The Public Health Institute's

Breast Cancer Answers Project

"A hand held my body from out of the earth as the sun healed my wounded breast."
Ethel Herst

Our Mission

Our mission is to improve access to and awareness of breast cancer clinical trial information, support patients receiving treatment, and improve the quality of life of patients with breast cancer.

Click on the flowers below to visit each area of the BCA web site.

Explore New Treatments

A Clinical Trials Matching System that matches breast cancer patients to clinical trial information in California based on stage of disease, prior treatment, and other specific criteria. All clinical trials in the database are IRB-approved.

Visit Our Art Gallery

A unique artwork collection from those touched by breast cancer.

Read Personal Stories from Breast Cancer Survivors

Stories from breast cancer survivors describing their experiences with breast cancer treatment.

More Breast Cancer Resources

Other online resources for breast cancer information

What is Herceptin and what are the Risks with Herceptin Therapy?

A breast lump or pain and tenderness in the breast tend to be scary affairs today for women and even men with all the information and spotlight rightly cast on breast cancer. However, because breast cancer shows no outward signs in its earliest stages, people suffering from pain and lumps can often safely assume that they are in no trouble from cancer at least. However, early detection can make breast cancer a survivable ordeal, so prompt attention to any changes, pain or lumps in the breast is key in arresting cancer in a treatable stage.

What to watch for

Pain and tenderness in the breast is termed mastalgia, and there are multiple causes for this issue beyond breast cancer. Mastalgia can be caused by certain medications related to fertility like the medicines included in fertility treatment and birth control. It can also be caused by changing levels of hormones due to menstruation as well breast cysts. Some other issues that may initiate mastalgia as a negative side effect rather than breast cancer are improperly fitting bras and large breasts. Stress has also been known to be a contributor of mastalgia in many cases.

Check all lumps

When people are self-examining for signs and symptoms of breast cancer, they are told to look for lumps as simply one part of the examination, but because of the amount of press surrounding this portion of a self-exam, breast lumps solely are associated with breast cancer. However, the truth is that lumps found in this area are not cancer in a vast amount of the cases of the lumps. Teen hormones and damaged fat tissue account for all but 10 percent of all breast lumps found in women, and this is the case for women in their twenties continuing into the early fifties. These noncancerous lumps are called benign and are caused mostly from damaged tissue also known as fat necrosis, breast infection, fibrocystic breast disease also known as lumpy breasts and noncancerous tumors.

However, in the case of fat necrosis, masses are not able to be eliminated from a positive diagnosis without a physical collection from the mass itself through an invasive tissue collection procedure called a biopsy. Additionally, although 90 percent of existing lumps are found to be noncancerous or benign, new lumps that appear without pain is a common breast cancer symptom. Because a woman may be familiarizing themselves with the normal contours and features of the breast when they first begin monthly examinations, even minor pain may begin to be noticeable because there are natural constant changes occurring to the body. However, there are definite signs of problems that are indicators for women that a closer look form a doctor sooner rather than later may be in order.

Alarm is warranted

Pain and new lumps in the breast that would normally be associated with menstruation but that does not abate when the cycle is complete and before the next cycle should require special noting, as does any changes in nipple shape. Discharge from a single nipple should cause due alarm especially when the discharge is red, clear, yellow or brown. Additionally, women should be vigilant for swelling or lumps in the collarbone and underarm area as well as rashes, swelling or any other inexplicable itchiness or skin irritation in the breast may signal an issue. Hard, irregular shaped lumps are often cancerous, and later stage breast cancer has noticeable physical changes occurring in the breast like enlargement of existing lumps, enlarged skin with exposed pores, growth of one breast, and inward facing nipples as well as armpit and vaginal pain.

Worried About Lump in Breast?

In the US currently, breast cancer deaths are declining, but it is still the second leading cause of death in women attributable to cancer. Early detection, improved screening, better treatment and women being armed with better information is credited with the decline in death rates, and while all lumps occurring even in the region of the breast should be evaluated in order to get a proper diagnosis that excludes breast cancer, 80 to 90 percent of breast lumps are benign. Additionally, there are myriad causes of benign breast lumps, and many being painful, they are caused by trauma and infection, and others are non-cancerous growths that may or may not be dangerous in themselves.

Be calm but verify

Injuries to the breast caused by trauma ruptures vessels in the breast causing a hematoma in the injured area characterized by a noticeable lump. When this damage occurs in the fat cells, fat necrosis occurs forming lumps in the breast. When breast tissue becomes inflamed that inflammation is termed mastitis, and this condition may occur in women whose breast are incurring infection. Certain trauma is elected like body piercings, and infections caused by these elective procedures are exceedingly hard to eradicate, but some are the side effect of very natural reasons like breastfeeding. When a condition called clogged milk, duct occurs causing a suspected lump, it is the result of an infection sustained around the nipple from the suckling action of babies. These infections can also cause abscesses in the breast, and when the infection spreads impacting a larger area of the skin causing irritation and redness, the condition is termed cellulitis.

Most are benign

 Other benign lumps can be a group of hyperactive breast cells, or breast cysts. Cysts are fluid-filled sacs, and they may occur within the breast tissue. Cysts are not often found in women younger than 35 years of age, and they often occur during menstruation in women exceeding this age. The lumps presented by this condition vary in size, but often they present sensitive places on the breast. Fibrocystic changes also cause lumps and associated pain, and the condition called fibrocystic breasts occur when women breasts are sensitive due to hormonal fluctuations. Additionally, benign tumors in the breast that cause lumpiness are termed fibroadenomas. These tumors are firm and often mildly tender, and they form faster in teens and in pregnant women. Fibroadenomas can occur in those under 30, but most commonly, they occur in women ages 30 to 35.

