Symptoms And Diagnosis Of Metastatic Breast Cancer
The most common parts of the body where breast cancer tends to spread are the bones, lungs, brain, and liver. But metastatic breast cancer can affect other parts of the body, as well.
Metastatic breast cancer symptoms can be very different depending on the cancers location, but may include:
biopsy of any suspicious area
a tap, removal of fluid from the area with symptoms to check for cancer cells a pleural tap removes fluid between the lung and chest wall a spinal tap removes fluid from around the spinal cord and a tap of fluid in the abdomen removes fluid in the abdominal cavity
These tests may also be used if you have no history of breast cancer and your doctor is having trouble determining the cause of your symptoms.
When breast cancer spreads to other parts of the body, its important to confirm whether the cancer has certain characteristics that may influence your treatment options, such as HER2 status and hormone receptor status. If you have been diagnosed with metastatic breast cancer years after an early-stage breast cancer diagnosis, it may seem logical to assume that the hormone receptor status and HER2 status are the same. But research has shown that the hormone receptor status and HER2 status of early-stage breast cancer can be different than that of a metastatic recurrence.
A biopsy may be done to determine these factors that can influence your treatment, which will be listed in your pathology report.
Treatment Options For Metastatic Breast Cancer
Treatment for metastatic breast cancer often is based on systemic therapies, which use drugs rather than surgery or radiation. Metastases treatments are designed to shrink tumors and slow their growth, help ease symptoms and improve quality of life. Treatment may change, such as when one therapy stops working, or the side effects become too uncomfortable. Rather than having only one treatment, most patients undergo several treatments combined to help fight the cancer.
The four broad categories of drug-based treatments are:
How Breast Cancer Spreads
- Breast cancer can spread to other regions of the body in a few primary ways:4 1. Through the lymph system: Breast tumor cells may dislodge from the tumor in the breast and enter tiny lymphatic vessels that are present throughout the breasts. From there they can be carried through lymphatic channels to lymph nodes and beyond.5 It is lymphatic spread which is an importan
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Multidisciplinary Approaches To Chest Wall Recurrences Of Breast Cancer
A chest wall recurrence of breast cancer following mastectomy is a complex clinical problem that can push centers to the limits of their resources.
The management of postmastectomy chest wall recurrences of breast cancer has long challenged clinicians. A tissue diagnosis combined with proper imaging and staging of patients to ensure the disease is localized are the first steps in management. Multimodal therapy offers patients the best chances of cure. In properly selected patients, complete surgical resection to negative margins, including full-thickness chest wall resection when required, followed by reconstruction that is well planned, can provide local control with very low surgical mortality and acceptable morbidity. Radiation therapy provides additional local control, while systemic therapy is an adjunct that prolongs survival in many cases. Multidisciplinary care combined with careful patient selection are the keys to successful chest wall resection for locally recurrent breast cancer after mastectomy.
Chest Wall Tumor Treatment
The chest cavity which houses the lungs, heart and other vital body parts is a bone-and-muscle cage framed by the sternum , spine and ribs. It helps support breathing and movement of the upper arms and shoulders. Like any other part of the body, the walls of the chest cavity are susceptible to tumors.
Chest wall tumors are classified as either primary tumors, which originate in the bone or muscle of the chest wall, or secondary tumors which originate elsewhere in the body and spread to the chest wall. Virtually all secondary tumors are malignant.
Most chest wall tumors found in children are primary, while most found in adults are secondary. All of these tumors tend to be a lump on the chest wall surface or growth that invades the bone or muscle.
How Can I Be Sure That My Cancer Will Be Detected Before It Has Spread
While you cant prevent breast cancer altogether, there are certain things you can do to reduce your risk of discovering it at an advanced stage. For example:
- Get routine mammograms. The American Cancer Society recommends having a baseline mammogram at age 35, and a screening mammogram every year after age 40.
- Examine your breasts every month after age 20. Youll become familiar with the contours and feel of your breasts and will be more alert to changes.
- Have your breasts examined by a healthcare provider at least once every three years after age 20, and every year after age 40. Clinical breast exams can detect lumps that mammograms may not find.
Diagnosis And Treatment Of Chest Wall Cancer
The only way to determine if you have chest wall cancer is to get certain tests performed. Commonly, your doctor may order:
- A CT scan or MRI
Depending on whether the tumor is primary or metastatic, and taking into consideration other factors relating to your age and overall health, a combination of treatments may include surgery, chemotherapy, and radiation therapy.
Our oncology team at Main Line Health has vast expertise in diagnosing and treating this rare form of cancer. If your symptoms are concerning you, get in touch with us.
To schedule an appointment with a specialist at Main Line Health, or .
