What Is Stage 4 Breast Cancer
Also known as metastatic breast cancer, the cancer in this stage has spread beyond the breast, underarm and internal mammary lymph nodes to other parts of the body near to or distant from the breast. The cancer has spread elsewhere in the body. The affected areas may include the bones, brain, lungs or liver and more than one part of the body may be involved.
At stage 4, TNM designations help describe the extent of the disease. Higher numbers indicate more extensive disease. Most commonly, stage 4 breast cancer is described as:,
- T: T1, T2, T3 or T4 depends on the size and/or extent of the primary tumor.
- N1: Cancer has spread to the lymph nodes.
- M1: The disease has spread to other sites in the body.
Tamoxifen And Raloxifene For Women At High Risk
Although not commonly thought of as a healthybehavior, taking the prescription drugs tamoxifenand raloxifene can significantly lower the risk ofbreast cancer in woman at high risk of the disease.Approved by the FDA for breast cancer prevention,these powerful drugs can have side effects, sothey arent right for everyone. If you think youreat high risk, talk to your doctor to see if tamoxifen or raloxifene may be right for you.
Do I Still Need A Second Opinion If My Mammogram Came Back Positive
Mammograms are about 87% effective in detecting invasive breast cancer cells. Depending on the doctor and his or her interpretation of the mammogram, test results can still yield a false-negative or false-positive. You should always follow-up and get a specialists second opinion to confirm the diagnosis and to get more information about your treatment options and next steps.
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What If You Find A Lump
First, donât panic. Eighty percent of breast lumps arenât cancerous. They often turn out to be harmless cysts or tissue changes related to your menstrual cycle. But let your doctor know right away if you find anything unusual in your breast. If it is cancer, the earlier itâs found, the better. And if it isnât, testing can give you peace of mind.
The Importance Of Screening
If youve been diagnosed with breast cancer, and especially if you have higher risk due to a hereditary gene mutation or other factors, screening can mean earlier detection of a recurrence or new breast cancer. Regular breast cancer screenings have been shown to reduce the risk of dying from breast cancer and increase survival rates.
Talk with your healthcare team about the type of screening plan thats best for you.
Below you can find articles, personal stories, and downloadable resources with more information about diagnosis, talking with family, and finding emotional support.
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What Are The Stages Of Breast Cancer
There are two different staging systems for breast cancer. One is called anatomic staging while the other is prognostic staging. The anatomic staging is defined by the areas of the body where the breast cancer is found and helps to define appropriate treatment. The prognostic staging helps medical professionals communicate how likely a patient is to be cured of the cancer assuming that all appropriate treatment is given.
The anatomic staging system is as follows:
Stage 0 breast disease is when the disease is localized to the milk ducts .
Stage I breast cancer is smaller than 2 cm across and hasn’t spread anywhere including no involvement in the lymph nodes.
Stage II breast cancer is one of the following:
- The tumor is less than 2 cm across but has spread to the underarm lymph nodes .
- The tumor is between 2 and 5 cm .
- The tumor is larger than 5 cm and has not spread to the lymph nodes under the arm .
Stage III breast cancer is also called “locally advanced breast cancer.” The tumor is any size with cancerous lymph nodes that adhere to one another or to surrounding tissue . Stage IIIB breast cancer is a tumor of any size that has spread to the skin, chest wall, or internal mammary lymph nodes .
Stage IV breast cancer is defined as a tumor, regardless of size, that has spread to areas away from the breast, such as bones, lungs, liver or brain.
Does A Benign Breast Condition Mean That I Have A Higher Risk Of Getting Breast Cancer
Benign breast conditions rarely increase your risk of breast cancer. Some women have biopsies that show a condition called hyperplasia . This condition increases your risk only slightly.
When the biopsy shows hyperplasia and abnormal cells, which is a condition called atypical hyperplasia, your risk of breast cancer increases somewhat more. Atypical hyperplasia occurs in about 5% of benign breast biopsies.
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Symptoms Included In This Guide Are: Breast Pain Breast Lump Breast Size Shape Or Symmetry Questions Redness Of Breast
- Breast lump: fibroadenoma, cyst. See Breast Lump details below
- Nipple discharge: milk, blood, pus, clear fluid
- Acute breast pain with redness : often an infection.
- Acute breast pain and fullness without redness : always consider pregnancy
- Recurrent breast pain with menstrual periods: cyclic mastalgia. See details below.
- Chronic breast pain, unrelated to menstrual period and usually just one side: fibroadenoma, cyst. Marijuana use can cause breast pain.
The Cost Of Breast Cancer Treatment For Young Women
Everyone with breast cancer is at risk for suffering from economic toxicity with the diagnosis, says Dr. Silber. At the time they are diagnosed with breast cancer, younger women are less likely to be financially sound or to have established themselves in a career that provides sick leave and paid time off theyre also likelier to have small children, she says.
