Breast cancer

Breast cancer overview

If you have breast cancer, you are in good hands at Fred Hutchinson Cancer Center. Our experts care for people with all types and stages of the disease. More than that, we are leaders in preventing and screening for breast cancer, evaluating patients who have signs or symptoms, researching new therapies and keeping survivors healthy. 

Following the merger of long-time partners, Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance, the organization was renamed to Fred Hutchinson Cancer Center. We are an independent, nonprofit organization that also serves as UW Medicine's cancer program. 

Screening Checking for disease when there are no symptoms. Because screening may find diseases at an early stage, there may be a better chance of curing the disease Checking for disease when there are no symptoms. Because screening may find diseases at an early stage, there may be a better chance of curing the disease. Examples of cancer screening tests are the mammogram (for breast cancer), colonoscopy (for colon cancer) and Pap and HPV tests (for cervical cancer). Screening can also include a genetic test to check for a person’s risk of developing an inherited disease. Sign In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. Some examples of signs are fever, swelling, skin rash, high blood pressure and high blood glucose. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain.

About breast cancer

We have many specialized clinics and programs to meet your breast cancer needs. When you come to Fred Hutch, we match you with the health care services and providers that are right for you. Your care here is always personalized. We customize your first appointment — and all your visits with us — to your unique situation. 

Preventing breast cancer

Many factors may play a part in your risk for breast cancer. Some, like your age, you cannot change. Others, you can. For instance, being more active can lower your risk.

For some people, genetics play an important role. Changes in certain genes or a strong family history of breast or ovarian cancer can increase your risk. But you still have choices, and there are steps you can take to protect yourself.

At Fred Hutch, we can help you understand your risk level and take action to reduce it. We look carefully at all your risk factors. Then we offer information and services that can make a difference.    

  • Our breast cancer screening experts can help you figure out which screening tests are right for you, based on your age, health, risk level and other things.
  • The Breast Health Clinic team can assess your breast cancer risk. We can also make a screening and follow-up plan for you if you may be higher-risk for any of these reasons: 
    • You have a family history of breast cancer.
    • You had an atypical (unusual) breast biopsy.
    • You have dense breasts.
  • The Clinical Genetics and Genetic Counseling Service can assess your risk level if you are at high risk because of personal or family history.
  • The Breast and Ovarian Cancer Prevention Program can help if either of the following is true:
    • You have a strong family history of ovarian or endometrial cancer.
    • You tested positive for a gene change that increases your risk for breast or gynecologic cancer.
Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Gene The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. Gene The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. Screening Checking for disease when there are no symptoms. Because screening may find diseases at an early stage, there may be a better chance of curing the disease Checking for disease when there are no symptoms. Because screening may find diseases at an early stage, there may be a better chance of curing the disease. Examples of cancer screening tests are the mammogram (for breast cancer), colonoscopy (for colon cancer) and Pap and HPV tests (for cervical cancer). Screening can also include a genetic test to check for a person’s risk of developing an inherited disease.
Preventing breast cancer

Get a prevention and screening plan custom-made for you. 

Risk factors for breast cancer

The following factors are linked with higher breast cancer risk:

  • Being female
  • Getting older
  • Having a body mass index (BMI) over 30 after menopause
  • Having had proliferative breast lesions such as atypia (“proliferative” means there is more cell growth than normal, and “atypia” means the cells look abnormal)
  • Having dense breast tissue
  • Taking hormone therapy for menopause symptoms for more than 4–5 years
  • Having your first menstrual period before age 13 or having later menopause (in the U.S., the average age for menopause is 52)
  • Having never given birth
  • Having your first full-term pregnancy at an older age
  • Having already had breast cancer
  • Having a family history of breast cancer
  • Having a family history of certain genetic mutations (changes)
  • Drinking more than four alcoholic drinks per week
  • Smoking
  • Being exposed to therapeutic ionizing radiation, such as having radiation therapy to your chest or breast

These factors may lower your breast cancer risk:

  • Breastfeeding
  • Being physically active
  • Losing weight after menopause
  • Eating a low-fat diet after menopause
  • Medicine (chemoprevention) or surgery (such as a risk-reducing mastectomy), which may be options for some higher-risk people

If you have questions or concerns about your risk level or how to lower your risk, talk with your primary care physician or ask for a referral to the Breast Health Clinic at Fred Hutch.

Hormone therapy Hormones can cause some cancers to grow. To slow or stop growth, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove a hormone-producing gland. Treatment that adds, blocks or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. Hormones can also cause certain cancers (such as prostate and breast cancer) to grow. To slow or stop the growth of cancer, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy and hormone treatment. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. 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 or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain.
Risk factors for breast cancer

Many things can affect the chances that you might develop breast cancer. 

Screening for breast cancer

Screenings, like mammograms, help save lives by finding breast cancer before you feel a lump or notice other signs or symptoms. Your screening plan will depend on how high your risk is. Fred Hutch experts can talk with you about if you need screening mammograms and how often. We can also explain how other imaging tests and breast exams can help. 

We screen using the most advanced form of mammography. It is called 3D mammography or digital breast tomosynthesis. For people with higher risk, we also use breast MRI (magnetic resonance imaging). MRI is a powerful tool for finding breast cancer early.
 