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Is A Tumor In The Chest More Likely To Be Metastatic
Cancer in nearby breast or lung, for example, is sometimes more likely to invade the chest wall. More than 50 percent of malignant chest wall tumors are metastatic. Primary chest wall tumors are predominantly sarcomas, malignant tumors that form in the bone, soft tissue and skeletal muscle in the chest area.
When Should I See My Healthcare Provider
See your healthcare provider if you have any symptoms of a chest wall tumor. Theyll talk with you about your symptoms and your family history, and they may run tests to investigate further.
If your provider diagnoses you with a chest wall tumor, follow their guidance for treatment. After treatment, its essential that you keep your follow-up screenings and appointments. Chest wall tumors can come back even after successful removal. So, early detection and treatment for recurrences can help improve your long-term prognosis.
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Integrative Therapies For Metastatic Breast Cancer
You may find it beneficial to add integrative therapies to your treatment plan. There are many evidence-informed integrative modalities to boost the mind and body. Practices like gentle yoga, meditation, massage and music therapy may feel enjoyable and reduce stress and anxiety levels.
To help our patients maintain quality of life after a metastatic breast cancer diagnosis, our team of breast cancer experts may offer supportive care services to help manage side effects of the disease and its treatments. These may include:
Before starting any integrative therapies, however, ask your care team for advice on which ones are most suited to you and fit into your overall treatment plan, as well as how to do them safely.
Breast Injuries & Chest Wall Ailments
Similar to any other part of your body, the breasts and chest wall can incur injuries too. During an accident, while playing sports, or just taking care of everyday activities, you might feel sharp or sudden pain from a breast injury and notice that it lasts for several days or weeks afterward. Furthermore, neck sprains or pinched nerves in the shoulders can also result in referred breast pain.
Pain from breast injuries can be treated with over-the-counter pain medication and it typically subsides within a few weeks. Neck sprains or pinched shoulder nerves benefit from physical therapy as well as cold and heat packs to reduce any inflammation. And seatbelt pillows from Intimate Rose, which are primarily designed to help patients recover from breast surgery, can also be a useful tool to protect any painful areas from the pressure of a seatbelt.
It is also important to keep an eye on additional symptoms like a breast bruise, severe swelling, or an infection. If these do not subside within a week or two after an injury, make an appointment with your doctor for further examination.
Chest Wall Ailments
The treatment for chest wall injuries will depend on the cause, therefore if you notice any of the above symptoms, it is always best to consult with a doctor for examination and diagnosis.
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Ethical Approval And Consent To Participate
This study retrospectively collected the clinicopathological data of the patients, and did not collect the body fluids and tissue specimens of the patients. This study did not affect the treatment decision. All the research data were kept confidential and not used for commercial purposes. Exception to the requirement of informed consent was approved by the Institutional Ethics Committee of Zhongnan Hospital of Wuhan University .
Medications For Other Conditions
If you are taking medication for another condition, it could be the reason why your boobs are sore. Certain medications used to treat mental health conditions, kidney and heart diseases, as well as high blood pressure can cause tender breasts. Birth control pills, hormone replacement therapy, and fertility treatments can also result in side effects like breast pain.
If you believe your breast pain could be linked to any medications you are taking, schedule an appointment with your doctor to discuss and make changes to your treatment if necessary.
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Possible Questions To Ask Your Doctor
What Are The Types Of Breast Cancer
There are several different types of breast cancer, including:
Can cancer form in other parts of the breast?
When we say breast cancer, we usually mean cancers that form in milk ducts or lobules. Cancers can also form in other parts of your breast, but these types of cancer are less common. These can include:
- Angiosarcoma. This rare type of cancer begins in the cells that make up the lining of blood or lymph vessels.
- Phyllodes tumors. Starting in the connective tissue, phyllodes tumors are rare. Theyre usually benign , but they can be malignant in some cases.
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When Should You See A Doctor
If you are experiencing any of the above-mentioned symptoms, do not delay. Visit a specialist immediately. Do not forget to check your breasts once every month, preferably a week after your menstruation is over. Go for regular screening tests and mammograms at least once a year after you turn 40.
What Are The Symptoms Of Chest Wall Cancer
The most common symptoms of chest wall cancer are:
- A mass or lump protruding from the chest
- Impaired movement
Sometimes chest wall cancer does not exhibit any symptoms. About 20 percent are found incidentally on chest X-rays. For that reason, it is important that you regularly see your physician and alert him or her should you notice any irregularities.
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Additional Tools For Diagnosing Advanced Breast Cancer
The additional tools below are often used specifically for diagnosing advanced cancer:
Sentinel lymph node biopsy: This procedure removes sentinel lymph node cells during surgery for examination. When breast cancer spreads, it often heads first to the lymph nodes.
