How Much Do Tamoxifen And Raloxifene Lower The Risk Of Breast Cancer
Multiple studies have shown that both tamoxifen and raloxifene can reduce the risk of developing estrogen receptor-positive breast cancer in healthy postmenopausal women who are at high risk of developing the disease. Tamoxifen lowered the risk by 50 percent. Raloxifene lowered the risk by 38 percent. Overall, the combined results of these studies showed that taking tamoxifen or raloxifene daily for five years reduced the risk of developing breast cancer by at least one-third. In one trial directly comparing tamoxifen with raloxifene, raloxifene was found to be slightly less effective than tamoxifen for preventing breast cancer.
Both tamoxifen and raloxifene have been approved for use to reduce the risk of developing breast cancer in women at high risk of the disease. Tamoxifen is approved for use in both premenopausal women and postmenopausal women . Raloxifene is approved for use only in postmenopausal women.
Less common but more serious side effects of tamoxifen and raloxifene include blood clots to the lungs or legs. Other serious side effects of tamoxifen are an increased risk for cataracts and endometrial cancers. Other common, less serious shared side effects of tamoxifen and raloxifene include hot flashes, night sweats, and vaginal dryness.
Testing For Proteins And Genes
The breast cancer cells will be tested for certain proteins called estrogen and progesterone receptors. If the cancer has these proteins, it’s called a hormone receptor positive breast cancer. The cells are also tested to see if the cancer makes too much of the HER2 protein. If it does, it’s called a HER2-positive cancer. These cancers are sometimes easier to treat. If the cancer doesn’t test positive for any of these proteins, it’s called a triple-negative breast cancer.
The cells might also be tested for certain genes, which can help decide if chemo might be helpful and how likely it is that the cancer will come back. Ask your doctor to explain the tests they plan to do, and what the results might mean.
How Can I Protect Myself From Breast Cancer
Follow these three steps for early detection:
- Get a mammogram. The American Cancer Society recommends having a baseline mammogram at age 35, and a screening mammogram every year after age 40. Mammograms are an important part of your health history. Recently, the US Preventive Services Task Force came out with new recommendations regarding when and how often one should have mammograms. These include starting at age 50 and having them every two years. We do not agree with this, but we are in agreement with the American Cancer Society and have not changed our guidelines, which recommend yearly mammograms starting at age 40.
- Examine your breasts each month after age 20. You will become familiar with the contours and feel of your breasts and will be more alert to changes.
- Have your breast 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 may not be detected by mammogram.
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Urgent Advice: You Should See Your Gp If You Notice:
- a new lump or area of thickened tissue in either breast that was not there before
- a change in the size or shape of one or both breasts
- bloodstained discharge from either of your nipples
- a lump or swelling in either of your armpits
- dimpling on the skin of your breasts
- a rash on or around your nipple
- a change in the appearance of your nipple, such as becoming sunken into your breast
Breast pain is not usually a symptom of breast cancer.
Does Breast Pain Increase The Risk Of Breast Cancer
Though it’s uncommon, there are some painful breast conditions which may raise your risk. Both radial scars and multiple or complex fibroadenomas increase your risk of breast cancer Many breast conditions which cause pain confer only a minimally increased risk of breast cancer, such as ductal ectasia, fat necrosis, a breast abscess, simple fibroadenomas, and others.
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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.
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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Visible Changes In The Nipple Or Skin
After puberty, your nipples remain fairly consistent in shape, size and color. Generally, there shouldnt be any sudden changes with your nipples or skin. But if there are any visible changes, such as a red, itchy or scaly rash inversion or sucking-in of the nipple dimpling, puckering or other changes in the skin on or around the nipple, you should see your doctor.
As breast cancer progresses, it grows and pushes other things out of the way, Dr. Duncan says. This can cause changes in the breast, skin and nipple as the breasts internal structure changes.
Hormones And Hormone Medicine
Hormone replacement therapy
Hormone replacement therapy is associated with an increased risk of developing breast cancer. However, the risk is a very low one.
