Noticing Changes To Your Breasts
The ACS no longer recommends regular breast self-exams, since theres no evidence that they help reduce breast cancer deaths.
However, knowing how your breasts normally look and feel can help you identify any changes early on. Take notice of the following:
- skin dimpling
Once youve established a baseline for how your breasts look and feel, itll be easier to identify any changes in the future.
If you do notice any changes, or if anything causes you worry, let your doctor know. They can determine if theres cause for concern.
Its common to see asymmetry in breast size, which can be normal.
A note on breast exams
The American Cancer Society no longer recommends regular clinical breast exams or breast self-exams. Theres little evidence that these exams help reduce deaths from breast cancer in women at average risk for the condition.
However, these exams may still be performed in certain scenarios.
For instance, some healthcare professionals may choose to perform clinical breast exams and counsel women on risk and early detection, in particular those at a higher-than-average risk for cancer. In addition, some women might prefer to use routine breast self-exams as a way to track possible changes to their breasts.
Premenstrual Breast Pain And Swelling
- Main Symptom: breast fullness and pain.
- Cause: extra body fluid from female hormone cycles.
- Other symptoms: headache, swollen feet .
- Timing: mainly noticed in the week prior to menstrual periods.
- Course: improves during menstrual period and goes away between menstrual periods.
- Physical Findings: fullness that can be felt throughout both breasts.
- Onset: usually 2 years after onset of periods . Similar onset as for menstrual cramps.
- Frequency: 10% of teens and 50% of adult women.
- Treatment: mainly ibuprofen and support bra. If breast pain can’t be controlled with ibuprofen, 80% can be improved by birth control pills.
- Other treatments: daily exercise and getting enough sleep.
Why You Shouldn’t Think Twice About Getting A Lump Checked
A woman’s risk for breast cancer is highest after the age of 50, but even young women can develop breast cancer. Since any lump could potentially be cancerous, it’s critical that you have any lump you may have felt evaluated by a doctor no matter your age.
“While many lumps will end up being benign breast lump disease, many others won’t be and we don’t want to miss out on diagnosing breast cancer,” says Dr. Joshi. “Through mammograms and other imaging modalities, breast cancer is very easy to catch and diagnose, and when caught early breast cancer is very, very treatable.”
In addition, Dr. Joshi says you shouldn’t avoid having a lump checked just because you’re worried about having a painful biopsy.
“Mammograms and breast ultrasounds are very powerful tools that can help us diagnose even the smallest breast cancers with very high specificity,” explains Dr. Joshi. “We don’t need to biopsy the lump in every case.”
Lastly, if you’re nervous about going to your doctor’s office to have a lump checked during COVID-19, don’t be. Houston Methodist doctor offices and imaging centers have enhanced safety measures in place and are taking extra precautions to keep you safe during your appointment or mammogram, including:
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Its Like Getting Hit By Lightning
Breast cancer is the second-most common cancer among women in the United States. This year, more than 226,000 new cases will be diagnosed, most in women over 45. Only 1 in 8 instances occur in people younger than that, and even then, the disease is far more common among those in their thirties and early forties. According to data from the American Cancer Society, the probability of a woman getting breast cancer is just 1 in 1,681 at age 20, compared with 1 in 232 at age 30, and 1 in 69 at age 40.
Certain women may be at higher risk, of course, but Haney was not thought to be among them. Aside from gender, she had none of the traditional risk factors. Though her mother is a thyroid cancer survivor, there was no history of breast or ovarian cancer on either side of the family, and both she and her mom tested negative for the BRCA 1 and 2 gene mutations. Haney had also been active her entire life, so she was and remains in great shape.
Compounding this is that no effective screening tool exists for people under 40. Most women dont start getting mammograms until later in life, so the disease may go undetected in younger individuals who dont know what signs or symptoms to look for.
There are so many women who wait, Haney says. Most people my age put off . They just dont think its anything to worry about. I feel really lucky that we caught my cancer early.
Causes Of Breast Cancer
No one knows the exact cause of breast cancer, but there are known risk factors such as:
- Changes to your genes: Known as genetic mutations
- Family history of breast cancer: If your mother or grandmother had breast cancer, you might be terrified you will get it too. But only about 5% to 10% of people diagnosed with breast cancer have a family history of this disease.
- More dense breasts: Breasts with higher amounts of connective tissue vs. fat can mask cancers.
- Personal history of cancer
- Prior exposure to radiation: Young women who have had radiation therapy for another condition, like Hodgkin lymphoma, are especially at high risk.
- Obesity: Being overweight or obese heightens the risk of breast cancer after menopause.
- Sedentary lifestyle
Some factors like smoking, obesity, and alcohol use are preventable factors, while others like older age and genetics are out of your control.
