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Table 12.1
Stages of Breast Disease Leading to Breast Cancer
1. Normal breast epithelial cell
Normal and healthy tissue.
2. Intermediate or mutant cell
Exposure to a carcinogen, such as radiation, or the result of acquired genetic alterations.
3. Atypia
Atypical appearance of cells. Various promoting factors, such as hormones and/or dietary influences can cause atypia. Hyperplasia, a condition in which there are too many cells in the tissue, precedes atypia.
4. Carcinoma in situ
Cancer is confined to a particular site and has not formed a rumor mass that can be detected by examination. These cancers are usually detected by mammography.
5. Invasive or infiltrating cancer
Cancer cells have penetrated the membranes that surround the duct or lobule. They will eventually form a lump that can be felt.
6. Angiogenesis/dissemination
The cancer has spread out of its primary tumor site.
7. Axillary lymph node metastases
There is lymph node involvement.
8. Distant micrometastases
The cancer has spread outside the lymph nodes and has invaded an organ.
9. Overt metastatic disease
The cancer has spread to more than one site.

Demographics And Statistics
Breast cancer is the most common cancer among women worldwide and accounts for about 30 percent of all newly diagnosed cancers in women in the United States. 1 A much smaller percentage of men also get breast cancer.
Ninety-nine percent of all malignant breast neoplasms are carcinomas, of which nearly all are adenocarcinomas (malignant tumors originating in glandular epithelium).2
The lifetime risk of breast cancer for women is now one person in eight.3
There has been a sharp increase in breast cancer rates: a 25 percent rise overall between 1973 and 1993,4 a 45 percent rise in Portland, Oregon,5 and a 31 percent increase in Seattle, Washington.6
The incidence of in situ breast cancer has increased roughly fivefold since the 1970s, somewhat attributable to the widespread use of mammography screening, and also to the increased use of hormone replacement therapy.7

 
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