Women who use the contraceptive pill have a slightly increased risk of developing breast cancer. The risk starts to decrease once you stop taking the pill. Your risk of breast cancer is back to normal 10 years after stopping.
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The Earliest Symptoms Of Breast Cancer Are Often Better Felt Than Seen
Breast cancer is one of the leading causes of death globally. It afflicts both women and men. One of the most common cancers in women, it affects around 2.1 million women each year.
The earliest symptoms of breast cancer, however, are often better felt than seen, hence being aware of ones breast by regular examination by self or a clinician, can help detect sudden changes that warrant further investigation, says Dr Geeth Monnappa, consultant obstetrician and gynaecologist, Fortis La Femme Hospital, Richmond Road, Bengaluru.
This Breast Cancer Awareness Month, the doctor explains that although the emphasis has always been on the detection of lumps in the breast or armpit, one needs to know about other signs of cancer that need immediate attention. These are:
1. Change in the size or shape of the breast
Its common for breasts to swell and feel painful prior to a period. But if you notice a change in the size of one breast in particular, its probably best to consult your doctor about it.
2. Nipple discharge
Any discharge from the breast thats watery, bloody or milky, in a person who isnt breastfeeding, needs a complete evaluation.
3. Pulling in of the nipple
Although many people have flat or inverted nipples as a normal feature, if you notice that your nipples are pointing inwards instead of outward of late, consult your doctor.
4. Redness or flaky skin in the nipple or breast
5. Irritation or dimpling of the breast skin
Screening for early detection
Your Nipple Is Turning Inward
If your nipple is starting to turn inward when it wasn’t retracted before, it could be a sign of inflammatory breast cancer, which is much more aggressive than other types of breast cancer, says the American Cancer Society. Because of that, you should book an appointment with your doctor as soon as possible to discuss any concerning changes.
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Emotional Stages Of Breast Cancer
People often experience a wide range of emotions with breast cancer, and these can change with different stages in the journey. What might you or a loved one expect at the time of diagnosis, during treatment, and on to survivorship? It’s important to note that every person is different and experiences breast cancer in their own unique way. That said, it can be comforting to know you’re not alone with some of the feelings you have feelings that may have left you feeling isolated and alone. We will highlight some of the emotions and concerns that are common at three important times in your journey.
How Breast Cancer Pain May Feel
If breast cancer is the cause of breast pain, it will often be present in only one breast, whereas benign breast pain is often on both sides.
Breast cancer pain can be persistent and very specific, usually hurting in just one spot. But, breast cancer can be present in your breast before it causes pain. If you have other symptoms of breast cancer, such as nipple retraction, sudden swelling of your breast, or sudden skin changes, consult your doctor for a clinical breast exam.
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A Change In Your Breast May Be An Early Sign Of Breast Cancer Heres What To Look For
Breast cancer affects approximately one in eight women in their lifetime. But today, breast cancer is becoming more and more treatable especially when its caught early.
There are a few signs and symptoms to watch out for, says Mona Duncan, MD, general surgeon at Geisinger. Thats why its so important to go for your regular checkups and mammograms, and to perform monthly breast self-exams at home.Learn how to perform a breast self-exam.
How To Make Breast Self
Make it routine. The more you examine your breasts, the more you will learn about them and the easier it will become for you to tell if something has changed. Try to get in the habit of doing a breast self-examination once a month to familiarize yourself with how your breasts normally look and feel. Examine yourself several days after your period ends, when your breasts are least likely to be swollen and tender. If you are no longer having periods, choose a day that’s easy to remember, such as the first or last day of the month.
Get to know your breasts’ different neighborhoods. The upper, outer area near your armpit tends to have the most prominent lumps and bumps. The lower half of your breast can feel like a sandy or pebbly beach. The area under the nipple can feel like a collection of large grains. Another part might feel like a lumpy bowl of oatmeal.
