Breast Cancer

Breast cancer is a diagnosis no one wants to hear, but it’s a reality many people face. From the moment those words are uttered, lives are changed.

But what exactly is breast cancer, and how does it develop? For many, understanding the basics is the first step in navigating a path forward.

Breast cancer begins in the tissue of the breast — most often in the milk ducts or lobules — and can either stay localized (non-invasive breast cancer) or spread to other parts of the body (invasive breast cancer, or metastatic breast cancer). Symptoms can range from lumps or changes in breast or nipple appearance to more serious signs like pain, swollen lymph nodes, and even fever if the cancer has advanced.

There are various types of breast cancer, each requiring different treatment approaches. Estrogen-positive (ER+), progesterone-positive (PR+), and triple-negative breast cancer (TNBC) are just a few examples. The four main types of breast cancer are:

• HR+/HER2-: Most common cancer type (90 cases per 100,000 women)

• HR-/HER2-: Less common cancer type (13.6 cases per 100,000 women)

• HR+/HER2+: Also less common cancer type (12.4 cases per 100,000 women)

• HR-/HER2+: Least common cancer type (5.1 cases per 100,000 women)

Approximately five to 10 percent of breast cancers are linked to genetic factors, commonly involving the BRCA1 and BRCA2 genes. But the disease can affect anyone — even men, on occasion.

While traditional treatments like chemotherapy and radiation are effective for many, more aggressive forms, such as triple-negative breast cancer, often call for additional strategies.

Recent research suggests that medical cannabis might play a role in treatment, especially for cancers with cannabinoid receptors, potentially helping slow tumor growth and even kill cancer cells.

Understanding breast cancer in all its forms is crucial, not just for those diagnosed but for anyone who wants to be informed.

Breast Cancer Causes

Breast cancer risk isn’t influenced by just one factor — there are many elements that can increase the likelihood of developing the disease. Some are beyond our control, like age or family history, while others, such as lifestyle choices or hormone-related factors, may play a role. Understanding these potential risks can help in making informed decisions about your health.

Factors that can increase the likelihood of developing cancer include:

• A family history of breast cancer, including BRCA1 and BRCA2 gene mutations
• A personal history of breast cancer or other conditions affecting the breasts, e.g. lobular carcinoma in situ (LCIS)
• Age
• Excessive alcohol consumption
• Smoking tobacco
• Obesity
• Exposure to radiation
• Experiencing menopause at a later age
• Beginning your period at a younger age
• Dense breast tissue
• Having children at an older age or never having children
• Hormone therapy

Breast Cancer Symptoms & Health Effects

Breast cancer symptoms can vary widely and may not always be obvious. Staying aware of any physical changes is important (typically via a standard breast screening), as early detection can make a significant difference in outcomes. Whether it’s a noticeable lump or a subtle change, knowing what to look for can help guide timely action.

Symptoms of breast cancer include:

• A lump or swelling in the breast, upper chest or armpit
• A change to the skin, such as puckering or dimpling
• A change in the color of the breast – the breast may look darker, red or inflamed
• A nipple change, for example it has become pulled in (inverted)
• Rash or crusting around the nipple
• Unusual liquid (discharge) from either nipple
• Changes in size or shape of the breast
• If the cancer has spread and has become metastatic breast cancer, swollen lymph nodes and fever

Breast Cancer Diagnosis

Breast cancer diagnosis typically involves a series of steps to confirm the presence of cancer and determine its type and stage.

Doctors will first evaluate physical symptoms and any noticeable changes in the breast. If they suspect breast cancer is present, they’ll conduct further tests to gather more information about the suspicious area.

Early diagnosis plays a critical role in increasing the chances of successful treatment and long-term outcomes.

Breast cancer is commonly diagnosed by one or more of the following:

• X-rays
• Breast cancer screening (mammography)
• A biopsy – where a small sample of breast tissue is taken to be examined under a microscope
• Tumor marker blood test

Breast Cancer Prognosis

Thanks to advancements in treatment and early detection, rates among breast cancer survivors have steadily risen as breast cancer mortality has dropped. In countries like the U.S. and U.K., the five-year survival rates for breast cancer now range between 80 percent and 90 percent for those diagnosed between 2012 and 2018, respectively.

The 10-year survival rate remains encouraging at about 80 percent.

While breast cancer can be a difficult journey, these statistics reflect the positive strides in medical research, offering optimism and a brighter outlook for many patients

Breast Cancer Treatments

Treating breast cancer often involves a combination of approaches tailored to the specific type and stage of the disease.

From surgery to remove cancerous tissue to therapies like chemotherapy, radiation, and targeted treatments, there are many ways to address the condition.

Patients may also explore complementary therapies to manage side effects, and new research continues to expand treatment options, offering hope for more effective care.