One very effective method of alleviating the fear involved in performing a monthly breast self-exam and discovering lumps is familiarizing oneself with the natural contours and feel of the body when breasts are concerned. The area of the breast nearest the armpit accrues lumps and bumps often. The lower breast section can feel like small grains of sand while the texture underneath the nipple can feel like larger grains. Discovering what is normal, what is not and at what times of the month will make people more sensitive to the changes that may be cancer forming.

Can Benign Cysts Become Cancerous?

Tumors and cysts are distinctly different. A tumor is a mass of tissue, and they can form in any part of the body. Tumors can be benign or malignant, but cysts rarely progress into any form of cancer. A cyst is a fluid or air filled sack and like tumors, they can form in any part of the body, and this includes bones and organs. Although most cysts are benign, they can become cancerous. It is important to have any lumpy feature in the breast examined closely even for people with histories of benign cysts. Lumps are not necessarily cysts by any means, but if they get larger or remain for an extended period measured in weeks, it is important medically to investigate further.

Techniques for confirming or denying

Ultrasounds are the most accessible method for determining cysts, but routine mammograms are important independent of a woman’s history of cysts or any other temporary or long term lumpiness in the breast. Additionally, biopsies via the insertion of a needle into the affected potential lump will determine if the mass is a cyst. If the sac is fluid filled, the inserted needle has the ability to also drain the cyst of fluid. This fluid is further examined for the presence of cancer cells. However, if the lump is made of tissue, the needle can also extract a sample for cancer testing and diagnosis of cause also, so when a person detects a lump in the breast or associated area, simply have it examined by a doctor.

Possible alternative issues

Epithelial hyperplasia is a harmless, somewhat heavy proliferation of breast cells, but atypical hyperplasia, are breast cells that may be changing, and because of this change in normal healthy cells, atypical hyperplasia corresponds with a slight risk of breast cancer developing sometime in the future. Although as stated before, some cysts can become cancerous, both types of hyperplasia are possibilities for growths determined to not be cysts.

Some cysts are cyclical, and these are generally harmless. They start at the beginning of menstruation and then subside greatly or vanish altogether. However, they should always be evaluated by the proper doctor. Other variations of cysts include hepatic or liver cysts, renal or kidney cysts, epidermoid or cysts that occur underneath the skin, and ovarian and breast cysts. Cysts determined uniform by ultrasound or a CT scan commonly are not cancerous although monitoring is strongly advised. Cysts that are more solid deserve further evaluation because some malignancy is possible. Sometimes an entire area may be removed through a biopsy for further analysis. This is necessary because all types of cancer are capable of producing cysts.

Can I Inherit Breast Cancer? Simple answer, yes, but...?

When families face the reality of a close family member incurring cancer, people concerned also for their families often ask if their cancer is hereditary, and any conclusion on the matter from the scientists, researchers and doctors fighting cancer is that the connection is unclear at best. The facts are that abnormalities in someone’s gene pool can be passed down generationally, but it is also a fact that 90 percent of breast cancer is not inherited. When this cancer is of the inherited form, the disease usually reveals itself early in life, and medically, this age is deemed under 40. Another issue is that the problem will usually show up in multiple relatives including one’s children, and in many cases, affects both breasts. However, when a mother or other female relative receives a diagnosis of cancer it does not mean their child will have the disease. This is because there are multiple risk factors with familial ties being only one, and only five to ten percent of breast cancer has this type of origin. When considering options related to the hereditary nature of cancer in one’s own family or in general consult a physician and have personal risk factors identified. Genetic abnormalities deliver a group of instructions that are flawed, and this process is repeated throughout the building of the DNA structure causing the gene to reproduce this abnormality rather than a healthy cell functioning appropriately. There are two genes in particular associated with the onset of inherited breast cancer.

.... there are no simple answers

These are the BRCA1 and BRCA2 genes because of their propensity to carry the genetic abnormality and how their malfunctioning impairs the body. These genes are present in all people and when functioning appropriately, they heal cells when damaged and keep certain cells functioning according to their purpose. Because of this, the appropriately functioning genes actually protect the body from certain cancers, so when they are discovered in an impaired state, this condition correlates to a higher risk in women with the abnormal gene whether the gene is inherited or not. However, when it is discovered that women with breast cancer have the abnormal BRCA1 or BRCA2 gene, in many cases, there is a history of some type of cancer in the family. However, it is also to be noted that people with paternal or maternal associations of familial cases of cancer or that have female family members incurring certain cancers including breast cancer before the age of 60 will likely also have the abnormal gene. This is also true if a family member has triple-negative breast cancer, cancer in both breast, is of Jewish heritage or is an African American who has incurred cancer before the age of 35. Additionally, families with a member or members who have had ovarian cancer as well as cancer in both breast on either the paternal or maternal family only most often have the impaired form of BRCA1 or BRCA2 gene, as well as families who have a case of male breast cancer. Genetic testing is necessary to determine any correlations.

The Breast Cancer Answers Project was created under funding by the Office of Women's Health and continues under funding from the Breast Cancer Fund to the Public Health Institute's C/NET Solutions Project in Berkeley, California. The Public Health Institute is a non-profit organization.

Warning: The information on the Breast Cancer Answers web site is intended for educational purposes only and is not intended to be used for diagnosis or treatment of a health problem or disease. The information on this web site is not a substitute for professional care. If you have or suspect you have a health problem, please consult a health care provider.

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