Targeted Drug Therapies For Breast Cancer
Targeted therapies are newer treatments for breast cancer patients. They utilize specific proteins within cancer cells, like the HER-2 protein. Targeted therapies can stop the HER-2 protein from stimulating tumor growth in cancer cells that have this protein. Targeted therapies have fewer side effects than traditional chemotherapy because they only target cancer cells. They are often used in combination with chemotherapy.
Combining Ultrasound For Breast Cancer With Mri Or Biopsy
Research shows that the combination of ultrasound with Magnetic Resonance Imaging is a particularly good combination in follow-up evaluation of lesions found on mammography.
The detail of the MRI greatly assists in diagnostic and treatment decisions. Ultrasound is also very useful in guiding the needle during a follow-up biopsy.
Is Breast Cancer Genetic
Breast cancer occurs in both men and women, but it is about 100 times more likely to affect women than men. Women over age 55 and those with a close relative who have had the condition are at greatest risk for developing breast cancer. Still, up to 80% of women who do get breast cancer do not have a relative with the disease. Certain inherited genetic mutations dramatically increase a women’s risk of breast cancer. The most common of these are genes known as BRCA1 and BRCA2. Women who inherit mutations in these genes have up to an 80% chance of developing breast cancer.
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How Does A Radiologist See Breast Cancer On Mammography & Ultrasound
When you look at mammography or ultrasound images, you might wonder how radiologists make any sense of them. How can they identify potential cancers in those Rorschach tests of gray and white? While even the most advanced imaging technology doesnt allow radiologists to identify cancer with certainty, it does give them some strong clues about what deserves a closer look. Today well discuss a few things that radiologists are on the lookout for when examining mammography and breast ultrasound images.
When radiologists look at a mammogram, theyre looking for three primary things:
- Changes from what is seen in previous images
If youve had a mammogram before, it is helpful to give your current radiologist access to your previous mammography images. Anytime you visit a new mammography clinic, let them know where youve had breast imaging done in the past so they are able to note any changes over time.
Masses comprise a variety conditions, including cysts, benign solid tumors, and malignancies. Their size, shape, borders, and internal composition can give insight into whether they represent cancer. Cancerous tumors often appear as white masses with blurry or spiked borders, which indicate infiltration into the surrounding tissue. Cysts are often indistinguishable from solid tumors on a mammogram, so ultrasound is often used to determine whether a mass is solid or fluid filled .
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.
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What Can An Ultrasound Reveal About A Potential Breast Cancer Lesion
A sonogram gives a good indication of the liquid or solid nature of a lesion, or perhaps a combination.
Liquid masses tend to be darker in color and homogeneous.
An experienced radiologist gains a feel for what the different textures of a sonogram tend to represent. The shape of a lesion and also its margin are also quite evident on sonograms.
The above factors help determine whether a lesion is cancerous or benign .
Breast cancer lesions also tend to be somewhat random in shape, but not always. Benign fibroadenomas are usually round or oval.
However, ultrasound is not a definitive test, and tissue analysis via biopsy is usually necessary. Even when ultrasound suggests the presence of a fibrous nodule or complex cyst, a biopsy is still justified. Up to 15% of these types of growths end up being malignant.
Any echoes on the sonogram indicates that a solid nodule of some kind has blocked the path of the sound wave.
Analysis of the solid nodules on a breast sonogram requires considerable expertise and can give further clarity as to the benign or malignant nature of the lesion.
How Are Breast Lumps Diagnosed And Evaluated
Most breast lumps are benign . Proving that a lump is not cancer often involves imaging tests. One or more of the following imaging tests may be performed:
- mammogram: Mammography uses low dose x-rays to examine the breasts. This type of imaging involves exposing the breasts to a small amount of ionizing radiation to obtain pictures of the inside of the breasts. Either two single images or two tomosynthesis images are taken of each breast to begin the evaluation. Additional images may be needed. See theSafety page for more information about x-rays.
- breast ultrasound: Breast ultrasound uses sound waves to create pictures of the inside of the breasts. Breast ultrasound can capture images of areas of the breast that may be difficult to see with mammography. It can also help to determine whether a breast lump is solid or fluid.
- breast MRI: Breast MRI uses a powerful magnetic field, radiofrequency pulses and a computer to produce detailed pictures of the inside of the breasts. MRI is helpful in evaluating breast lumps that are not visible with mammography or ultrasoundalthough it may not be appropriate for all women. Your doctor will help determine if breast MRI is right for you. Breast MRI requires injection of contrast material.
If a lump is proven to be benign by its appearance on these exams, no further steps may need to be taken. Your doctor may want to monitor the area at future visits to check if the breast lump has changed, grown or gone away.
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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
Alternative To Reconstructive Surgery: Prosthesis
A prosthesis, or breast form, is an alternative to reconstructive surgery. A prosthesis offers the appearance of breasts without surgery. This is a device that is worn inside a bra or bathing suit to permit a balanced appearance when clothed. Breast prostheses come in many shapes, sizes, and materials . Breast prosthetic devices are often covered by insurance plans.
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Stage 4 Breast Cancer
Stage 4 breast cancer can have a tumor of any size, and its cancer cells have spread to nearby and distant lymph nodes as well as distant organs.
