

The treatment of breast cancer must be individualized and is based upon several factors. Optimal management in most cases requires collaboration between surgeons (breast cancer surgeons and reconstructive surgeons, who are typically plastic surgeons) and doctors who specialize in radiation and medical oncology. Each woman should discuss the available treatment options with her doctors to determine what treatment is best for her.

Early-stage localized breast cancer

Local therapy  —  Two surgical options are available for treating localized breast cancer:

● Mastectomy (removal of the breast)

● Breast-conserving therapy (BCT), also called lumpectomy

BCT consists of breast-conserving surgery (lumpectomy), which may also be referred to as wide excision, quadrantectomy, or partial mastectomy. BCT also requires radiation therapy to reduce the chances of cancer coming back in the same breast. However, there are some people for whom radiation therapy to the remaining breast may not be necessary, particularly older women who have small, node-negative cancers that are hormone receptor positive. The combination of surgery and radiation usually results in cosmetically acceptable preservation of the breast without compromising breast cancer outcomes.

In centers that specialize in breast cancer treatment, approximately 60 percent of women with early-stage breast cancer are candidates for BCT. In 25 to 50 percent of women, there are medical, cosmetic, and/or social and emotional reasons for having a mastectomy rather than BCT. However, assuming that the patient is considered a good candidate for BCT, survival outcomes are the same whether BCT or mastectomy is performed. (See "Patient education: Surgical procedures for breast cancer — Mastectomy and breast-conserving therapy (Beyond the Basics)" .)

Radiation therapy to the chest wall and surrounding lymph node areas may also be recommended for people who have had a mastectomy. Factors such as positive lymph nodes, large tumors, and positive margins play into the decision.

Breast reconstruction (surgery to rebuild the breast) is an important option for women who undergo mastectomy and may be considered at the time of the mastectomy or at a later date. Consultation with a plastic surgeon prior to the mastectomy is essential if immediate reconstruction is desired. Knowledge of the need for postmastectomy radiation may influence the plastic surgeon's decision as to the timing of the reconstruction (immediate or delayed). Also, not all women are eligible for reconstruction, so consultation with a plastic surgeon prior to surgery is important to determine eligibility. Some women choose not to have reconstruction.

Systemic therapy  —  Systemic (body-wide) anticancer treatment that is given before or after surgery is called "adjuvant systemic therapy." The term "neoadjuvant" is used when the treatment is given before surgery. Many women with early disease that is triple negative or HER2 positive will get neoadjuvant therapy; then, depending on the results of the surgery (and whether all the cancer was able to be removed), they may get additional treatment as well.

The goal of systemic therapy is to eliminate or prevent the growth of any cancer cells that may have escaped the breast and that might grow in other organs (metastases). The first place that breast cancer spreads is the lymph nodes under the armpit (axilla). When breast cancer metastasizes to lymph nodes in the axilla (the axillary lymph nodes), the chance for cure is lower than when it is only in the breast. People with metastases or cancer cells in other organs such as the liver, lung, or bone are rarely cured. However, systemic therapy may prevent metastases in many cases, and thus cure many women who would not be cured otherwise. Systemic therapy, therefore, has become an important component of breast cancer treatment because it significantly decreases the chance that a cancer will return, especially in situations where the cancer had already spread to the axillary lymph nodes. This, in turn, improves the chances of surviving breast cancer.

Systemic therapy is recommended for the vast majority of women with stage II breast cancer, and for many women with stage I disease. (See "Patient education: Treatment of early-stage, hormone-responsive breast cancer in premenopausal women (Beyond the Basics)" and "Patient education: Treatment of early-stage, hormone-responsive breast cancer in postmenopausal women (Beyond the Basics)" .)

