Breast Cancer Awareness Month: Safeguarding Breast Health

October is Breast Cancer Awareness Month in the United States. First instituted in 1985 as a week-long awareness campaign, the initiative was pioneered by the American Cancer Society (ACS) in partnership with Imperial Chemical Industries Pharmaceuticals, now part of AstraZeneca. Pink became the international symbol of breast health in 1992. The color was popularized by Evelyn Lauder, Senior Corporate Vice President of Estée Lauder, and Alexandra Penney, Editor-in-Chief of Self magazine, when they began distributing pink ribbons with the magazine's Breast Cancer Awareness Month issue. The action was influenced by Lauder’s breast cancer diagnosis in 1989 and the lack of awareness of the subject. Evelyn Lauder's pursuit to create awareness also led her to establish the Breast Cancer Research Foundation in 1993. 

Every year, medical societies, federal agencies, and nonprofit organizations host special events and educational programs to create breast cancer awareness and raise funds to further cancer research. Many organizations also distribute free resources covering topics such as self-examination, early detection, signs and symptoms, treatment, and cancer-care guides on their online platform or in print form. The Omnigraphics’ Breast Cancer Sourcebook extensively covers types, risk factors, screening, and treatment of breast cancer.

Breast Cancer Statistics

The National Cancer Institute (NCI) estimates 297,790 new cases of female breast cancer will be diagnosed in the United States, and 43,170 breast cancer cases will result in death in 2023. Although uncommon, breast cancer can also occur in men, and Cancer.Net estimates that, in 2023, approximately 2,800 men will be diagnosed with breast cancer.

Understanding Breast Cancer

Cancer in the breast occurs from an overgrowth of cells and can develop in either one or both breasts. Breasts are made up of connective tissue, lobules, and ducts. The lobules are milk-producing glands, and the ducts are tubes that carry the milk to the nipple. The lobules and ducts are held together in place by the connective tissue. Breast cancers usually originate in the lobules or ducts but can spread to other areas of the breasts or other parts of the body. Advancement of breast cancer is classified into the following stages:

• Stage 0: The cancer is noninvasive and limited to its point of origin in the ducts or lobules.
• Stage I: The cancer cells have spread to the surrounding breast tissue.
• Stage II: The tumor is small (less than two to five centimeters) and may or may not have spread to the nearby lymph nodes.
• Stage III: The tumor has grown in size and spread to nearby organs or lymph nodes.
• Stage IV: The tumor has spread to other parts of the body. At this stage, the cancer is called metastatic breast cancer.

Signs and Symptoms of Breast Cancer

Signs of breast cancer differ from person to person, and may include the following:

• a lump or mass in the breast or underarm
• pain in any part of the breast
• swelling in a portion of the breast
• changes in shape or size of the breast
• a clear or blood-stained fluid discharge from the nipple
• crusty or flaky skin (areola) around the nipple
• an inverted nipple
• changes to the breast skin, such as pitting or dimpling

Types of Breast Cancer

Invasive ductal carcinoma (IDC) is the most common type of breast cancer and makes up approximately 80 percent of all cancers in the country, according to the Cleveland Clinic. It starts in the ducts of the breast. Invasive ductal carcinoma can spread to the surrounding tissues or other parts of the body. Although IDC can develop at any age, it mainly occurs in females over the age of 55.

Invasive lobular carcinoma (ILC) makes up nearly 10 to 15 percent of breast cancer cases in the United States. It begins in the lobules of the breast and can spread to nearby tissues. The cancer can also metastasize to other parts of the body.

Less common types of breast cancer include:

• Ductal carcinoma in situ (DCIS). Sometimes referred to as pre-cancer or Stage 0 cancer, DCIS is when the cancerous cells have not spread beyond the ductal walls. DCIS is less likely to be invasive. According to the ACS, 55,720 new cases of DCIS will be diagnosed in 2023. The Cleveland Clinic states that DCIS accounts for 20 to 25 percent of all new cancers in the United States. The risk of DCIS increases with age.
• Triple-negative breast cancer (TNBC). According to the Cleveland Clinic, this aggressive form of cancer accounts for nearly 15 percent of all invasive cancers in the country. TNBC is difficult to treat since it lacks estrogen, progesterone, and HER2 receptors associated with breast cancer. Medical News Today states that TNBC accounts for 10 to 20 percent of all breast cancers, affecting 13 in every 100,000 females in the United States. It is more likely to occur in those under the age of 50.
• Inflammatory breast cancer (IBC). Characterized by dimpling or pitting of the breast skin, swelling, tenderness, or bruise-like redness, IBC occurs in the lymph vessels and is considered an aggressive form of cancer. According to the Cleveland Clinic, IBC accounts for 1 to 5 percent of breast cancer cases in the country. ACS reports that women under 40 are at risk for developing inflammatory breast cancer.
• Paget’s disease of the breast. Unrelated to the metabolic bone disease of the same name, Paget’s disease of the breast is a rare form of cancer that originates in the skin of the nipple and the areola—the dark skin surrounding the nipple. Paget’s disease of the breast can spread to surrounding tissue. The condition mainly occurs in those over the age of 50. The Cleveland Clinic states that Paget’s disease of the breast accounts for less than 4 percent of all breast cancers in the United States.
• Lobular carcinoma in situ (LCIS). LCIS, the presence of abnormal cells in a milk gland, is not itself a type of cancer, but it is a marker for increased risk of breast cancer, according to the Cleveland Clinic. Women diagnosed with LCIS have a 20 percent chance of developing breast cancer compared to 12 percent in the general female population. Females between the ages of 40 to 60 are at risk for developing LCIS. 

Preventive Measures for Breast Cancer

A variety of environmental and genetic factors can cause breast cancer. While it's not possible to completely eliminate the risk of breast cancer, you can reduce your risk by following a few simple measures.

• Maintain a healthy body weight by eating a balanced diet of fruits, vegetables, whole grains, legumes, and nuts.
• Engage in regular exercise. The ACS recommends 150 minutes a week of moderate exercise and 75 minutes a week of vigorous exercise for adults.
• Avoid consuming alcohol or reduce intake to one drink a day. Studies suggest that even small quantities of alcohol consumption can increase the risk of breast cancer.
• Breastfeeding for a year or longer, as recommended by the ACS, can reduce the risk of breast cancer.
• Limit the use of postmenopausal hormone therapy to treat symptoms of menopause. Consult with your doctor and keep the dosage low and duration short.

For more information on breast cancer prevention, visit National Cancer Institute. 

Find more educational guides by the National Breast Cancer Foundation here.