Chest X-ray: This detailed image of the chest may help doctors see whether cancer has spread to the bones.
Computed tomography scan: Also known as a CAT scan, this procedure takes detailed pictures of internal areas of the body using a computer linked to an X-ray machine. A dye may be used to help the organs show up more clearly in the images.
Bone scan: This procedure looks for bone metastasis, or cancer cells that have spread to the bone. A small amount of radioactive material is injected into the blood, then detected with a scanner.
Positron emission tomography scan: A PET scan is a detailed imaging tool that uses a radioactive drug, known as a tracer, to search for cancer cells within your body.
Malignant Chest Wall Tumors
- Soft tissue sarcomas: Include malignant fibrous histiocytoma, liposarcoma, and neurofibrosarcoma
- Chondrosarcomas: Malignant tumor of cartilage, usually on the front of the chest where the ribs and sternum connect
- Osteosarcoma: Tumor of the bone
- Ewing sarcoma: A group of bone and soft tissue tumors
- Solitary plasmacytoma: Rare plasma-cell tumor in the bone
- Liposarcoma: Tumor of fatty tissue
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Diagnosis Of Chest Wall Recurrence
CWR was defined as either of the following situations: pathologic diagnosis: core needle biopsy or surgical excision that confirms recurrence from BC imaging diagnosis: enhanced CT or enhanced MRI or PET/CT that shows new nodules/mass in chest wall physical examination: some small nodules of skin in chest wall diagnosed by physical examination . To guarantee the accuracy of the diagnosis of tumor recurrence, the size of diseases diagnosed by imaging or physical examination should have changes in the subsequent anticancer therapies.
Distributions Of Chest Wall Recurrence For Various T And N Stages
Distributions of CWR for various T and N stages are shown in supplementary files . Ratio of skin recurrence for T4 stage was higher than T1 , T2 and T3 stages. Additionally, ratio of skin recurrence for N3 stage was higher than N2 stage , N1 stage and N0 stage . When T or N stages occurred later in patients, there was a higher risk of skin recurrence.
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Types Of Chest Wall Sarcomas
The following types of sarcomas could grow in the chest wall:
- Chondrosarcoma: Forms in cartilage and is the most common type of primary chest wall bone cancer. It usually presents as a slowly enlarging, painful mass.
- Osteosarcoma: Forms in bone, typically during a period of accelerated growth, such as adolescence. It typically presents as a rapidly enlarging, painful mass.
- Ewings sarcoma: Forms in bone, and most often affects children and young adults. It usually presents as a painful mass with fever and fatigue.
- Plasmacytoma: Arises from plasma cells and is an isolated form of multiple myeloma. You may feel pain but not see a mass. This is one of the few chest wall tumors that we rarely treat surgically.
- Malignant fibrous histiocytoma: The most common soft tissue sarcoma, this often occurs in adults. These usually present as a slowly growing, painless mass.
- Rhabdomyosarcoma: Forms in striated muscle, and most often affects children and young adults. These usually present as a rapidly growing, painless mass.
Scar Tissue Post Surgery Or After Radiation Therapy
Breast surgery for a mastectomy or breast implants and radiation therapy for breast cancer can sometimes result in the development of scar tissue that can cause numbness or breast pain. In addition to breast pain, patients might also notice a firmer feel to the breast or lumps around surgical scars.
Physical therapy can be beneficial for relieving the pressure of post-surgery scar tissue in the breasts, and in severe cases, additional surgery can be required to remove it. As you heal with physical therapy sessions or additional surgery, it can help to use a mastectomy pillow that lays gently across your chest with the side pillows under each arm to prevent any rubbing or chaffing against surgical scars or painful scar tissue.
Our mastectomy pillows also come with adjustable shoulder straps and gel packs for hot and cold therapy.
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Breast Cancer In Situ Dcis And Lcis
Many breast cancers being found are very early cancers known as breast cancer in situ or noninvasive cancer. Most of the cancers are found by mammography. These very early cells changes may become invasive breast cancer. Two types of breast cancer in situ are:
- Ductal carcinoma in situ , which means that abnormal cells are found only in the lining of a milk duct of the breast. These abnormal cells have not spread outside the duct. They have not spread within the breast, beyond the breast, to the lymph nodes under the arm or to other parts of the body.There are several types of DCIS. If not removed, some types may change over time and become invasive cancers. Some may never become invasive cancers. DCIS is sometimes call intraductal carcinoma.
- Lobular carcinoma in situ , which means that abnormal cells are found in the lining of a milk lobule. Although LCIS is not considered to be actual breast cancer at this noninvasive stage, it is a warning sign of increased risk of developing invasive cancer.LCIS is sometimes found when a biopsy is done for another lump or unusual change that is found on a mammogram.