There are three types of systemic therapy. Some women may receive multiple types of these treatments depending on their tumor characteristics:

● Endocrine therapy (also called hormone or antiestrogen treatment) – Endocrine therapy is only recommended for women with estrogen receptor (ER)-positive breast cancer. Because it has very few life-threatening side effects and is so effective, it is recommended for almost all women with ER-positive disease, regardless of stage. Endocrine therapy reduces the odds of a breast cancer recurrence by nearly 50 percent. There are two types of endocrine therapies that are used in the adjuvant setting: selective estrogen receptor modulators (SERMs) such as tamoxifen or raloxifene and aromatase inhibitors (AIs) such as anastrazole. This is a treatment taken daily for a minimum of five years.

Women with high-risk hormone receptor-positive, HER2-negative disease may also be offered a medication called abemaciclib.

● Anti-HER2 therapy – Anti-HER2 therapy is usually recommended for people whose tumors make a lot of HER2 (see 'HER2' above). Trastuzumab (brand name: Herceptin) and pertuzumab (brand name: Perjeta) are approved for adjuvant and neoadjuvant (before surgery) treatment. The main risk of trastuzumab is a small risk of heart damage. Doctors usually do echocardiograms (imaging tests of the heart) to monitor for this. Some people who received systemic treatment before surgery may get a different drug after surgery called trastuzumab emtansine (T-DM1) if there is remaining cancer at the time of surgery.

● Chemotherapy – The decision to treat early-stage breast cancer with chemotherapy is based on many factors, such as the stage and grade of a tumor and whether it lacks hormone receptors or makes a lot of the HER2 protein. There are several types of chemotherapies used in the adjuvant setting, and they are usually given in combination or sequentially. Your oncologist will decide the regimen that is best for you. Additionally, they may want to give the chemotherapy before surgery, especially if the cancer is stage II with certain receptor patterns or if it is stage III.

A genetic test called Oncotype DX Recurrence Score (RS) can be performed on the tumor tissue to help with decision making about chemotherapy for women with ER-positive, HER2-negative, and node-negative breast cancer (and in select cases, people with node-positive breast cancer). The test looks at 21 different genes in order to evaluate the genetic makeup of the tumor and provides a number score to help predict the chance of recurrence. The score is called the "recurrence score," and the results range from 0 to 100. Cancer doctors will often use this information, in combination with other information about the individual and their tumor, to guide decision making about the need for chemotherapy.

In general, people with a low recurrence score whose cancers also have other low-risk features may not need chemotherapy, whereas those with a high score benefit more from chemotherapy. Antiestrogen therapy is recommended for all people with hormone receptor-positive disease, regardless of the recurrence score.

Other genetic tests are available that look at different genes than the RS and may be used on your tumor instead of Oncotype.

● Immunotherapy – Some women with "triple negative" cancers will benefit from immunotherapy, which uses the body’s own immune system to fight cancer.

● Other systemic treatments – For women with BRCA1 or BRCA2 genetic mutations whose cancer is HER2 negative but has high-risk features, use of a medication called a poly(ADP-ribose) polymerase inhibitor following adjuvant therapy can be beneficial. For women with hormone receptor-positive, HER2-negative, node-positive breast cancer at high risk   of recurrence, the addition of a medication that inhibits cyclin dependent kinase 4/6 can improve outcomes.

Locally advanced and inflammatory breast cancer  —  Although not precisely defined, the term "locally advanced" implies one or more of the following: a tumor larger than 5 cm (about 2 inches), many palpable positive surrounding lymph nodes, cancer nodules or ulceration in the skin overlying the breast, or fixation of the cancer to the chest wall behind the breast. Another form of locally advanced breast cancer is "inflammatory breast cancer," which causes swelling, redness, or thickening of the skin due to its invasion by cancer cells. The likelihood of curing locally advanced and inflammatory breast cancer is lower than for smaller cancers and cancers that do not have any of these physical findings but is still possible with appropriate treatment.