The testing your doctor does will determine the stage of your breast cancer, which will affect your treatment.
Although they generally have less of it, men have breast tissue just like women do. Men can develop breast cancer too, but its much rarer.
According to the ACS , breast cancer is 100 times less common in white men than in white women. Its 70 times less common in black men than in black women.
That said, the breast cancer that men develop is just as serious as the breast cancer women are diagnosed with. It also has the same symptoms.
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.
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Typical Categories Of Breast Ultrasound Results
Abnormal results of ultrasound will tend to fall into four categories.
So, a radiologist can usually tell if the echoes are caused by benignfibrous nodules .
Of slightly greater concern are sonographic indications of a complex cyst.
The third and fourth informal categories are more worrying and indicate an increase in the likelihood of cancer. These are suspicious lesion, and lesion highly suggestive of cancer.
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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Common Symptoms Of Breast Cancer
1. The first and the most common sign of breast cancer is a LUMP IN THE BREAST .9% of these lumps are benign and confused with cysts. Breast cysts are sacs of fluid in the breast tissue, which are quite common.
2. A LUMP OR THICKENED AREA in either breast or in the underarm area, it can be detected by regular self-examination for breast cancer.
3. A CHANGE IN SIZE OR SHAPE of one or both breasts.
4. PAIN in either breast or armpit unrelated to your period.
5. DISCHARGES Coming from either nipple, it may be bloody, or milky, if present when not breastfeeding you should be checked by a doctor right away.
6. DIMPLING Dimpling or sunken skin on your breasts, often referred to as orange-peel, from the similarity of appearance
7. RASHESAND REDNESS Rashes around your nipple. Redness or an enlarged underarm lymph node
This poster is one of the best illustrations that summarizes the visible and hidden signs of breast cancer:
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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Change In Size Shape Or Feel Of Your Breast
A cancer might cause your breast to look bigger or have a different shape than usual, it might feel different.
Many healthy women find that their breasts feel lumpy and tender just before their period.
It can help to be breast aware. This means getting to know the size, shape and feel of your breasts.
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.
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Breast Cancer Treatments: Chemotherapy
Chemotherapy drugs are given to kill cancer cells that are located anywhere in the body. It can be administered by a slow IV infusion, by pill, or by a brief IV injection, depending upon the drug. Sometimes chemotherapy is given after surgery to help prevent the cancer from recurring . Side effects of chemotherapy can include an increased risk of infection, nausea, fatigue, and hair loss.
If all visible cancer has been removed, there is still the possibility that cancer cells have broken off or are left behind. Adjunct chemotherapy is given to assure that these small amounts of cells are killed. Since some women have a very low risk of recurrence even without chemotherapy, it is not given in all cases.
Neoadjuvant chemotherapy is given before surgery. There is no correlation between neoadjuvant chemotherapy and long-term survival, but there are advantages to see if the cancer responds to the chemotherapy before surgical removal. This can also reduce the size of the cancer and allow for a less extensive surgery in some patients.
Chemotherapy for Advanced Breast Cancer
Chemotherapy can be used if the cancer has metastasized to distant sites in the body. In this case, doctors will determine the most appropriate treatment.
Chemotherapy Side Effects
- Permanent damage to the heart, lung, liver, kidneys, or reproductive system
What Are Lymph Nodes
Lymph nodes are small, rounded structures of about 1 mm to 25 mm that are found throughout the body.
The lymph nodes form part of the lymphatic system. The lymphatic system is an important part of the immune system that protects the body from disease and infection. It contains a network of thin tubes called lymph vessels that are found throughout the body. These lymph vessels transport a clear fluid called lymph between the lymph nodes. The lymph nodes filter the lymph to trap or remove substances harmful to the body, such as bacteria or cancer cells. This helps to protect the body from disease or infection. The lymph then passes back to the blood.
The closest lymph nodes to the breast are those in the armpit, which are known as axillary nodes. The axillary nodes drain lymph from nearby tissues, including the breast. There are also lymph nodes under the breastbone and in the neck . The number of lymph nodes varies between different people. There are usually about 15-30 lymph nodes in the armpit.
Because the lymph vessels carry lymph away from the breast, in the case of breast cancer, cancer cells can enter the lymph vessels and begin to grow in the lymph nodes. The axillary nodes are often the first place of cancer spread outside the breast. Usually, surgery is used to remove one or more of the axillary nodes to help check for cancer spread. Cancer found in the lymph nodes affects the staging and treatment of breast cancer.
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What Are The Symptoms Of Breast Cancer
Breast pain can be a symptom of cancer. If you have any symptoms that worry you, be sure to see your doctor right away.
Different people have different symptoms of breast cancer. Some people do not have any signs or symptoms at all.
Some warning signs of breast cancer are
- New lump in the breast or underarm .
- Thickening or swelling of part of the breast.
- Irritation or dimpling of breast skin.
- Redness or flaky skin in the nipple area or the breast.
- Pulling in of the nipple or pain in the nipple area.
- Nipple discharge other than breast milk, including blood.
- Any change in the size or the shape of the breast.
- Pain in any area of the breast.
Keep in mind that these symptoms can happen with other conditions that are not cancer.
If you have any signs or symptoms that worry you, be sure to see your doctor right away.