Depending on the type of cancer, the most common treatment methods include:

• Chemotherapy
• Radiation therapy
• Biological therapy
• Hormonal therapy
• Targeted therapy
• Surgery

What Patients Say About Their Treatment

When Nancy Deol was diagnosed with invasive ductal carcinoma, she never expected her journey to include chemotherapy. However, medical cannabis became a crucial part of her recovery, helping her manage chronic pain and the side effects of aggressive treatments.

“The one thing that people don’t understand is that when you’re going through cancer treatment, chemotherapy, radiation, there’s a lot of drugs they give you — everything from steroids to antinausea meds,” she says. “As soon as I knew those two things would be part of my treatment plan, I immediately decided I needed that medical cannabis card.”

First-Line Treatments

When breast cancer is diagnosed early, surgery is typically the first step to remove the tumor. Depending on the case, this may involve a lumpectomy or a mastectomy.

For more advanced, life-threatening estrogen-receptor-positive breast cancer, chemotherapy is often the primary treatment.

Chemotherapy targets rapidly growing cancer cells, sometimes in combination with hormone therapies to block estrogen, which fuels the cancer’s growth.

These treatments work together to manage the disease and improve outcomes.

Other Treatments

Beyond first-line treatments like surgery and chemotherapy, several other options are available, depending on the type and progression of the breast cancer.

Hormone therapy remains a crucial treatment for estrogen-receptor-positive cancers, working to block or lower the body’s hormone production to slow or stop the cancer’s growth. Medications such as tamoxifen or aromatase inhibitors are commonly used for this purpose.

Radiation therapy is often utilized after surgery to eliminate any remaining cancer cells, reducing the risk of recurrence.

Targeted therapies — which focus on specific proteins or genetic mutations driving cancer growth — can be particularly effective for patients whose cancer has spread (metastatic breast cancer) or isn’t responding well to initial treatments,

These treatments may be combined with first-line options to provide a comprehensive, multi-faceted approach to managing the disease, offering additional support where surgery or chemotherapy alone may not be sufficient.

Adjunctive Therapy & Alternative Treatments

While there’s no solid scientific proof that alternative treatments can cure breast cancer, many people use adjunctive therapies to help manage symptoms and boost their well-being during treatment.

Eating a healthy diet — like the Mediterranean diet, which focuses on whole grains, lean proteins, and healthy fats — can support overall health and may aid recovery.

Avoiding processed foods and adding anti-inflammatory and antioxidant-rich options like turmeric, green tea, and leafy greens are also popular ways to help with side effects.

Although these changes won’t replace medical treatments, they can boost energy, reduce inflammation, and support the body’s immune system during the challenges of cancer treatment.

Cannabis for Breast Cancer

Medical cannabis has long been used to help manage the side effects of cancer and its treatments, including chronic pain (like joint and neuropathic pain), anxiety, nausea, vomiting, appetite loss, and insomnia.

However, recent research indicates that cannabis might have benefits beyond symptom management — it could also play a role in targeting cancer itself. While conventional treatments like chemotherapy and radiation are effective for many types of breast cancer, aggressive forms like triple-negative breast cancer often respond less effectively.

Cannabis contains compounds like tetrahydrocannabinol (THC) and cannabidiol (CBD), which can ease side effects and might even make radiation therapy more effective.

Some types of breast cancer have cannabinoid receptors, which can be targeted to trigger apoptosis (cell death) of the breast cancer cells.

Cannabinoids may also inhibit the progression of some types of tumor.

It’s important to note that some breast cancer drugs, like tamoxifen, come with serious side effects, including liver problems, blood clots, and a higher risk of stroke.

Tamoxifen may also not work well for some people with certain genetic traits or those taking antidepressants like Paxil, Prozac, or Zoloft.

In these cases, medical cannabis could offer a safer way to manage symptoms like anxiety and depression.

However, patients need to be careful when choosing cannabis strains and dosages, especially for estrogen-positive breast cancers.

THC can raise estrogen levels, which could potentially encourage tumor growth. For those with weakened immune systems, it’s crucial to use cannabis that’s free of contaminants and avoid smoking it, as that can be harmful.

And for patients undergoing immunotherapy, cannabis might reduce the treatment’s effectiveness, so it’s best to proceed with caution.

Additional Information for Patients

Those facing difficulties due to their breast cancer diagnosis may wish to contact support services, such as the American Breast Cancer Support Association, the National Breast Cancer Association, Inc., or the Susan G. Komen Breast Cancer Foundation.

Breast Cancer FAQs

What is the life expectancy of a person with breast cancer?

• 5-year relative survival rate for breast cancer = 91.2% (91 out of 100 people are alive 5 years after they’ve been diagnosed with breast cancer).
• 10-year breast cancer relative survival rate = 84% (84 out of 100 people are alive after 10 years).