If you suffer from economic challenges prior to a cancer diagnosis, breast cancer is going to make that worse, says Dr. Silber. Thats especially true for younger women who are from poorer socioeconomic backgrounds and dont have access to the services or much leeway in terms of employment, she says.
I take care of women who are young, poor, single mothers who may be working at jobs that dont have good human resources supportlike, for example, a young woman working at a mini mart at night, says Dr. Silber. She may be doing hard and not particularly safe work, and might not have health benefits.
It can be a struggle to keep a job or get a raisebreast cancer patients may become semi-unemployable due to all the medical appointments they need, she explains.
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Additional Markers For Breast Cancer Staging
Additional markers specific to breast cancer will further define your stage, which may be helpful in choosing targeted treatments to fight the cancer.
- ER: The cancer has an estrogen receptor. Estrogen is a hormone, and some cancers have receptors that respond to estrogen.
- PR: The cancer has a progesterone receptor. Progesterone is also a hormone.
- HER2: The cancer makes the protein HER2 .
- G: Grade of cancer refers to how different the cells look from normal. Grade 1 indicates that the cells look fairly normal, while grade 2 cells are growing a little faster, and grade 3 cells look markedly different than normal breast tissue.
These markers, along with the TNM measurements, define your stage.
A cancer recurrence refers to cancer that returns in the same breast, and it requires new staging. This new stage is marked by an R at the end to indicate restaging. If it develops in the other breast, its considered a new cancer.
Breast Cancer: Why Me
The most obvious risk factor for breast cancer is being a woman. Men get the disease, too, but itâs about 100 times more common in women. Other things that make it more likely include being over age 55 or having a close relative who had the disease. Still, up to 80% of women with breast cancer have no family history of the illness.
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Survival Rates For Inflammatory Breast Cancer
Inflammatory breast cancer is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time its found, and is more likely to come back after treatment than other types of breast cancer. The outlook is generally not as good as it is for other types of breast cancer.
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
Avoid Birth Control Pills Particularly After Age 35 Or If You Smoke
Birth control pills have both risks and benefits. The younger a woman is, the lower the risks are. While women are taking birth control pills, they have a slightly increased risk of breast cancer. This risk goes away quickly, though, after stopping the pill. The risk of stroke and heart attack is also increased while on the pill particularly if a woman smokes. However, long-term use can also have important benefits, like lowering the risk of ovarian cancer, colon cancer and uterine cancer not to mention unwanted pregnancy so theres also a lot in its favor. If youre very concerned about breast cancer, avoiding birth control pills is one option to lower risk.
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What Tumor Factors Threaten My Life More
There are important tumor biology factors not well reflected in survival statistics by breast cancer stage. Below we list a few important factors that carry a higher risk to life beyond just the stage of cancer. You must ask your surgeon or medical oncologist to explain your receptor status and give you a copy of your biopsy pathology report.
Triple Negative Receptor breast cancer
Triple negative breast cancer is considered a more aggressive breast cancer. Invariably it does require chemotherapy. If you have triple negative breast cancer the risk of dying is higher than the standard statistics usually quoted for a particular stage of breast cancer . Learn more about Triple Negative Breast Cancer with our video lesson
HER2-Positive breast cancer
HER2-positive breast cancers are also more aggressive tumors. But the good news is that we now have incredibly effective, targeted chemotherapy and immunotherapy for HER2-positive cancers. Our video lesson covers HER2-Positive Breast Cancer in more detail .
Breast Cancer at a Young Age
Women younger than 40 have a higher chance of being diagnosed with a more advanced stage breast cancer. Also, the specific cancer type younger women develop has a higher chance of being more aggressive . As a result, age is a relative risk factor for survival.
Untreated breast cancer
Teaching everyone to be an expert in their own breast cancer care.
What Happens After The Local Breast Cancer Treatment
Following local breast cancer treatment, the treatment team will determine the likelihood that the cancer will recur outside the breast. This team usually includes a medical oncologist, a specialist trained in using medicines to treat breast cancer. The medical oncologist, who works with the surgeon, may advise the use of the drugs like tamoxifen or anastrozole or possibly chemotherapy. These treatments are used in addition to, but not in place of, local breast cancer treatment with surgery and/or radiation therapy.
After treatment for breast cancer, it is especially important for a woman to continue to do a monthly breast examination. Regular examinations will help you detect local recurrences. Early signs of recurrence can be noted in the incision area itself, the opposite breast, the axilla , or supraclavicular region .
Maintaining your follow-up schedule with your physician is also necessary so problems can be detected when treatment can be most effective. Your health care provider will also be able to answer any questions you may have about breast self-examination after the following procedures.