Start a journal where you record the findings of your breast self-exams. This can be like a small map of your breasts, with notes about where you feel lumps or irregularities. Especially in the beginning, this may help you remember, from month to month, what is normal for your breasts. It is not unusual for lumps to appear at certain times of the month, but then disappear, as your body changes with the menstrual cycle .
Learn more about Breastcancer.org’s recommendations on when to begin annual mammograms.
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Surgery For Breast Cancer
Most women with breast cancer have some type of surgery. Common types of breast surgery are lumpectomy, mastectomy, and taking out lymph nodes from the underarm. Women who have a mastectomy may also decide to have the breast shape rebuilt, either at the same time or later on.
Choosing between lumpectomy and mastectomy
Lumpectomy only takes out the lump and a little bit around it. It lets you keep most of your breast. The downside is that youll most likely need radiation treatment after surgery. But some women who have a mastectomy also need radiation afterward.
When choosing between a lumpectomy and mastectomy, be sure to get all the facts. At first you may think that a mastectomy is the best way to get it all out. Some women tend to choose mastectomy because of this. But in most cases, lumpectomy is just as good as mastectomy. Talk to your cancer care team. Learn as much as you can to make the right choice for you.
If you have a mastectomy, you may want to think about having your breast shape rebuilt. This is called breast reconstruction. Its not done to treat the cancer. Its done to build a breast shape that looks a lot like your natural breast.
If youre going to have a mastectomy and are thinking about having reconstruction, you should talk to a plastic surgeon before the mastectomy is done. Your breast can be rebuilt at the same time the mastectomy is done or later on.
Side effects of surgery
Early Signs Of Breast Cancer
Pinpointing breast cancer in its earliest stages isnt easy becauseare different for everyone. Sometimes there is a palpable lump or tenderness. Very often, there is neither. Generally, breast cancer shows no symptoms in the early stage.
However, there are certain changes in the breast that may indicate breast cancer in both men and women.
Whether you are a man or a woman, its important to become familiar with your breasts so you can recognize when changes occur and seek timely treatment. Know the facts and understand your risk factors for the disease, such as , by reviewing these frequently asked questions.
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What Are The Warning Signs Of Breast Cancer
- A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
- A mass or lump, which may feel as small as a pea.
- A change in the size, shape, or contour of the breast.
- A blood-stained or clear fluid discharge from the nipple.
- A change in the look or feel of the skin on the breast or nipple .
- Redness of the skin on the breast or nipple.
- An area that is distinctly different from any other area on either breast.
- A marble-like hardened area under the skin.
These changes may be found when performing monthly breast self-exams. By performing breast self-exams, you can become familiar with the normal monthly changes in your breasts.
Breast self-examination should be performed at the same time each month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month.
Symptoms Of Angiosarcoma Of The Breast
Another rare form of breast cancer, angiosarcoma forms inside the lymph and blood vessels. Only a biopsy may definitively diagnose this type of cancer. Angiosarcoma can cause changes to the skin of your breast, such as the development of purple-colored nodules that resemble a bruise. These nodules, if bumped or scratched, may bleed. Over time, these discolored areas may expand, making your skin appear swollen in that area. You may or may not have breast lumps with angiosarcoma. If you also have lymphedema, which is swelling caused by a buildup of lymphatic fluid, angiosarcoma may occur in the affected arm. Cancer treatment sometimes damages the lymph vessels, which may lead to lymphedema.
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‘i Felt Something Like A Hard Round Piece Of Cheese’
After a shower one night, I did a self-breast check. I felt something like a round, hard piece of cheese about the size of a quarter. I had just had a mammogram six months earlier. I felt healthy, biked all the time, and wouldnt have guessed that something wasnt right in my body. But I didnt wait to see what was going on. I went to the doctor immediately and was referred for an ultrasound and needle biopsy. I was diagnosed at age 46 with stage 3 breast cancer, and soon after had a mastectomy. I would never recommend to anyone to ‘wait and see.’ While it was a very scary realization, youre only saving yourself if you take care of it aggressively.
Sandy Hanshaw, founder of Bike for Boobs, San Diego