FAQ's (Frequently Asked Questions):

What are the symptoms of breast cancer?

Unfortunately, early small breast cancers rarely cause any symptoms, however, symptoms may occur as a lump felt in the breast during self-examination.

Occasionally, there will be a dimpling effect of the skin in the area of a tumor, a discharge from a nipple, a nipple will invert, or the breast will become red and swollen, appearing to be infected.

Any of these symptoms should be reported to your physician immediately.

I have no family history of breast cancer. Does this mean I will not develop the disease?

No. All women (and some men) are susceptible to developing breast cancer, however, having a family history does increase the risk of developing the disease.

What are the most common types of breast cancer?

Intraductal carcinoma in situ is a form of breast cancer that, although it spreads to other ducts within the breast, provided it is detected and treated at an early stage, does not spread to other parts of the body.

Infiltrating ductal carcinoma accounts for the majority of breast cancer cases. It develops in the milk ducts but invades other tissues in the breast. This is a slow-growing type of cancer and it can be months or years before a lump is detected through a breast exam.

If not detected early, this type of cancer can spread to the lymph nodes and then to other areas of the body by way of the lymphatic system or the blood.

What are the risk factors for developing breast cancer?

The primary risk factor is being female, however, other risk factors are personal or family history of breast cancer, onset of first menstrual period before age 12, menopause after age 50, not having children or having the first child after age 30, alcohol abuse, being overweight, eating a high fat diet, and the aging process.

What can I do to prevent myself from getting breast cancer?

Unfortunately, the cause of breast cancer is unknown at present, so there is no way to prevent it.

Is there a specific age group that makes a woman more susceptible to breast cancer?

The odds of getting breast cancer does increase with age, however, it can also occur in younger women.

What is the importance of monthly breast self-examinations?

Monthly self-exams should be performed to familiarize yourself with your breasts so you will become aware of any abnormalities that may occur.

In menstruating women, these exams should be done a week after the beginning of each menstrual cycle.

For non-menstruating women, a day of the month should be selected and the exam done every month on that day.

What Is Immunotherapy?

Many cancer doctors now regard immunotherapy as the "fourth modality," or fourth way, to treat cancer. Many advances against cancer in the future will probably come from this field.

Immunotherapy is treatment that uses certain parts of the immune system to fight disease, including cancer. This can include stimulating your own immune system to work harder, or using an outside source, such as manmade immune system proteins.

Other terms used to describe immunotherapy include:

• Biologic response modifiers
• Biologic therapy

Some oncologists (cancer doctors) now consider immunotherapy as the fourth way of treating cancer. The 3 most common forms of treatment are:

• Surgery
• Radiation
• Chemotherapy

Immunotherapy is sometimes used by itself, but it is most often used as an adjuvant (along with or after another type of therapy) to add to the anticancer effects of the main therapy.

The thought of using your own immune system to fight cancer is appealing.

Immunotherapy currently has a small role in treating the most common types of cancer. Researchers have made important progress in this field in the past few years. Many are optimistic that more effective immunotherapies can be developed that will have a greater impact on the outlook for people with cancer.

How Your Immune System Works

Your immune system is a collection of organs, specialized cells, and substances that help protect you from disease. These cells and substances circulate throughout your body to protect it from germs that cause infections, and from cancer.

To understand how your immune system works, think of your body as a country, and the immune system as that country's defense forces. Think of viruses, bacteria, and parasites as a hostile, foreign army, because they are not normally found in your body. When they enter your body, they want to use your body's resources to serve their own purposes, and they don’t mind hurting you in the process.

This analogy is a popular one among immunologists (scientists who study the immune system). They use the term foreign to describe substances from invading germs not normally present in the body.

Reacting to Antigens

Anything that causes the immune system to react (producing an immune response) is called an antigen, from the Greek words anti, meaning against, and genein, meaning to produce. Microorganisms such as viruses, bacteria, and parasites contain substances that are not normally present in the body. These foreign substances cause the immune system to react to them.