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Your Areolas Have Gotten Thicker
You probably have a pretty good idea of how your areolas usually look and feel at this pointtheyve been on your body for quite some time, after allso if you notice any thickening, its something to check out. This can also take place in the breast skin as well, says the American Cancer Society.
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Types Of Cancers That Develop In Adolescents
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can then spread to other areas of the body. To learn more about cancer and how it starts and spreads, see Cancer Basics.
For statistical purposes, cancers in adolescents are often thought of as those that start between the ages of 15 and 19. Cancer is not common in teens, but a variety of cancer types can occur in this age group, and treating these cancers can be challenging for a number of reasons.
Most cancers occur in older adults. Cancers that start in childhood are much less common. The types of cancers that develop in children are often different from the types that develop in adults. Childhood cancers are often the result of DNA changes in cells that take place very early in life, sometimes even before birth. Unlike many cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors.
The types of cancers that occur in adolescents are a mix of many of the types that can develop in children and adults. The types of cancers seen in adolescents are not unique to this age group, but the most common types are different from those most common in young children or adults.
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Can Cancer Form In Other Parts Of The Breast
Cancers can also form in other parts of the breast, but these types of cancer are less common. These can include:
- Angiosarcomas. This type of cancer begins in the cells that make up the lining of blood or lymph vessels. These cancers can start in breast tissue or breast skin. They are rare.
- Inflammatory breast cancer. This type of cancer is rare and different from other types of breast cancer. It is caused by obstructive cancer cells in the skins lymph vessels.
- Paget disease of the breast, also known as Paget disease of the nipple. This cancer affects the skin of the nipple and areola .
- Phyllodes tumors. These are rare, and most of these masses are not cancer. However, some are cancerous. These tumors begin in the breasts connective tissue, which is called the stroma.
How Is Breast Cancer Treated
If the tests find cancer, you and your doctor will develop a treatment plan to eradicate the breast cancer, to reduce the chance of cancer returning in the breast, as well as to reduce the chance of the cancer traveling to a location outside of the breast. Treatment generally follows within a few weeks after the diagnosis.
The type of treatment recommended will depend on the size and location of the tumor in the breast, the results of lab tests done on the cancer cells, and the stage, or extent, of the disease. Your doctor will usually consider your age and general health as well as your feelings about the treatment options.
Breast cancer treatments are local or systemic. Local treatments are used to remove, destroy, or control the cancer cells in a specific area, such as the breast. Surgery and radiation treatment are local treatments. Systemic treatments are used to destroy or control cancer cells all over the body. Chemotherapy and hormone therapy are systemic treatments. A patient may have just one form of treatment or a combination, depending on her individual diagnosis.
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How Survival Rate Is Estimated
Survival rates for all cancers are estimated by looking at data on large numbers of people who have a certain type of cancer. Researchers gather information about the people over periods of time, such as 5 years, 20 years, or longer.
Living Beyond Breast Cancer, like the American Cancer Society, uses U.S. survival rates based on data from the Surveillance, Epidemiology, and End Results Program, known as SEER, of the National Cancer Institute . The NCI works with the North American Association of Central Cancer Registries to gather this information from every state in the U.S. on an ongoing basis.
For breast cancer, the SEER database uses 5-year relative survival rates. A relative survival rate in breast cancer means that women who have the same stage and type of breast cancer are compared to women in the overall population who do not have cancer. For example, if women who have a certain stage and type of breast cancer are found to be about 90 percent as likely as women who dont have that cancer to live at least 5 years after being diagnosed, then the 5-year relative survival rate for the diagnosed women is 90 percent.
What Should A Teenage Girl Do If She Finds A Lump In Her Breast
- Loyola University Health System
- If a lump is found in the breast of an adolescent girl, she often will undergo an excisional biopsy. However, breast cancer is rare in adolescents, and the vast majority of teenage breast lumps are benign. A recent study suggests that a breast ultrasound might eliminate the need for biopsy in many cases.
If a lump is found in the breast of an adolescent girl, she often will undergo an excisional biopsy.
However, breast cancer is rare in adolescents, and the vast majority of teenage breast lumps turn out to be benign masses that are related to hormones.
A recent Loyola University Health System study published in the American Journal of Roentgenology suggests that a breast ultrasound examination might eliminate the need for biopsy in many cases.
Loyola radiologists performed ultrasound examinations on 20 girls ages 13 to 19 who had lumps in their breasts, including one girl who had a lump in each breast. The ultrasound studies indicated that 15 of the 21 lumps appeared to be benign, while and six were suspicious.
Follow-up biopsies or clinical examinations found that all 21 lumps were benign. These findings suggest that if a breast ultrasound finds nothing suspicious, the patient likely does not need to have an excisional biopsy, said lead author Dr. Aruna Vade, a professor in the Department of Radiology at Loyola University Chicago Stritch School of Medicine.
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