What Does It Mean When You Have A Lump In Your Breast
For some people, the first indication is a new lump or mass within the breast. People with this type of cancer may also experience: swelling of all or part of the breast. pain in the breast or nipple. irritation or dimpling of the breasts skin. redness, scaling, or thickening of the nipple or skin.
A Flattening Or Indentation Of The Breast
We all know that breasts can seemingly deflate with age, however if you notice that one of your breasts seems suddenly flat or you see an indentation in your breast tissue, you should make an appointment with your doctor. This type of change in your breast tissue may indicate a tumor that cannot be seen or felt.
More Recent Reports: Modern Chemotherapy Regimens
In more recent reports, covering a period of time during which adjuvant chemotherapy regimens incorporated anthracyclines and/or taxanes, weight gain is reported but generally to a lesser degree than earlier studies. In a prospective study from Turkey, Basaran et al reviewed weight change in 176 women receiving adjuvant chemotherapy between 2003 and 2007, 98% of whom received an anthracycline-based regimen, with or without a taxane 72% had gained weight at end of year one. Age, menopausal status and comorbidities impacted the degree amount of weight gain.
Makari-Judson and associates conducted a retrospective review of 185 patients with early stage breast cancer and evaluated weight change at diagnosis, 1, 2 and 3 years. Ninety percent of this patient population received an anthracycline-containing regimen . Weight gain at 2 years was greater than one year, plateauing at year 3. Recursive partitioning analysis associated weight gain at year 1 with younger age, closer to ideal BMI and adjuvant chemotherapy. In fact, older and overweight patients receiving chemotherapy tended to lose weight, although these patients constituted a smaller subgroup. Length of chemotherapy, specific chemotherapy regimens, and hormonal therapy were not found to be significant predictors of weight gain. Of patients who had gained weight at year 1, only one in five had returned to baseline by year 3.
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Unexplained Loss Is Often The First Sign Of Disease
Many people would consider a weight loss without dieting or exercise a pleasant surprise. But when the loss is sudden and unexplained, it could be the first warning sign of a serious health issue. This is especially true for those experiencing loss of more than five percent of body weight over the course of several months.
Weight loss is common among people with cancer and often the very first sign of the disease. On its own, it cannot diagnose cancer but will often suggest to doctors that tests be performed to, at the very least, exclude cancer as a cause.
Weight And Breast Cancer Risk
Most reports have suggested that obesity is associated with an increase in hormone receptorpositive postmenopausal breast cancer, but not in hormone receptornegative disease. A secondary analysis of the Womens Health Initiative demonstrated a 52% increase in the risk of hormone receptorpositive breast cancer in obese vs normal-weight women but no significant increase in the risk of hormone receptornegative cancers. There is an estimated12% increase in the risk of developing breast cancer for each 5-point increase in body mass index .
Studies have shown that obese premenopausal women are at slightly lower risk of developing breast cancer compared with their normal-weight counterparts.
It is not well understood why obesity is associated with an increased risk of postmenopausal hormone receptorpositive breast cancer but a decrease in the risk of premenopausal hormone receptorpositive breast cancer. One hypothesis for the pathophysiology relating obesity to breast cancer risk focuses on the differential impact of obesity on sex hormone levels in premenopausal and postmenopausal women. Postmenopausal women derive oestradiol from peripheral conversion of androgens by the enzyme aromatase. Adipose tissue is rich in aromatase, which results in obese women having higher levels of oestradiol. Overall, approximately 15% of breast cancer cases in postmenopausal women may be attributable to elevated weight.
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Gut Bacteria May Play A Role In Weight Gain
Some studies have highlighted the link between the gut microbiome and obesity in people without cancer. Dr Ayelet Shai, Director of Oncology at the Galilee Medical Center, initiated a study to see if this is also the reason for weight gain in cancer patients who received chemotherapy. She conducted the study along with Professor Omry Koren, an expert in gastrointestinal bacteria at the Azrieli Faculty of Medicine of Bar-Ilan University.
The study included 33 women who were about to begin chemotherapy for breast cancer and gynecological cancer. They were weighed before the treatment and again approximately five weeks after the treatment. Nine of the women experienced weight gain to a degree that was defined as significant . The researchers found a smaller diversity of gut bacteria and different bacterial strains in these women compared to that of the women who did not gain weight.
When the gut microbiota of women who gained weight was transferred to germ-free mice, the animals developed glucose intolerance and chronic inflammation. Based on these findings, the researchers suggested that gut bacteria may be partly responsible for metabolic changes that lead to weight gain following chemotherapy treatment.
The study results also suggest that the composition of intestinal bacteria may help predict which women will gain weight as a result of chemotherapy.