Treatment generally includes a combination of systemic therapy, surgery, and radiation therapy. Additional therapies, depending on the cancer receptors, may include endocrine therapy (if the tumor is hormone receptor positive), anti-HER2 therapy (if the tumor is HER2 positive), immunotherapy (if the tumor is triple negative), and targeted therapy (eg, a cyclin dependent kinase 4/6 inhibitor, for select node-positive, hormone receptor-positive, HER2-negative cancers). In most cases, systemic therapy is given before surgery (neoadjuvant therapy). In fact, the treatment for locally advanced breast cancer is very similar to that for nonlocally advanced disease, except that more people receive neoadjuvant treatment, and more are treated with mastectomy than BCT (although BCT may be an option in some cases in which there has been a good response to neoadjuvant therapy), and almost everyone receives radiation therapy after surgery. (See "Patient education: Locally advanced and inflammatory breast cancer (Beyond the Basics)" .)

Metastatic breast cancer  —  "Metastatic" means the cancer has spread beyond the breast. Few, if any, people with metastatic breast cancer are cured (meaning the disease goes completely away and never comes back); however, substantial progress has been made in improving the length of time people live with metastatic breast cancer and their quality of life during that time.

Doctors usually treat metastatic breast cancer with the approach that is most likely to reduce the symptoms related to the cancer with as few side effects as possible. This strategy is usually accomplished with a judicious use of "systemic therapy" that treats the whole body, such as chemotherapy, endocrine therapy, trastuzumab, immunotherapy, targeted therapy (which targets certain proteins that drive the growth of some cancers), or some combination of these options. Surgery and radiation therapy are used to control disease in certain areas, such as bone metastases that are particularly symptomatic or about to cause a fracture, brain or spinal cord metastases, and skin metastases on the chest that are causing symptoms. (See "Patient education: Treatment of metastatic breast cancer (Beyond the Basics)" .)

The choice of treatment for metastatic breast cancer depends upon many individual factors, including features of the cancer (especially whether it produces hormone receptors and HER2), the expected response to various therapies, treatment-related side effects, the extent and location of metastases, and a woman's personal preferences.

Each woman should discuss the available treatment options with her physician to determine which choice is best for her. (See "Patient education: Treatment of metastatic breast cancer (Beyond the Basics)" .)

CLINICAL TRIALS

There are many unanswered questions about the evaluation and treatment of breast cancer. Many advances have been made that have led to more effective and less toxic treatments over the last several decades. Ask your doctor if you are eligible for a clinical trial and then decide if participation is right for you.

Videos addressing common questions about clinical trials are available from the American Society of Clinical Oncology ( https://www.cancer.net/research-and-advocacy/clinical-trials/welcome-pre-act ).

WHERE TO GET MORE INFORMATION

Your health care provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site ( www.uptodate.com/patients ). Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below.

Patient level information  —  UpToDate offers two types of patient education materials.

The Basics  —  The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Breast cancer (The Basics) Patient education: Breast cancer screening (The Basics) Patient education: Common breast problems (The Basics) Patient education: Genetic testing for breast, ovarian, prostate, and pancreatic cancer (The Basics) Patient education: Breast reconstruction after mastectomy for cancer (The Basics) Patient education: Choosing surgical treatment for early-stage breast cancer (The Basics) Patient education: Ductal carcinoma in situ (DCIS) (The Basics) Patient education: Inflammatory breast cancer (The Basics) Patient education: Breast biopsy (The Basics) Patient education: Sentinel lymph node biopsy for breast cancer (The Basics) Patient education: Breast ultrasound (The Basics) Patient education: Mammogram (The Basics) Patient education: Mastectomy (The Basics)

Beyond the Basics  —  Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient education: Factors that affect breast cancer risk in women (Beyond the Basics) Patient education: Medications for the prevention of breast cancer (Beyond the Basics) Patient education: Breast cancer screening (Beyond the Basics) Patient education: Genetic testing for hereditary breast, ovarian, prostate, and pancreatic cancer (Beyond the Basics) Patient education: Surgical procedures for breast cancer — Mastectomy and breast-conserving therapy (Beyond the Basics) Patient education: Treatment of early-stage, hormone-responsive breast cancer in premenopausal women (Beyond the Basics) Patient education: Treatment of early HER2-positive breast cancer (Beyond the Basics) Patient education: Lymphedema after cancer surgery (Beyond the Basics) Patient education: Treatment of early-stage, hormone-responsive breast cancer in postmenopausal women (Beyond the Basics) Patient education: Locally advanced and inflammatory breast cancer (Beyond the Basics) Patient education: Treatment of metastatic breast cancer (Beyond the Basics)