How Healthcare Is Changing To Keep People Safe
As anyone who has gone to a clinic or hospital in recent months knows, the pandemic is changing how healthcare is delivered. Healthcare facilities of all types and sizes are taking new steps to keep patients and staff from getting COVID-19.
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We all understand that COVID-19 is not going away, and so what we are all trying to do is adapt to the new normal so that we can limit exposures in the hospital and to healthcare workers, said Julie Sprunt, M.D., FACS, a breast surgeon with Texas Breast Specialists in Austin, Texas.
Some of the new safety strategies that healthcare facilities have adopted include:
Screening for COVID-19 symptoms
You are asked over the phone before a medical appointment and when you arrive at an appointment whether you have COVID-19 symptoms, have been in close contact to someone with COVID-19, or are waiting on an outstanding COVID-19 test result.
Some facilities ask these questions and take each persons temperature with a thermal scanner at the door, before they go into the building.
At many healthcare facilities, everyone patients and staff members must wear masks all the time.
More use of telemedicine
COVID-19 testing before surgery and chemotherapy
Shorter hospital stays
When To Start Screening
We recommend mammogram screening to start no earlier than age 40 and no later than age 50 for women of average risk for breast cancer, and continue through to at least age 74, says Dr. Andrejeva-Wright. Screening mammography should occur at least once every two years. For women whose screening mammograms show they have dense breasts, an extra testa breast ultrasoundis recommended.
Dr. Andrejeva-Wright says it is important to talk with a health care provider about when you should start getting mammograms, based on your unique health profile, and to make an appointment to see your doctor if you notice any unusual breast changes.
Any time a woman feels a breast mass, which does not go away, while doing a breast self-exam at any age, she should get it checked out, says Dr. Silber.
More than half of the time, women detect breast cancers themselves when they notice an unusual breast change. Whenever there is a new mass or lump, tell your doctorit should be evaluated by a clinical physical examination followed by breast imaging, says Dr. Andrejeva-Wright. Other signs to be aware of include asymmetry of the breasts and nipple changes such as discharge or peeling skin around the nipple.
Says Dr. Andrejeva-Wright, These symptoms dont mean you have breast cancer, but its a reason to seek an opinion from a medical provider.
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Soft Tissue And Bone Cancers
Sarcomas are cancers that start in connective tissues such as muscles, bones, or fat cells. There are 2 main types of sarcoma:
- Soft tissue sarcomas
- Bone sarcomas
Sarcomas can develop at any age, but some types occur most often in older teens and young adults.
Soft tissue sarcomas: These cancers can start in any part of the body, but they often develop in the arms or legs. Rhabdomyosarcoma, a cancer that starts in cells that normally develop into skeletal muscles, is most common in children younger than 10, but it can also develop in teens and young adults. Most other types of soft tissue sarcomas become more common as people age. Symptoms depend on where the sarcoma starts, and can include lumps , swelling, or bowel problems.
Bone sarcomas: The 2 most common types of bone cancer,osteosarcoma and Ewing sarcoma, are most common in teens, but they can also develop in young adults. They often cause bone pain that gets worse at night or with activity. They can also cause swelling in the area around the bone.
Osteosarcoma usually starts near the ends of the leg or arm bones. The most common places for Ewing sarcoma to start are the pelvic bones, the bones of the chest wall , or in the middle of the leg bones.
Breast Cancer Does Not Stop During Covid
In spite of the COVID-19 pandemic, I strongly encourage people to get their mammography test. This is because early testing is so important in treating breast cancer, according to Dr. Mary Lou Te-Charcos, an OB-Gyne who has been practicing for almost 9 years in Cebu. In addition to working with several hospitals around Cebu, the OB-Gyne has continually served cancer patients throughout the pandemic from her clinic in HPDs newly renovated Mandaue branch.
Newly renovated Mandaue branch of Hi-Precision Diagnostics Cebu | Contributed Photo |
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What Are The Symptoms Of Inflammatory Breast Cancer
Symptoms of inflammatory breast cancer include swelling and redness that affect a third or more of the breast. The skin of the breast may also appear pink, reddish purple, or bruised. In addition, the skin may have ridges or appear pitted, like the skin of an orange . These symptoms are caused by the buildup of fluid in the skin of the breast. This fluid buildup occurs because cancer cells have blocked lymph vessels in the skin, preventing the normal flow of lymph through the tissue. Sometimes the breast may contain a solid tumor that can be felt during a physical exam, but more often a tumor cannot be felt.
Other symptoms of inflammatory breast cancer include a rapid increase in breast size sensations of heaviness, burning, or tenderness in the breast or a nipple that is inverted . Swollen lymph nodes may also be present under the arm, near the collarbone, or both.