Do you need chemotherapy for stage 1 breast cancer?

If caught early enough, you may undergo surgery to remove breast cancer tissue. Chemotherapy, aka “chemo,” is sometimes used after surgery for early-stage breast cancer to help lower the chances that your breast cancer will come back.

What are the pros and cons of medical cannabis for breast cancer?

Possible pros include a reduction in:

• Pain
• Anxiety
• Insomnia
• Appetite loss
• Nausea
• Vomiting
• Some evidence that cannabinoids in cannabis induce cell death (apoptosis) in breast cancer cells
• Possible treatment for treatment-resistant, aggressive forms of cancer

Possible cons include:

• Possible that cannabinoids in cannabis, particularly THC, may induce breast cancer cell growth in those with estrogen-positive breast cancer. However, there is little evidence that this has occurred so far.
• Some may find the psychoactive effects of cannabis overwhelming, particularly if a large amount of THC is used. This may induce anxiety and paranoia.
• High-quality, tested products need to be available in order to reduce the chances of infection – cancer patients are an immunocompromised population.
• Smoking cannabis should be avoided due to potential health problems.

Can men get breast cancer?

Yes, men can get breast cancer, although it is much rarer. About 1% of all breast cancer cases occur in men. Because male breast cancer is uncommon, it’s often diagnosed at a later stage, which can affect outcomes. Symptoms in men can include breast lumps, changes in the breast or nipple, or discharge from the nipple.

What is the top breast cancer risk factor?

Several risk factors can increase the likelihood of developing breast cancer, including:

• Age (the risk increases with age)
• Family history of breast cancer, particularly with BRCA1 or BRCA2 gene mutations
• Personal history of breast cancer or certain non-cancerous breast conditions
• Lifestyle factors, such as alcohol consumption, obesity, and smoking
• Hormonal factors, like hormone replacement therapy or early menstruation

Can breast cancer come back after treatment?

Yes, breast cancer can return after treatment, either in the same location (local recurrence) or in other parts of the body (distant recurrence).

The risk of recurrence depends on several factors, including the type and stage of the initial cancer and how it was treated.

Regular follow-up appointments and monitoring are crucial to detect any signs of recurrence early.

References:

• American Cancer Society. (n.d.). Breast cancer: Treatment of breast cancer by stage. https://www.cancer.org/cancer/managing-cancer/treatment-types.html
• BMC Medicine. (2023). Anti-inflammatory effects of food. https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02934-3
• Breast Cancer Support Association. (n.d.). Breast cancer support. https://breastcancersupportassociation.org/
• Centers for Disease Control and Prevention. (n.d.). Breast cancer risk factors. https://www.cdc.gov/breast-cancer/risk-factors/index.html
• Cleveland Clinic. (n.d.). Breast cancer surgery. https://my.clevelandclinic.org/health/treatments/8338-breast-cancer-surgery
• Komen, S. G. (n.d.). Breast cancer signs and symptoms. https://www.komen.org/breast-cancer/signs-symptoms/warning-signs/
• Komen, S. G. (n.d.). Hormone therapy for breast cancer. https://www.komen.org/breast-cancer/treatment/type/hormone-therapy/aromatase-inhibitors/
• Memorial Sloan Kettering Cancer Center. (n.d.). Tamoxifen: Side effects and risks. https://www.mskcc.org/cancer-care/patient-education/medications/adult/tamoxifen?msk_tools_print=pdf
• National Breast Cancer Foundation. (n.d.). Breast cancer risk factors. https://www.nationalbreastcancer.org/breast-cancer-risk-factors/
• National Cancer Institute. (n.d.). BRCA gene mutations: What are BRCA1 and BRCA2? https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet
• National Cancer Institute. (n.d.). Breast cancer treatment fact sheet. https://www.cancer.gov/types/breast/hp/breast-treatment-pdq
• National Cancer Institute. (n.d.). Hormone therapy for breast cancer. https://www.cancer.gov/types/breast/breast-hormone-therapy-fact-sheet
• NutritionFacts.org. (n.d.). Anti-inflammatory foods. https://nutritionfacts.org/topics/anti-inflammatory/
• SEER Cancer Stat Facts. (n.d.). Breast cancer subtypes. https://seer.cancer.gov/statfacts/html/breast-subtypes.html
• SEER Cancer Stat Facts. (n.d.). Breast cancer statistics. https://seer.cancer.gov/statfacts/html/breast.html
• Springer. (2022). Emerging cancer treatments in 2022. https://link.springer.com/article/10.1007/s40290-022-00420-4
• Springer. (2024). New developments in breast cancer treatment. https://link.springer.com/article/10.1007/s11912-024-01589-4

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