Cancer cells also have unusual substances on their outer surfaces that can act as antigens, marking the cells as different or abnormal. Antigens produce a reaction from the immune system that can lead to destruction of both the antigen and anything the antigen is attached to or part of, such as a bacterial cell or a cancer cell.

Generally, the immune system is much better at recognizing germs than cancer cells. Germs are truly "foreign" to the body, and their cells differ quite a bit from normal human cells. In contrast, the differences between normal cells and cancer cells may be less clear cut. Continuing the military analogy, cancer cells are less like soldiers of an invading army and more like traitors within the ranks of the human cell population

The Immune System: Key Players

The response to antigens is a highly coordinated process that uses the many types of cells of the immune system.

Most cells of the immune system are lymphocytes. Several types of lymphocytes work together to attack cancer cells:

• B cells (B lymphocytes)
• T cells (T lymphocytes)
• Killer T cells
• Helper T cell

Antigen-presenting cells (APCs) are not lymphocytes but work closely with lymphocytes to fight cancer. The two main groups of antigen-presenting cells are:

• Monocytes and macrophages
• Dendritic cells

Other types of white blood cells, known as granulocytes, also make up an important part of the immune system.

Lymphocytes

B cells and plasma cells: B cells (B lymphocytes) are formed and develop in the bone marrow, which is the soft, spongy inner part of some bones. B cells then move to and collect in lymph nodes, which are bean-sized collections of immune system cells that are found throughout the body. Small, vein-like channels called lymphatic vessels connect the lymph nodes to each other. B cells also collect in some internal organs such as the spleen.

B cells can’t directly destroy germs or cancer cells by themselves, but they play an important role in immune defenses by producing antibodies. Antibodies are large proteins that circulate throughout the body (in the blood and lymphatic vessels.

When a B cell comes into contact with a foreign antigen (from a germ or cancer cell), it turns into another cell type called a plasma cell. Plasma cells produce antibodies that specifically recognize and bind (attach) to the antigen on the foreign cell’s surface. It will not bind to other substances that are part of normal human cells and tissues. The antibodies may directly cause the cell to die, or they may mark it for destruction by other immune system cells, such as T cells.

T cells: Some lymphocytes that are formed in the bone marrow enter the bloodstream before they are fully mature. From the bloodstream, they enter the thymus (a small gland in the chest in front of the heart and behind the breastbone) where they mature and gain new disease-fighting properties.

Once they leave the thymus gland, they are known as T lymphocytes or Tcells (named for the T in thymus). T cells gather in the lymph nodes and spleen, where they work together with other immune system cells. Special molecules similar to antibodies are on the surface of T cells.These special molecules allow T cells to recognize and react to parasites, cancer cells, and cells infected by viruses.

There are 2 main kinds of T cells. They perform different tasks.

Cytotoxic T lymphocytes are also known as killer T cells. Cytotoxic means poisonous to a cell. When these cells come in contact with cancer cells they recognize, they give off substances that destroy the cells.

Helper T cells do not directly kill cancer cells or germs, but they release substances that help B cells and cytotoxic T cells to work more effectively.

Natural killer (NK) cells: Lymphocytes called natural killer (NK) cells have molecules on their outer surfaces that allow them to attach to cancer cells. Once in contact, the NK cells release substances that split the cancer cells open. After killing the cancer cells, the NK cells then find other cancer cells to attack.

Antigen-Presenting Cells (APCs)

Antigen-presenting cells (APCs) help lymphocytes recognize antigens on cancer cells. Antigen-presenting cells include monocytes and dendritic cells.

Monocytes and macrophages: Monocytes are produced by the bone marrow and released into the bloodstream. Some monocytes enter tissues and organs. Here they become macrophages (from the Greek words macros, meaning large, and phagein, meaning to eat) capable of surrounding and "eating" cells. They display antigens from the devoured cells on their outer surface, so that lymphocytes can recognize them. Both monocytes and macrophages can act as APCs to help start an immune response.

Dendritic cells: Dendritic cells are the most powerful type of antigen-presenting cell. They are found in lymph nodes, the skin, and some internal organs. Dendritic cells are the focus of many cancer vaccines currently in development.

Source: ACS