It is important to note that these symptoms may also be signs of other diseases or conditions, such as an infection, injury, or another type of breast cancer that is locally advanced. For this reason, women with inflammatory breast cancer often have a delayed diagnosis of their disease.
When To Worry About Breast Lumps
So, you feel a lump in your breast. Or, is it a lump? You’re unsure.
The one thing you are sure about is that you’re worried and that you’ve got a lot of questions.
If you’re concerned about something that feels like a lump in your breast, Dr. Jitesh Joshi, medical oncologist at Houston Methodist Cancer Center, has answers to your questions about breast lumps, as well as some advice.
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Breast Lumps In Adolescents: Causes
- Breast masses in teens are almost always benign .
- Breast cancer is very rare in teens
- Fibroadenoma: most breast masses in teens are fibroadenomas. They are 1 inch oval or round, rubbery, non-tender mass. Most often in upper-outer quadrant of breast. Not associated with breast cancer. Natural course: 50% go away within 5 years, others need removal.
- Juvenile fibroadenomas: breast masses that are larger than 2 inches in size. Benign, but need to be removed by surgery.
- Breast cysts
- Breast abscess: this is a red, painful lump. Main cause is Staph bacteria. Main triggers are nipple injury, nipple piercing or lactation . Needs oral antibiotics and needle removal of the pus.
- Breast collections of blood from injury: may take weeks or months to resolve.
Cu Cancer Center Member Anosheh Afghahi Md Explains Whats Going On And How Doctors Are Dealing With The Problem
The COVID-19 vaccines are beginning to significantly slow the spread of the virus, but the Pfizer and Moderna and vaccines are having an unforeseen consequence for breast cancer doctors. The vaccines often cause swelling in the armpit or underarm that can mimic the lumps associated with breast cancer, causing some women undue concern.
Medical oncologist and University of Colorado Cancer Center member Anosheh Afghahi, MD, has encountered the problem in her own practice in the following discussion she explains what is happening and what providers are doing about it.
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The Emotional Toll Of Breast Cancer
Younger women are more likely to be affected to the point of depression if they feel overwhelmed by the disease. In addition, unlike older breast cancer patients, they generally lack a strong peer support system
“I think when you’re older you expect it more… it’s not something that’s atypical for your peer group,” said Bryndza’s doctor, Dr. Dawn Hershman, co-director of the breast cancer program at the Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center. “When you’re young you feel like you’re the only one. Everybody wants to help but no one knows what it’s like.”
But younger women may not want empathy, craving normality instead. Often, the greatest source of anxiety for a young woman with breast cancer is not the disease — it’s whether their peers will treat them differently. Both Thompson and Bryndza said they felt the most anxious about heading back to school.
“Because she was so young, she did not know exactly what was, and that helped her deal with it,” Anderson said. “But she was worried about her peers — if they were going to talk about her as if she had a disease… She didn’t want a lot of young people to know. I guess because she didn’t understand herself what was going on, they might not understand either.”
Things Fall Apart
“It was hard because I was such a wreck, emotionally, sometimes,” Bryndza said. “I needed to focus on myself and my health and it was hard to be in a relationship when I had to worry about myself.”
The First Wave: Widespread Delays And Disruptions In Breast Cancer Care
On March 11, 2020, the World Health Organization said that COVID-19 had become a pandemic a disease that has spread across multiple countries. The U.S. declared a national emergency shortly after. As the first shutdowns began and many of us started to learn the term social distancing,” thousands of Americans received even more troubling news: they had a breast cancer diagnosis.
Nancy Richards, 67, of Barnstable, Mass., was one of those people. She found out in March that she had invasive ductal carcinoma. Because it was her second breast cancer diagnosis, she quickly made up her mind about what to do without having to do much research.
Since it was right at the beginning of the pandemic, everything was sped up very quickly, she said. I went from diagnosis to surgery in 2 weeks.
On the day of her surgery a double mastectomy with no reconstruction Nancy had to go to the hospital alone. No visitors were allowed.
My husband had to drop me off and pick me up at the curb. Like a parcel. That was a little bit hard, she said.
To protect her from being exposed to COVID-19, the hospital discharged Nancy right after the surgery, and almost all of her follow-up care took place over the phone.
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If Maria wanted to have surgery in March, her surgeon told her that she could have only the breast with cancer removed and no reconstruction.
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Can I Lower My Risk Of Getting A Second Cancer
There’s no sure way to prevent all cancers, but there are steps you can take to lower your risk and stay as healthy as possible. Getting the recommended early detection tests, as mentioned above, is one way to do this.
Its also important to stay away from tobacco products. Smoking increases the risk of many cancers, including some of the second cancers seen after breast cancer.
To help maintain good health, breast cancer survivors should also: