How Is Inflammatory Breast Cancer Treated
Inflammatory breast cancer is generally treated first with systemic chemotherapy to help shrink the tumor, then with surgery to remove the tumor, followed by radiation therapy. This approach to treatment is called a multimodal approach. Studies have found that women with inflammatory breast cancer who are treated with a multimodal approach have better responses to therapy and longer survival. Treatments used in a multimodal approach may include those described below.
What Are The Risk Factors For Breast Cancer
Being a woman and getting older are the main risk factors for breast cancer.
Studies have shown that your risk for breast cancer is due to a combination of factors. The main factors that influence your risk include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older.
Some women will get breast cancer even without any other risk factors that they know of. Having a risk factor does not mean you will get the disease, and not all risk factors have the same effect. Most women have some risk factors, but most women do not get breast cancer. If you have breast cancer risk factors, talk with your doctor about ways you can lower your risk and about screening for breast cancer.
Relative Risks Greater Than 1
A relative risk between 1 and 1.99 may be presented in several ways.
For example, in the exercise study above, the relative risk was 1.25.
You may see:
- Inactive women have a relative risk of 1.25 compared to active women.
- Inactive women have a 25 percent higher risk of breast cancer compared to active women.
- Inactive women have a 1.25-fold increased risk of breast cancer compared to active women.
When a relative risk is 2 or more, its often presented as the number of times the risk is increased.
For example, women with atypical hyperplasia have a relative risk of about 4 compared to women without atypical hyperplasia.
You may see:
- Women with atypical hyperplasia have 4 times the risk of breast cancer of women without atypical hyperplasia.
- Theres a 4-fold increase in the risk of breast cancer among women with atypical hyperplasia compared to women without atypical hyperplasia.
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Breast Changes During Your Lifetime That Are Not Cancer
Most women have changes in the breasts at different times during their lifetime.
- Before or during your menstrual periods, your breasts may feel swollen, tender, or painful. You may also feel one or more lumps during this time because of extra fluid in your breasts. Your health care provider may have you come back for a return visit at a different time in your menstrual cycle to see if the lump has changed.
- During pregnancy, your breasts may feel lumpy. This is usually because the glands that produce milk are increasing in number and getting larger. While breastfeeding, you may get a condition called mastitis. This happens when a milk duct becomes blocked. Mastitis causes the breast to look red and feel lumpy, warm, and tender. It may be caused by an infection and it is often treated with antibiotics. Sometimes the duct may need to be drained.
- As you approach menopause, your hormone levels change. This can make your breasts feel tender, even when you are not having your menstrual period. Your breasts may also feel more lumpy than they did before.
- If you are taking hormones your breasts may become more dense. This can make a mammogram harder to interpret. Be sure to let your health care provider know if you are taking hormones.
- After menopause, your hormone levels drop. You may stop having any lumps, pain, or nipple discharge that you used to have.
Your Armpit Lymph Nodes Are Swollen
Most people are always looking for bumps in their breasts, but don’t forget to check your lymph nodes for swelling, too. “Many patients who end up diagnosed with breast cancer that has spread to the lymph nodes have no symptoms in the breast, no changes in the structure of the breast, but they come in for a consult because they feel something under their arm,” says Alvarez. “This may mean that cancer from the breast has traveled to the lymph nodes, and now there is lymph node invasion.”
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Treatment At A Glance
Treatment for breast cancer depends on how far the disease has spread and your general health when you are diagnosed. Some treatment options include:
- Surgery:In these cases, a lumpectomy or mastectomy is carried out. A lumpectomy includes the removal of the tumor and surrounding tissue. A mastectomy involves the removal of the whole breast.
- Radiation:Using cancer-killing beams, radiation therapy targets undetected cancer cells, further reducing the risk of cancer returning.
- Hormone therapy:This treatment is effective for those breast cancers that are affected by hormones in the blood.
- Chemotherapy: This is usually given after breast surgery but before radiation, and uses drugs directly injected into the vein via a needle or taken in pill form to target and kill cancer cells.
