Breast Cancer Multidisciplinary Clinic
Lifespan Cancer Institute

Breast Cancer Symptoms, Conditions, Causes and Risk Factors

Breast cancer is a cancer that forms in the cells of the breast. It develops in the breast tissue, which has many parts. Milk-producing glands connect to the nipple through narrow ducts, which are supported by fat and fibrous material, or connective tissue. The rest of the breast tissue is made up of blood vessels, nerves and channels to the lymph nodes.

Cancer cells most commonly form in the milk glands and ducts of the breast. When several cancer cells accumulate, they form a mass of tissue known as a lump, growth, or tumor. Early detection is key to diagnosing breast cancer. Screenings like mammograms, ultrasounds, or MRIs will help catch abnormalities early.

What are the causes of breast cancer?

The exact cause of breast cancer, and cancer in general, is unknown. We do know that cancer is characterized by abnormal cell growth.

Research indicates that breast cancer may be caused by a combination of risk factors and genetic makeup. It's estimated that five to ten percent of breast cancer cases are linked to hereditary gene mutation. There are several inherited, defective genes that can increase your risk of breast cancer. The two most common are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes also increase the risk of ovarian cancer.

If your family has a strong history of breast cancer or other cancers, blood tests can help identify hereditary defective BRCA or other genes. Talk with your doctor about consulting with a genetic counselor, who can review your family's health history and discuss genetic testing in detail.

What are the signs and symptoms of breast cancer?

In its early stages, breast cancer usually does not cause symptoms. However, as the tumor grows, it can cause changes in how the breast looks and feels.

Symptoms include:

  • A lump or thickening in or near the breast or underarm area
  • A change in the size or shape of the breast
  • Dimpling or puckering in the skin of the breast, including a pitted surface like the skin of an orange
  • A nipple turned inward, or that has changed in location or shape
  • Cloudy or bloody discharge from the nipple
  • Scaly, red, or swollen skin anywhere on the breast

You should see your doctor about any symptom that does not go away. Most often, these symptoms are not due to cancer.

What are the types of tumors?

Tumors can be benign (non-cancerous) or malignant (cancerous).

Benign tumors

  • Are rarely life-threatening
  • Can be removed and typically don't grow back
  • Don't invade surrounding tissue
  • Don't spread throughout the body

Malignant tumors

  • May be life-threatening
  • Many times can be removed, but can grow back
  • Can invade and harm surrounding tissue and organs
  • Can spread throughout the body

While not common, benign growths can become premalignant. If you feel a lump, have it examined by your doctor.

What is inflammatory breast cancer?

Inflammatory breast cancer is a rare and little known—but the most aggressive—form of breast cancer. It is usually not detected by mammograms or ultrasounds. In inflammatory breast cancer, cancer cells block the lymph vessels in the breast. Inflammatory breast cancer can be deadly because it can be difficult to detect, grows quickly, and spreads to other parts of the body. Also, while public awareness of breast cancer has grown in recent years, many women are unfamiliar with inflammatory breast cancer and may not seek treatment because they don't recognize its symptoms.

Unlike other kinds of breast cancer, inflammatory breast cancer does not typically cause a lump or lumps in the breast; therefore, it cannot be detected by breast self-exams or most diagnostic imaging methods. Symptoms of inflammatory breast cancer include swelling, warmth, itching, or thickening of the breast tissue, or breast skin that becomes discolored (like a bruise or bug bite), or rippled (like the skin of an orange). Normal breasts may have inverted nipples or may vary from each other somewhat in size or shape, but if such changes in breast appearance develop suddenly (over the course of weeks or months), it may be a sign of inflammatory breast cancer.

Inflammatory breast cancer is diagnosed by a doctor's clinical examination and usually confirmed by a biopsy, mammogram, and ultrasound.

Treatment is different from other breast cancers. Aggressive chemotherapy treatment is usually required, followed by surgery and/or other procedures.

What is triple-negative breast cancer?

Triple-negative breast cancer is considered a more aggressive (likely to spread) form of cancer. It is often found in a later stage, with a poorer prognosis.

Triple negative breast cancer accounts for about 10 to 20 percent of cases. This type of breast cancer is not “fueled” by hormones (estrogen, progesterone) or HER2, so it does not respond to typical hormone or targeted treatments used for other types of breast cancer. This year, however, we have seen data that adding immunotherapy improves how the triple-negative breast cancer responds to treatment and improves survival.

Also, a new type of drug has been shown to help people with hereditary breast and ovarian cancer syndrome (BRCA1 or BRCA2 genetic mutations), which also commonly presents as triple-negative breast cancer. Adding what is known as a PARP inhibitor prevents cancer cells from repairing themselves and targets cancer cells, minimizing damage to healthy cells. These findings are directly impacting how we can care for patients with breast cancer.

What are the risk factors for breast cancer?

A risk factor is anything that increases the likelihood for you to get a certain disease. Some risk factors can be avoided, such as consuming alcohol; however, the majority of risk factors can't be avoided, such as a family history.

The two most significant risk factors for breast cancer are age (women over 50) and a family history of breast cancer. If you have a risk factor, this does not mean that you will get breast cancer. Many women with one or more risk factors never get breast cancer, and many women with breast cancer have no risk factors other than gender.

Risk factors you may want to discuss with your doctor include:

  • Age: Your chances of getting breast cancer increase as you get older.
  • Personal health history: If you have, or have had, breast cancer in one breast, the risk of getting cancer in your other breast increases.
  • Family health history: Your risk is higher if there is a history of breast cancer in your family. This risk increases further if your family member had breast cancer before age 50.
  • Certain genome changes: Changes in certain genes, such as BRCA1 or BRCA2, substantially increase your risk.
  • Radiation therapy: If you underwent radiation therapy to the chest, including the breasts, before age 30 your risk increases.
  • Reproductive and menstrual history:
    • You had your first child after age 35
    • You have never had children
    • You had your first menstrual period before age 12
    • You went through menopause after age 55
  • Race: Caucasian women are at increased risk. 
  • Breast density: If you have large areas of dense tissue in your breasts, as shown through a mammogram, you are at increased risk.
  • Overweight after menopause: Your chances of breast cancer increase if you have gone through menopause and are overweight or obese.
  • Lack of physical activity: If you are physically inactive or have been for most of your life, you are at increased risk.
  • Consuming alcohol: If you drink alcohol daily, your chances of getting breast cancer increase.
  • Hormone replacement therapy: If you have received hormone therapy for five years or more, you are at increased risk. 

Take our quiz to determine your risk for breast cancer.