Professional level information  —  Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Adjuvant systemic therapy for HER2-positive breast cancer Adjuvant endocrine and targeted therapy for postmenopausal women with hormone receptor-positive breast cancer Overview of the treatment of newly diagnosed, invasive, non-metastatic breast cancer Breast-conserving therapy Breast imaging for cancer screening: Mammography and ultrasonography Clinical manifestations, differential diagnosis, and clinical evaluation of a palpable breast mass Diagnostic evaluation of suspected breast cancer Overview of the approach to early breast cancer in older women Genetic testing and management of individuals at risk of hereditary breast and ovarian cancer syndromes Cancer risks and management of BRCA1/2 carriers without cancer Mastectomy Tumor, node, metastasis (TNM) staging classification for breast cancer

The following organizations also provide reliable health information.

● National Cancer Institute

1-800-4-CANCER

( www.cancer.gov/ )

● American Society of Clinical Oncology

( www.cancer.net/cancer-types/breast-cancer )

● American Cancer Society

1-800-ACS-2345

( www.cancer.org )

● Susan G. Komen Breast Cancer Foundation

( www.komen.org )

• Sprague BL, Arao RF, Miglioretti DL, et al. National Performance Benchmarks for Modern Diagnostic Digital Mammography: Update from the Breast Cancer Surveillance Consortium. Radiology 2017; 283:59.
• Lehman CD, Arao RF, Sprague BL, et al. National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium. Radiology 2017; 283:49.
• Renart-Vicens G, Puig-Vives M, Albanell J, et al. Evaluation of the interval cancer rate and its determinants on the Girona Health Region's early breast cancer detection program. BMC Cancer 2014; 14:558.
• Lourenco AP, Barry-Brooks M, Baird GL, et al. Changes in recall type and patient treatment following implementation of screening digital breast tomosynthesis. Radiology 2015; 274:337.
• Gao Y, Babb JS, Toth HK, et al. Digital Breast Tomosynthesis Practice Patterns Following 2011 FDA Approval: A Survey of Breast Imaging Radiologists. Acad Radiol 2017; 24:947.
• Bernardi D, Macaskill P, Pellegrini M, et al. Breast cancer screening with tomosynthesis (3D mammography) with acquired or synthetic 2D mammography compared with 2D mammography alone (STORM-2): a population-based prospective study. Lancet Oncol 2016; 17:1105.
• Breast Cancer HER2 Status. American Cancer Society. Available at: https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-her2-status.html (Accessed on November 08, 2022).

Home / Essay Samples / Health / Breast Cancer / Breast Cancer Informative Speech Outline

Breast Cancer Informative Speech Outline

• Category: Health
• Topic: Breast Cancer , Cancer , Death

Pages: 6 (2573 words)

• Downloads: -->

--> ⚠️ Remember: This essay was written and uploaded by an--> click here.

Found a great essay sample but want a unique one?

are ready to help you with your essay

You won’t be charged yet!

Universal Health Care Essays

Assisted Suicide Essays

Underage Drinking Essays

Alcohol Abuse Essays

Drug Addiction Essays

Related Essays

We are glad that you like it, but you cannot copy from our website. Just insert your email and this sample will be sent to you.

By clicking “Send”, you agree to our Terms of service  and  Privacy statement . We will occasionally send you account related emails.

Your essay sample has been sent.

In fact, there is a way to get an original essay! Turn to our writers and order a plagiarism-free paper.

samplius.com uses cookies to offer you the best service possible.By continuing we’ll assume you board with our cookie policy .--> -->