Treatment Of Noninvasive Cancer
For ductal carcinoma in situ, treatment usually consists of one the following:
Removal of the tumor and a large amount of surrounding normal tissue with or without radiation therapy
Some women with ductal carcinoma in situ are also given hormone-blocking drugs as part of their treatment.
For lobular carcinoma in situ, treatment includes the following:
Classic lobular carcinoma in situ: Surgical removal to check for cancer and, if no cancer is detected, close observation afterward and sometimes tamoxifen, raloxifene, or an aromatase inhibitor to reduce the risk of developing invasive cancer
Pleomorphic lobular carcinoma in situ: Surgery to remove the abnormal area and sometimes tamoxifen or raloxifene to reduce the risk of developing invasive cancer
Women with lobular carcinoma in situ are often given tamoxifen, a hormone-blocking drug, for 5 years. It reduces but does not eliminate the risk of developing invasive cancer. Postmenopausal women may be given raloxifene or sometimes an aromatase inhibitor instead.
Considerations For Bilateral Mastectomy
Increasingly, women with unilateral breast cancer are treated with bilateral mastectomy . The reason is to stop the risk of death from developing bilateral breast cancer, or cancer in the opposite breast. However, this treatment is controversial because bilateral mastectomy is not proven to decrease death from breast cancer.
It’s important to speak with your healthcare provider and assess your risk of developing bilateral breast cancer and whether this surgical intervention is warranted.
Stage Of Breast Cancer
When your breast cancer is diagnosed, the doctors will give it a stage. The stage describes the size of the cancer and how far it has spread.
Ductal carcinoma in situ is sometimes described as Stage 0. Other stages of breast cancer describe invasive breast cancer .
- Stage 1 the tumour measures less than 2cm and the lymph nodes in the armpit aren’t affected. There are no signs that the cancer has spread elsewhere in the body.
- Stage 2 the tumour measures 2-5cm or the lymph nodes in the armpit are affected, or both. There are no signs that the cancer has spread elsewhere in the body.
- Stage 3 the tumour measures 2-5cm and may be attached to structures in the breast, such as skin or surrounding tissues. The lymph nodes in the armpit are affected. However, there are no signs that the cancer has spread elsewhere in the body.
- Stage 4 the tumour is of any size and the cancer has spread to other parts of the body .
This is a simplified guide. Each stage is divided into further categories: A, B and C. If you’re not sure what stage you have, ask your doctor.
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What Are The Possible Side
Side-effects follow every other surgery and the same is true with double mastectomy. If proper care is taken, one can get rid of such side-effects easily.
Tiredness: The patient of double mastectomy might feel extremely fatigued for a couple of days after the surgery. It can even get uncomfortable lying in bed. Arranging pillows around the torso and sleeping in a reclining position with the help of a recliner can prove to be effective.
Numbness: The patient of double mastectomy may experience some form of unusual sensations in the chest and underarms like itchiness or some form of pressure. The chest may feel overly sensitive or completely numb. This is not abnormal and will go away with time.
Stiffness: Some amount of stiffness may be experienced in arms and shoulders. Stretching exercises may provide some relief.
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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When To See Your Healthcare Provider
It’s important to talk to your healthcare provider if you have breast pain from any cause. Even if it’s not due to cancer, many women find that breast pain decreases their quality of life. In one study, 15% of women experienced breast pain at some time in their life that interfered with work and family activities. Make sure to talk to your healthcare provider if you are experiencing any unusual discomfort.
Heinz’s Form Of Cancer Rare But Treatable
Denise MannSTORY HIGHLIGHTS
- Teresa Heinz revealed that she has been diagnosed with early-stage cancer in both breasts
- Only about 2 to 5 percent of all breast cancer cases occur in both breasts simultaneously
- Tumors can be of different severity and/or type in each breast
- Expert: Prognosis depends on the side with the most aggressive type of cancer
— The recent revelation by Teresa Heinz, wife of U.S. Senator John Kerry, that she has been diagnosed with early-stage cancer in both of her breasts has likely left many women wondering, “Could this happen to me?”
It could, but it’s unlikely. Only about 2 percent to 5 percent of all breast cancer cases occur in both breasts at the same time, experts say.
” not unheard of, because whatever causes breast cancer on one side can act on both breasts,” says Nayana Dekhne, M.D., the director of the Comprehensive Breast Care Program at William Beaumont Hospital in Royal Oak, Michigan.
Even if you are one of the few women to experience this type of breast cancer, the scenario isn’t always as dire as it sounds. Breast cancer experts are quick to point out that a woman’s prognosis is not necessarily worse if she has breast cancer in both breasts, and that the outcomes in such cases are often excellent.
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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.
What Is A Bilateral Mastectomy
Also called a double mastectomy, this is when both breasts are surgically removed. The term Contralateral Prophylactic Mastectomy is also used by the medical community for removal of the opposite, non-cancerous breast. Most of the time the decision to have a bilateral mastectomy is a personal one and is not required to treat a breast cancer that is on one side.
There are situations where a bilateral mastectomy may be offered for consideration by your breast surgeon. The medical aspects are more complicated than listed below, but we include some common scenarios.
- BRCA mutation or other high-risk genetic mutation
- Strong family history of breast cancer
- Younger than 35 with breast cancer
- High risk for developing a new cancer
- Radiation to your chest at a young age
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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.
Genetic Counseling And Testing
If there are reasons to think you might have inherited a gene change that increases your risk of breast cancer , you might want to talk to your doctor about genetic counseling to see if you should be tested. To learn more, see Genetic Counseling and Testing for Breast Cancer Risk.
If you decide to be tested and a gene change is found, this might affect your decision about using the options below to help lower your risk for breast cancer
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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.