Why Do Weight And Muscle Loss Happen
One cause is the cancer itself. For example, in an effort to fight the cancer, the body produces substances called cytokines. These substances can lead to weight loss, muscle loss, and a decrease in appetite. Another common cause is the treatments for cancer. Radiation and chemotherapy often cause a decrease in appetite. They can also lead to side effects such as nausea, vomiting, and mouth sores, which can affect your ability to eat normally, further contributing to weight and muscle loss. Fatigue is also a factor, since the decreases in exercise and other physical activities that happen when youre not feeling well can contribute to muscle loss. For more information on treatment side effects like fatigue and mouth sores, read CancerCares booklet titled Understanding and Managing Chemotherapy Side Effects.
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How Long Do I Take Tamoxifen
The American Society of Clinical Oncology recommends that:
- newly diagnosed premenopausal and perimenopausal women take 5 years of tamoxifen as their first hormonal therapy after this first 5 years is done, the hormonal therapy taken for the second 5 years would be determined by the womans menopausal status:
- postmenopausal women could take another 5 years of tamoxifen or switch to an aromatase inhibitor for 5 years
- pre- and perimenopausal women would take another 5 years of tamoxifen
Body Weight And Breast Cancer Risk Before Menopause
Women who are overweight or obese before menopause have a 10-20 percent lower risk of breast cancer than those who are lean .
Although being overweight or obese is linked to a lower risk of breast cancer before menopause, weight gain should be avoided. This is because any weight gained before menopause may be carried into the postmenopausal years and most breast cancers occur after menopause.
After menopause, being overweight is linked to increased breast cancer risk.
Hormone receptor status
Women who are overweight or obese before menopause have a lower risk of overall breast cancer than those who are lean .
However, some findings suggest women who are overweight or obese may have an increased risk of estrogen receptor-negative breast cancers before menopause, including triple negative breast cancers .
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What Can I Do To Help Maintain My Weight And Build Strength
Along with taking any medicines your doctor prescribes, there are many things you can do to help your body stay strong. Good, balanced nutrition and proper hydration are very important:
Eat a balanced diet, and be sure to include protein to protect lean body mass. Beef, pork, poultry, tofu and soy nuts are excellent sources of protein. So are dairy products try some Greek yogurt, which is higher in protein than regular yogurt. For more information on nutrition during treatment, read CancerCares fact sheet title The Importance of Nutrition During Treatment.
Increase the number of calories you eat. Choose nutritious foods that you enjoy. If appetite is a problem, try eating smaller, more frequent meals make milkshakes, smoothies, and purees, which may be easier to digest and add milk or protein powder to your foods.
Drink plenty of liquids throughout the day. Water is best, but you can also get fluids from soups, popsicles and sports drinks.
Keep a journal. Keeping details of the side effects that you experience will help your health care team. Having a health care journal or notebook will allow you to keep all of your health information in one place. If you are experiencing constipation, it may be helpful to keep a journal detailing:
- Physical activities you do and how they affect your mood and energy level
- Fluid intake and type of fluid
- Medications youre currently taking
Does Inflammation Cause Breast Cancer
Chronic inflammation has been linked to a higher risk of breast cancer recurrence the proteins secreted by the immune system seem to stimulate breast cancer cells to grow, especially estrogen-receptor-positive breast cancer in postmenopausal women. We also know that women who gain weight after being diagnosed with breast cancer are more likely
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Stopping The Ovaries Working
In premenopausal women, doctors might use a type of hormone treatment to stop the ovaries from producing oestrogen. This type of drug is called a luteinising hormone releasing hormone . For example, goserelin and leuprorelin . You might have this on its own or with other hormone therapy drugs.
LHRH drugs work by blocking a hormone made in the pituitary gland that stimulates your ovaries to make and release oestrogen. This stops your ovaries from working. So you wonât have periods or release eggs while you are having the injections.
When you stop taking the drug, your ovaries should start working again. But, if youâre close to the age at which your menopause would naturally start, your periods might not start again.
Body Weight Breast Cancer Risk And Menopausal Status
Studies show a link between BMI and breast cancer risk. However, BMI affects risk differently before and after menopause.
- Before menopause, women who are overweight or obese have a modestly decreased risk of breast cancer .
- After menopause, women who are overweight or obese have an increased risk of breast cancer .
Komen Perspectives
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Breast Cancer & Weight Gain: What You Need To Know
Nearly 80% of people who are diagnosed with breast cancer will experience weight gain,1 reported to range between two pounds and 18 pounds. Not only is this an alarming trend for general health and self-image, but also some evidence suggests that pre-menopausal women who gain weight have a 1.5 fold increase risk of cancer recurrence.2 Other studies have shown that some types of treatment, such as anastrozole , are less effective at treating breast cancer in patients who are obese.3
Stephanie Graff, MD, Director of the Breast Cancer Program at Sarah Cannon Cancer Institute at HCA Midwest Health and Associate Director of the Breast Cancer Research Program at Sarah Cannon Research Institute shares what people should know about the risk factors for weight gain after a breast cancer diagnosis.
