Test results will tell if you have:

Breast changes that are not cancer ¹
Breast changes that are not cancer, but increase your risk of cancer ²
Breast changes that may become cancer ³
Breast cancer ⁴

Breast changes that are not cancer

These changes are not cancer and do not increase your risk of breast cancer. They are called benign changes.

Adenosis: Small, round lumps, or a lumpy feeling that are caused by enlarged breast lobules. Sometimes the lumps are too small to be felt. If there is scar-like tissue, the condition may be painful and is called sclerosing adenosis.

Cysts: Lumps filled with fluid. Breast cysts often get bigger and may be painful just before your menstrual period begins. Cysts are most common in premenopausal women and in women who are taking menopausal hormone therapy.

Fat necrosis: Round, firm lumps that usually don't hurt. The lumps most often appear after an injury to the breast, surgery, or radiation therapy.

Fibroadenomas: Hard, round lumps that may feel like a small marble and move around easily. They are usually painless and are most common in young women under 30 years old.

Intraductal papilloma: A wart-like growth in a milk duct of the breast. It's usually found close to the nipple and may cause clear, sticky, or bloody discharge from the nipple. It may also cause pain and a lump. It is most common in women 35-55 years old.

Ask your doctor when you will get your test results. See the chart in Breast Conditions and Follow-Up Care 5 for follow-up information.

Breast changes that are not cancer, but increase your risk of cancer

These conditions are not cancer, but having them increases your risk of breast cancer. They are considered risk factors for breast cancer. Other risk factors include, for example, your age and a family history of breast cancer.

• Atypical hyperplasia:
• Atypical lobular hyperplasia (ALH) is a condition in which abnormal cells are found in the breast lobules.
• Atypical ductal hyperplasia (ADH) is a condition in which abnormal cells are found in the breast ducts.
• Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the breast lobules. There are more abnormal cells in the lobule with LCIS than with ALH. Since these cells have not spread outside the breast lobules, it's called "in situ," which is a Latin term that means "in place."

The abnormal cells found in these conditions are not cancer cells. If you have ALH, ADH, or LCIS, talk with a doctor who specializes in breast health to make a plan that works best for you. Depending on your personal and family medical history, it may include:

• Mammograms every year
• Clinical breast exams every 6 to 12 months
• Tamoxifen (for all women) or raloxifene (for postmenopausal women). These drugs have been shown to lower some women's risk of breast cancer.
• Surgery. A small number of women with LCIS and high risk factors for breast cancer may choose to have surgery.
• Clinical trials. Talk with your health care provider about whether a clinical trial is a good choice for you.

"Instead of stressing that something abnormal was found, I realized how lucky I was to have this small breast change found early."

Breast changes that may become cancer

Ductal carcinoma in situ (DCIS): DCIS is a condition in which abnormal cells are found in the lining of a breast duct. These cells have not spread outside the duct to the breast tissue. This is why it is called "in situ," which is a Latin term that means "in place." You may also hear DCIS called Stage 0 breast carcinoma in situ or noninvasive cancer.

Since it's not possible to determine which cases of DCIS will become invasive breast cancer, it's important to get treatment for DCIS. Talk with a doctor who specializes in breast health to learn more. Treatment for DCIS is based on how much of the breast is affected, where DCIS is in the breast, and its grade. Most women with DCIS are cured with proper treatment.

Treatment choices for DCIS include:

• Lumpectomy. This is a type of breast-conserving surgery or breast-sparing surgery. It is usually followed by radiation therapy.
• Mastectomy. This type of surgery is used to remove the breast or as much of the breast tissue as possible.
• Tamoxifen. This drug may also be taken to lower the chance that DCIS will come back, or to prevent invasive breast cancer.
• Clinical trials. Talk with your health care provider about whether a clinical trial is a good choice for you.

Breast cancer

Breast cancer is a disease in which cancer cells form in the tissues of the breast. Breast cancer cells:

• Grow and divide without control
• Invade nearby breast tissue
• May form a mass called a tumor
• May metastasize, or spread, to the lymph nodes or other parts of the body

After breast cancer has been diagnosed, tests are done to find out the extent, or stage, of the cancer. The stage is based on the size of the tumor and whether the cancer has spread. Treatment depends on the stage of the cancer.

For more information about breast cancer and to get answers to any questions you may have, call 1-800-4-CANCER (1-800-422-6237). Two free booklets you can ask for are: What You Need To Know About Breast Cancer ⁶ and Surgery Choices for Women with Early-Stage Breast Cancer ⁷. You can also visit the National Cancer Institute (NCI) online at www.cancer.gov.

Glossary Terms

A disease or abnormal change in a gland. Breast adenosis is a benign condition in which the lobules are larger than usual.

A benign (not cancer) condition in which there are more cells than normal in the lining of breast ducts and the cells look abnormal under a microscope. Having atypical ductal hyperplasia increases the risk of breast cancer. Also called ADH and atypical ductal breast hyperplasia.