Puberty And Overlapping Breast Cancer Symptoms
When breasts begin to grow, they appear as a lump underneath the nipple. This is a normal part of the development process.
The breasts get bigger and rounder as the fatty tissue and milk-producing glands inside the breasts continue to grow. As the breast buds grow, you may notice tingling, aching, or itching in your chest, and your nipples may swell or become tender.
After your periods start, the changing hormones may make your breasts feel tender, swollen, or sore a week or so just before your period starts. This is all normal.
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How Does Psychological Stress Affect People Who Have Cancer
People who have cancer may find the physical, emotional, and social effects of the disease to be stressful. Those who attempt to manage their stress with risky behaviors such as smoking or drinking alcohol or who become more sedentary may have a poorer quality of life after cancer treatment. In contrast, people who are able to use effective coping strategies to deal with stress, such as relaxation and stress management techniques, have been shown to have lower levels of depression, anxiety, and symptoms related to the cancer and its treatment. However, there is no evidence that successful management of psychological stress improves cancer survival.
Evidence from experimental studies does suggest that psychological stress can affect a tumors ability to grow and spread. For example, some studies have shown that when mice bearing human tumors were kept confined or isolated from other miceconditions that increase stresstheir tumors were more likely to grow and spread . In one set of experiments, tumors transplanted into the mammary fat pads of mice had much higher rates of spread to the lungs and lymph nodes if the mice were chronically stressed than if the mice were not stressed. Studies in mice and in human cancer cells grown in the laboratory have found that the stress hormone norepinephrine, part of the bodys fight-or-flight response system, may promote angiogenesis and metastasis.
Why Dont All Of The Studies Agree
Induced abortion brings up many strong feelings in people, so it is often hard to study its long-term effects.
Before 1973, induced abortions were illegal in much of the United States. So when researchers asked a woman about past pregnancies, she may not have felt comfortable saying that she had an abortion. Even though abortion is now legal, it is still a very personal, private matter that many women do not like to talk about. This means that many women might not report having an abortion if asked for a study. In contrast, women with breast cancer are more likely to accurately report their reproductive histories, including a history of having an abortion. This recall bias could lead to retrospective studies finding links that arent found in prospective studies. Still, not everyone agrees that this is the reason that the different types of studies conflict.
In general, though, when prospective and retrospective studies conflict, experts generally accept the results of the prospective studies over the retrospective studies.
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Breast Lumps In Teenagers
It can be normal to feel lumps when your breasts are developing and these often disappear on their own.
If a lump causes you any discomfort, appears to get bigger or youre worried about it, talk to someone such as your GP. You may also want to talk to someone in your family or a school nurse.
Although its very unlikely that theres anything wrong, a doctor can check it out and should put your mind at rest. You can ask to see a female doctor or the practice nurse if this will make you feel more comfortable.
Very occasionally lumps are a sign of a benign breast condition. Benign means harmless, and a benign condition will not become a breast cancer. The most common benign lump as the breasts are developing is known as a fibroadenoma.
Teen Breast Cancer Outlook
It is estimated by researchers that 80% of teens diagnosed with breast cancer at the ages of 15 to 19 will still be alive 5 years later. Since its extremely rare in teens, doctors may take the approach of wait and see by delaying treatment. Its still important to take appropriate steps in preventing breast cancer like maintaining a healthy weight and diet, avoiding tobacco products, and staying physically active.
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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.
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.
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How Do Tamoxifen Raloxifene Anastrozole And Exemestane Reduce The Risk Of Breast Cancer
If you are at increased risk for developing breast cancer, four medications tamoxifen , raloxifene , anastrozole , and exemestane may help reduce your risk of developing this disease. These medications act only to reduce the risk of a specific type of breast cancer called estrogen receptor-positive breast cancer. This type of breast cancer accounts for about two-thirds of all breast cancers.
Tamoxifen and raloxifene are in a class of drugs called selective estrogen receptor modulators . These drugs work by blocking the effects of estrogen in breast tissue by attaching to estrogen receptors in breast cells. Because SERMs bind to receptors, estrogen is blocked from binding. Estrogen is the fuel that makes most breast cancer cells grow. Blocking estrogen prevents estrogen from triggering the development of estrogen-receptor-positive breast cancer.