Simultaneously hitting menopause
Women who become post-menopausal within the year they are diagnosed with breast cancer are the most likely to gain weight. An average woman without breast cancer gains three pounds with menopause.4 The risk of weight gain with menopause is highest in women who were at a healthy weight when reaching menopause. There does not seem to be a significant weight gain in women who quit hormone replacement at the time of a breast cancer diagnosis.
Treatment effects
Emotional wellness & coping skills
References
General Health And Wellness
Breast cancer is the most common cancer among women in the United States effecting one in eight women. Millions of women are surviving the disease thanks in part to early detection and improvements in treatment. Here are 14 Early Warning Cancer Symptoms That Often Get Ignored.
Sudden Changes In Skin
If you have a mole that is rapidly changing shape, color or size, call a dermatologist immediately.
Frequent Infections And Lengthy Fevers
If you have a fever that just wont go away, and theres no other justifiable cause, it may mean youre suffering from a blood-related cancer like leukemia.
Lumps Under Your Arms, On Your Neck Or Groin & Swollen Lymph Nodes
Sudden, drastic changes in your lymphatic system can definitely be a sign of lymphoma and other cancers.
Stubborn Back Pain
Long-lasting backaches are a clear sign of bone, liver breast and a variety of other dangerous cancers. If you have any pain thats lasted over a month, reach out to your doctor immediately.
Sudden Changes In Your Nails
Color or form changes in your nails such as clubbing is a big indicator or lung cancer. Although theyre hard to notice, its important to pay attention to and record any changes over a short period of time.
Chronic Cough, Shortness Of Breath & Wheezing
Oral Changes
Small white spots inside your mouth or on your lips are both signs of oral cancer. This is especially true with those who smoke cigarettes!
Chronic Heartburn
Sore, Swollen or Red Breasts
Weight Loss
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How Important Is Exercise
It’s really good for your overall health — but talk to your doctor before you begin any exercise program.
Physical activity can often help reduce the side effects of nausea and fatigue. It can also lift your energy levels. One study found that exercise after chemotherapy might boost infection-fighting T cells, too.
Even a moderate amount of exercise may help you live longer.
Strength training can help rebuild body mass and increase your strength. You need to take care when working with weights on the upper body, though. That’s because lymphedema — arm swelling — is a common concern after breast cancer treatment.
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When To Connect With Your Care Team
Some weight gain may be a side effect of cancer treatment or chemotherapy. But there are times when youll want to inform your doctor about weight gain, including if youre:
- Putting on 5 pounds or more a week
- Experiencing new onset shortness of breath
- Feeling dizzy or confused
- Having new signs of fluid retention, such as new arm or leg swelling, jewelry that fits tighter than it used to, or less flexibility
- Finding the weight gain concerning for any other reason
Expert
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What Cancer Treatments Can Cause Weight Gain
Cancer treatments such as chemotherapy, steroid treatment, and hormone treatments can lead to weight gain in different ways.
Chemotherapy. Chemotherapy uses drugs to destroy cancer cells. Chemotherapy can lead to weight gain by:
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Causing the body to hold on to excess fluid, called edema.
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Causing fatigue, making it harder to exercise.
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Increasing nausea that improves by eating more food.
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Triggering intense food cravings.
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Lowering your metabolism. Metabolism is the rate that the body uses energy. When your metabolism is low, you burn less calories, which can make you gain weight.
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Causing menopause, which also slows down your metabolism.
Steroid medications. Steroids are prescribed during cancer treatment for several reasons. This type of medication can reduce symptoms of inflammation, such as swelling and pain. They can treat nausea. And they can be used as a treatment for cancer itself, such as for multiple myeloma.
A common side effect of steroids is weight gain. Steroids can lead to weight gain by:
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Increasing your appetite and making you eat more.
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Increasing fat tissue in the abdomen, neck, face, or other areas with long-term use.
Weight Gain After Menopause
Its not just the weight a woman gains after age 18 that seems important to risk. The weight a woman gains after menopause also appears to be linked to an increased risk of breast cancer .
One large study showed women who gained 20 pounds or more after menopause had an 18 percent higher risk of breast cancer compared to those who gained little or no weight after menopause .
For a summary of research studies on weight gain and breast cancer, visit the Breast Cancer Research Studies section. |
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Some Research Connects Small Almost Imperceptible Lifestyle Habits To Weight Gain
We breast cancer survivors are quick to express gratitude for all life-saving treatments we receive.
Were just as quick to bemoan those treatments for the collateral damage left in their wake.
While the type and severity of treatment aftermath varies, if theres a unifying complaint, it has to be this: weight gain.
An aftermath thats particularly egregious, by the way.
Its enough to experience the horror and rigor of breast cancer. Must body dissatisfaction, clothes that no longer fit, and an increased risk of recurrence be part of the deal?
Scientific literature confirms a connection between breast cancer treatment and weight gain, and negative body image and body dissatisfaction in survivors.
I regularly hear from survivors that the reluctance of extra weight to budge is frustrating at best, maddening at worst, and depressing as hell.