Prevention Against Breast Cancer:
Making lifestyle changes can help lower your risk of breast cancer. Make an effort to:
- Enquire about breast cancer screening with your doctor.
- Breast self-examination might help you become more aware of your breasts.
- If you must drink alcohol, do it in moderation. If you prefer to drink, keep your alcohol consumption to no more than one drink each day.
- Most days of the week, you should exercise. On most days of the week, try to get in at least 30 minutes of exercise. If you havent been active in a while, consult your doctor and begin slowly.
- Hormone therapy for postmenopausal women should be kept to a minimum. Breast cancer risk may be increased by using a combination of hormones. Discuss the advantages and disadvantages of hormone therapy with your doctor.
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Reproductive History Estrogen Is The Main Hormone Associated With Breast Cancer Estrogen Affects The Growth Of Breast Cells Experts Believe That It Plays An Important Role In The Growth Of Breast Cancer Cells As Well The Type Of Exposure And How Long Cells Are Exposed To Estrogen Affects The Chances That Breast Cancer Will Develop
The start of menstruation is called menarche. Early menarche is when menstruation starts at an early age . Starting your period early means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk of breast cancer.
Menopause occurs as the ovaries stop making hormones and the level of hormones in the body drops. This causes a woman to stop menstruating. If you enter menopause at a later age , it means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk for breast cancer. Likewise, menopause at a younger age decreases the length of time breast tissue is exposed to estrogen and other hormones. Early menopause is linked with a lower risk of breast cancer.
Late pregnancy or no pregnancies
Pregnancy interrupts the exposure of breast cells to circulating estrogen. It also lowers the total number of menstrual cycles a woman has in her lifetime.
Women who have their first full-term pregnancy after the age of 30 have a slightly higher risk of breast cancer than women who have at least one full-term pregnancy at an earlier age. Becoming pregnant at an early age reduces breast cancer risk.
The more children a woman has, the greater the protection against breast cancer. Not becoming pregnant at all increases the risk for breast cancer.
What Is The Prognosis Of Patients With Inflammatory Breast Cancer
The prognosis, or likely outcome, for a patient diagnosed with cancer is often viewed as the chance that the cancer will be treated successfully and that the patient will recover completely. Many factors can influence a cancer patients prognosis, including the type and location of the cancer, the stage of the disease, the patients age and overall general health, and the extent to which the patients disease responds to treatment.
Because inflammatory breast cancer usually develops quickly and spreads aggressively to other parts of the body, women diagnosed with this disease, in general, do not survive as long as women diagnosed with other types of breast cancer.
It is important to keep in mind, however, that survival statistics are based on large numbers of patients and that an individual womans prognosis could be better or worse, depending on her tumor characteristics and medical history. Women who have inflammatory breast cancer are encouraged to talk with their doctor about their prognosis, given their particular situation.
Ongoing research, especially at the molecular level, will increase our understanding of how inflammatory breast cancer begins and progresses. This knowledge should enable the development of new treatments and more accurate prognoses for women diagnosed with this disease. It is important, therefore, that women who are diagnosed with inflammatory breast cancer talk with their doctor about the option of participating in a clinical trial.
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What Are Signs Of Breast Cancer Other Than Lumps
Other symptoms besides a lump that warn of breast cancer include:
- a nipple that turns inward
- redness, scaling, or thickening of the nipple.
- a change in the texture of the skin on the breast.
- clear or bloody discharge from the nipple, or a milky discharge if youre not breastfeeding.
- dimpled skin on the breast.
What Causes Breast Cancer
While there is no specific cause for breast cancer, some lifestyle factors are associated with a higher risk of developing the condition:
- Drinking alcohol may raise oestrogen levels in the body and is associated with a 30 to 50% increased risk of breast cancer.
- Unhealthy weight Being obese is associated with a 20 to 40% increased risk of breast cancer in post-menopausal women.
- Smoking, particularly if you started as a teenager, increases your breast cancer risk.
Other factors that cant be changed also impact your likelihood of getting breast cancer:
- Your age The older you get, the more likely it is your cells become damaged and progress to cancer. Nearly 4 in 5 new breast cancers are diagnosed in women over 50 years.
- Your family history Women with a first-degree relative with breast cancer are twice as likely to get it themselves than women without one.
- Having BRCA1, BRCA2 or other gene mutations Up to 1 in 10 breast cancers are due to a strong family history of these genetic mutations.
- Dense breasts Women with more dense tissue in their breasts may have a higher risk of breast cancer.
- Previous radiation exposure Women who were exposed to radiation therapy in the chest region may have 5 times the risk of breast cancer as women who were not.
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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.
Does Having Cancer In Both Breasts At The Same Time Affect Survival
National Breast Cancer Audit data shows that an average of 2.3% of women with invasive breast cancer in one breast also had cancer in the second breast diagnosed either at the same time, or within three months of the first diagnosis. This is called synchronous bilateral breast cancer .
The likelihood of SBBC increased with age, ranging from 1.4% in women under 40 to 4.1% in those over 80. It was also slightly more likely among patients with:
- tumours originating somewhere other than the milk duct
- large tumours
- less aggressive forms of cancer
- no cancer in the blood or lymphatic vessels.
Five-year survival for patients with SBBC was not significantly different from patients with cancer in one breast only. For this reason, SBBC is not considered useful in predicting survival for the majority of patients.
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Stage 3 Breast Cancer
- Stage 3A:
- The cancer has spread to 49 axillary lymph nodes or has enlarged the internal mammary lymph nodes, and the primary tumor can be any size.
- Tumors are greater than 5 cm, and the cancer has spread to 13 axillary lymph nodes or any breastbone nodes.