Imaging In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as X-rays (high-energy radiation), ultrasound (high-energy sound waves) and radio waves. Mammography The use of film or a computer to create a picture of the breast. Magnetic resonance imaging A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or X-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints and the inside of bones. Screening Checking for disease when there are no symptoms. Because screening may find diseases at an early stage, there may be a better chance of curing the disease Checking for disease when there are no symptoms. Because screening may find diseases at an early stage, there may be a better chance of curing the disease. Examples of cancer screening tests are the mammogram (for breast cancer), colonoscopy (for colon cancer) and Pap and HPV tests (for cervical cancer). Screening can also include a genetic test to check for a person’s risk of developing an inherited disease. Sign In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. Some examples of signs are fever, swelling, skin rash, high blood pressure and high blood glucose. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain.
Screening for breast cancer

Our specialized imaging team can help you understand current breast cancer screening guidelines. We create a screening plan that is right for you.  

Signs and symptoms of breast cancer

Often, a patient is the first to notice their breast has changed — even with regular screenings and exams by a physician. 

Lumps or changes in the size or shape of your breast could turn out to be normal and harmless. But they are worth a visit to a health care provider.

Physicians, advanced practice providers and nurses at the Fred Hutch Breast Health Clinic can help you with any of your concerns. We provide evaluations right away.  
 

Signs and symptoms of breast cancer

If you notice a breast change, have it checked. Our breast health specialists see people who are concerned about signs or symptoms.

Diagnosing breast cancer

When you come here with a breast concern, we make sure you get a diagnosis that is precise and accurate. We will also do any tests needed to understand the extent, or stage, of your cancer. Then we customize your treatment plan to your disease. 

Our expert radiologists and pathologists work closely with the rest of your Fred Hutch care team. Together, they will figure out your needs to get you the best outcome.  
 

Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Stage 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. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Diagnosing breast cancer

Diagnosis is about more than just knowing that you have breast cancer. The details of your disease matter.

Care at Fred Hutch

How does Fred Hutch approach treatment?

The safest, most effective and most widely accepted therapies for cancer become the “standard of care.” For many patients, these therapies will be a large part of their treatment. At Fred Hutch, we provide all standard therapies for breast cancer. We know how to choose the right ones for you and how to deliver them to give you the best chance at a full recovery.

Our physicians and researchers are always asking how we can make breast cancer treatments better and reduce side effects as much as possible. This is why we conduct clinical trials (also called clinical studies). Through these studies, we are able to offer you therapies that aren’t offered everywhere. A therapy that is going through trials today may become the new standard of care tomorrow.

Along with treating your cancer, a group of world-class professionals is here to support you. This team includes nurses, dietitians, physical therapists, social workers and psychologists. We also bring in supportive care services for your physical, mental and emotional well-being. 
 

Clinical trial 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. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies.
Medical oncologist Jennifer M. Specht, MD, talks about the different members of a patient's care team.

Treatment plan and process

Fred Hutch physicians with knowledge and experience in all types and stages of breast cancer will design your personalized treatment plan and provide your care. 

For most people, surgery is the first step. But there are many other treatment options, including radiation therapy, chemotherapy, endocrine therapy, targeted therapy and immunotherapy. We offer all of these treatments, and we choose and combine them to fit your unique case. For people who want it, we also offer breast reconstruction using implants or natural tissue.

As you go through treatment, your needs may change. Your care team at Fred Hutch is with you each step of the way. For example, we will help you deal with any side effects you have. We may suggest adding a new therapy that was just approved. Even after your breast cancer treatment is done, we will keep seeing you to protect your health over the long term.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Hormone therapy Hormones can cause some cancers to grow. To slow or stop growth, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove a hormone-producing gland. Treatment that adds, blocks or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. Hormones can also cause certain cancers (such as prostate and breast cancer) to grow. To slow or stop the growth of cancer, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy and hormone treatment. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. 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 or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
“At Fred Hutch, everyone who’s involved in a breast cancer patient’s care is laser-focused on offering state-of-the-art breast cancer care.”
— Jennifer M. Specht, MD, medical oncologist

Other resources

Care team
Care team

At Fred Hutch, a team of dedicated people surrounds you and your family to give you the highest level of care and support. You are the most important person on your care team. Our patients are at the center of everything we do.

Research
Research

Fred Hutch is a national leader in breast cancer research. Our scientists and physicians are working all the time to improve current treatments for breast cancer and develop new ones so every person with breast cancer can live a long, healthy life. 

Resources
Resources

There are many resources for learning about your disease, as well as organizations that provide support. Health educators at the Fred Hutch Patient and Family Resource Center have put together a list of trusted sources to help you get started.

For caregivers

Caregiver icon

When someone close to you needs treatment for breast cancer, you might step into the role of caregiver. Being a caregiver can mean many things, from lending a hand with daily living tasks to helping with medical decisions. It can also mean dealing with your own emotions and stress. 

At Fred Hutch, caregivers are valuable members of a patient’s care team. We see every day that your presence and your support make a difference. We know that what your friend or family member is going through affects you, too.

Part of our mission is to help you take care of yourself. Caring for yourself is good for your physical, mental and emotional health. It also helps you give your best to your loved one. Our social workers, Spiritual Health team and Patient and Family Resource Center staff are here to help support you.

Caregiver A person who gives care to people who need help, such as children, older people or patients who have chronic illnesses or disabilities. A person who gives care to people who need help taking care of themselves, such as children, older people or patients who have chronic illnesses or disabilities. Caregivers may be health professionals, family members, friends, social workers or members of the clergy. They may give care at home, in a hospital or in another health care setting.