Anastrozole and exemestane are in a class of drugs called aromatase inhibitors . These drugs work by blocking the production of estrogen. Aromatase inhibitors do this by blocking the activity of an enzyme called aromatase, which is needed to make estrogen.
Will I Die Of Breast Cancer
This is a difficult question to answer early in your cancer care but it is still worth asking. Many people just diagnosed with cancer have no idea how much of a risk to their life their unique situation poses. Most breast cancers carry a low risk of recurrence, especially early-stage cancers. The answer is usually reassuring.
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How A Breast Cancers Stage Is Determined
Your pathology report will include information that is used to calculate the stage of the breast cancer that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body. Your doctor will begin to determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. He or she also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.
The breast cancer staging system, called the TNM system, is overseen by the American Joint Committee on Cancer . The AJCC is a group of cancer experts who oversee how cancer is classified and communicated. This is to ensure that all doctors and treatment facilities are describing cancer in a uniform way so that the treatment results of all people can be compared and understood.
In the past, stage number was calculated based on just three clinical characteristics, T, N, and M:
- the size of the cancer tumor and whether or not it has grown into nearby tissue
- whether cancer is in the lymph nodes
- whether the cancer has spread to other parts of the body beyond the breast
Numbers or letters after T, N, and M give more details about each characteristic. Higher numbers mean the cancer is more advanced. Jump to more detailed information about the TNM system.
Jump to a specific breast cancer stage to learn more:
Breast Examination After Treatment For Breast Cancer
After surgery
The incision line may be thick, raised, red and possibly tender for several months after surgery. Remember to examine the entire incision line.
If there is redness in areas away from the scar, contact your physician. It is not unusual to experience brief discomforts and sensations in the breast or nipple area .
At first, you may not know how to interpret what you feel, but soon you will become familiar with what is now normal for you.
After breast reconstruction
Following breast reconstruction, breast examination for the reconstructed breast is done exactly the same way as for the natural breast. If an implant was used for the reconstruction, press firmly inward at the edges of the implant to feel the ribs beneath. If your own tissue was used for the reconstruction, understand that you may feel some numbness and tightness in your breast. In time, some feeling in your breasts may return.
After radiation therapy
After radiation therapy, you may notice some changes in the breast tissue. The breast may look red or sunburned and may become irritated or inflamed. Once therapy is stopped, the redness will disappear and the breast will become less inflamed or irritated. At times, the skin can become more inflamed for a few days after treatment and then gradually improve after a few weeks. The pores in the skin over the breast also may become larger than usual.
What to do
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Does Abortion Affect Hormones During Pregnancy
Concern about a possible link between abortion and breast cancer has been raised because abortion is thought to interrupt the normal cycle of hormones during pregnancy. Some believe that this interruption might increase a womans risk of developing breast cancer.
There are different types of abortion:
- Spontaneous abortion, which most people refer to as a miscarriage, is the loss of a fetus before 5 months into the pregnancy. It is often caused by problems with the fetus or with the maternal environment in which it is growing.
- Stillborn birth is usually considered to be the death of a fetus after 5 months gestation while still in the uterus .
- Induced abortion is a medical procedure done to end a pregnancy. It is what most people think of when they hear abortion.
All of these have been studied to see what effect they may have on a womans risk of developing breast cancer later in life.
Can Psychological Stress Cause Cancer
Although stress can cause a number of physical health problems, the evidence that it can cause cancer is weak. Some studies have indicated a link between various psychological factors and an increased risk of developing cancer, but others have not.
Apparent links between psychological stress and cancer could arise in several ways. For example, people under stress may develop certain behaviors, such as smoking, overeating, or drinking alcohol, which increase a persons risk for cancer. Or someone who has a relative with cancer may have a higher risk for cancer because of a shared inherited risk factor, not because of the stress induced by the family members diagnosis.
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