A benign (not cancer) condition in which cells look abnormal under a microscope and are increased in number.

A benign (not cancer) condition in which there are more cells than normal in the breast lobules and the cells look abnormal under a microscope. Having atypical lobular hyperplasia increases the risk of breast cancer. Also called ALH and atypical lobular breast hyperplasia.

An operation to remove the breast cancer but not the breast itself. Types of breast-conserving surgery include lumpectomy (removal of the lump), quadrantectomy (removal of one quarter, or quadrant, of the breast), and segmental mastectomy (removal of the cancer as well as some of the breast tissue around the tumor and the lining over the chest muscles below the tumor). Also called breast-sparing surgery.

An operation to remove the breast cancer but not the breast itself. Types of breast-sparing surgery include lumpectomy (removal of the lump), quadrantectomy (removal of one quarter, or quadrant, of the breast), and segmental mastectomy (removal of the cancer as well as some of the breast tissue around the tumor and the lining over the chest muscles below the tumor). Also called breast-conserving surgery.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

A sac or capsule in the body. It may be filled with fluid or other material.

The process of identifying a disease, such as cancer, from its signs and symptoms.

A noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, ductal carcinoma in situ may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive. Also called DCIS and intraductal carcinoma.

A benign condition in which fat tissue in the breast or other organs is damaged by injury, surgery, or radiation therapy. The fat tissue in the breast may be replaced by a cyst or by scar tissue, which may feel like a round, firm lump. The skin around the lump may look red, bruised or dimpled.

A benign (not cancer) tumor that usually forms in the breast from both fibrous and glandular tissue. Fibroadenomas are the most common benign breast tumors.

A description of a tumor based on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer.

In its original place. For example, in carcinoma in situ, abnormal cells are found only in the place where they first formed. They have not spread.

A benign (not cancer), wart-like growth in a milk duct of the breast. It is usually found close to the nipple and may cause a discharge from the nipple. It may also cause pain and a lump in the breast that can be felt. It usually affects women aged 35-55 years. Having a single papilloma does not increase the risk of breast cancer. When there are multiple intraductal papillomas, they are usually found farther from the nipple. There may not be a nipple discharge and the papillomas may not be felt. Having multiple intraductal papillomas may increase the risk of breast cancer. Also called intraductal breast papilloma.

A condition in which abnormal cells are found in the lobules of the breast. Lobular carcinoma in situ seldom becomes invasive cancer; however, having it in one breast increases the risk of developing breast cancer in either breast. Also called LCIS.

Surgery to remove abnormal tissue or cancer from the breast and a small amount of normal tissue around it. It is a type of breast-sparing surgery.

A doctor who specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, biological therapy, and targeted therapy. A medical oncologist often is the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists.

To spread from one part of the body to another. When cancer cells metastasize and form secondary tumors, the cells in the metastatic tumor are like those in the original (primary) tumor.

In medicine, it describes a procedure that does not require inserting an instrument through the skin or into a body opening. In cancer, it describes disease that has not spread outside the tissue in which it began.

A doctor who specializes in using radiation to treat cancer.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

The active ingredient in a drug used to reduce the risk of invasive breast cancer in postmenopausal women who are at high risk of the disease or who have osteoporosis. It is also used to prevent and treat osteoporosis in postmenopausal women. It is also being studied in the prevention of breast cancer in certain premenopausal women and in the prevention and treatment of other conditions. Raloxifene blocks the effects of the hormone estrogen in the breast and increases the amount of calcium in bone. It is a type of selective estrogen receptor modulator (SERM).

Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.

A benign condition in which scar-like tissue is found in a gland, such as the breast lobules or the prostate. A biopsy may be needed to tell the difference between the abnormal tissue and cancer. Women with sclerosing adenosis of the breast may have a slightly increased risk of breast cancer.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

There are 2 types of stage 0 breast carcinoma in situ: ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). DCIS is a noninvasive condition in which abnormal cells are found in the lining of a breast duct (a tube that carries milk to the nipple). The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may spread to other tissues, although it is not known how to predict which lesions will become invasive cancer. LCIS is a condition in which abnormal cells are found in the lobules (small sections of tissue involved with making milk) of the breast. This condition seldom becomes invasive cancer; however, having LCIS in one breast increases the risk of developing breast cancer in either breast. Also called breast carcinoma in situ.

A drug used to treat certain types of breast cancer in women and men. It is also used to prevent breast cancer in women who have had ductal carcinoma in situ (abnormal cells in the ducts of the breast) and in women who are at a high risk of developing breast cancer. Tamoxifen is also being studied in the treatment of other types of cancer. It blocks the effects of the hormone estrogen in the breast. Tamoxifen is a type of antiestrogen. Also called tamoxifen citrate.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.