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.”
What Are The Types Of Breast Cancer
The most common types of breast cancer are:
- Infiltrating ductal carcinoma. This cancer starts in the milk ducts of the breast. It then breaks through the wall of the duct and invades the surrounding tissue in the breast. This is the most common form of breast cancer, accounting for 80% of cases.
- Ductal carcinoma in situ is ductal carcinoma in its earliest stage, or precancerous . In situ refers to the fact that the cancer hasn’t spread beyond its point of origin. In this case, the disease is confined to the milk ducts and has not invaded nearby breast tissue. If untreated, ductal carcinoma in situ may become invasive cancer. It is almost always curable.
- Infiltrating lobular carcinoma. This cancer begins in the lobules of the breast where breast milk is produced, but has spread to surrounding tissues in the breast. It accounts for 10 to 15% of breast cancers. This cancer can be more difficult to diagnose with mammograms.
- Lobular carcinoma in situ is a marker for cancer that is only in the lobules of the breast. It isn’t a true cancer, but serves as a marker for the increased risk of developing breast cancer later, possibly in both or either breasts. Thus, it is important for women with lobular carcinoma in situ to have regular clinical breast exams and mammograms.
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.
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Symptoms If Cancer Has Spread To The Bones
You may have any of these symptoms if your cancer has spread to the bones:
- an ache or pain in the affected bone
- breaks in the bones because they are weaker
- breathlessness, looking pale, bruising and bleeding due to low levels of blood cells – blood cells are made in the bone marrow and can be crowded out by the cancer cells
Sometimes when bones are damaged by advanced cancer, the bones release calcium into the blood. This is called hypercalcaemia and can cause various symptoms such as:
Breast Screening After 70
If youre 71 or over you will not be automatically sent an invitation for screening.;
However, in some parts of the UK you can continue to have breast screening every three years if you contact your local breast screening unit and ask for it.;
Your GP surgery can put you in touch with your local breast screening clinic or you can look them up online.
Find out how to contact your local screening unit on the NHS website.;
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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.
Diagnosing Metastatic Breast Cancer
Getting a clear picture of where breast cancer has spread is essential for creating a personalized treatment plan. Your care team will likely use a combination of the following tests and tools to diagnose both localized and advanced breast cancer:
Ultrasound exam: With this imaging technique, sound waves create a picture of internal areas of the body.
Magnetic resonance imaging : This procedure produces detailed images using magnetic fields and radio waves.
Blood chemistry studies: A blood sample is taken to measure the amounts of certain substances that are released by your organs and tissues. A higher or lower amount of a particular substance may be a sign of disease.
Biopsy: A biopsy is the removal of cells or tissues so a pathologist may view them through a microscope. Your original breast cancer diagnosis was likely confirmed with a biopsy.
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Treatment Options For Metastatic Breast Cancer
Treatment for metastatic breast cancer often is based on systemic therapies, which use drugs rather than surgery or radiation. Metastases treatments are designed to shrink tumors and slow their growth, help ease symptoms and improve quality of life. Treatment may change, such as when one therapy stops working, or the side effects become too uncomfortable. Rather than having only one treatment, most patients undergo several treatments combined to help fight the cancer.
The four broad categories of drug-based treatments are:
Breast Cancer Symptoms You Shouldn’t Ignore
Most breast cancer symptoms are discovered by women during regular dailyactivities like bathing. Knowing how your breasts look and feel, andbeing alert for the signs and symptoms of breast cancer, like a lump,can help you detect the disease early, when it’s easiest to treat.
Most breast changes are due to hormonal cycles or conditions that are less worrying than breast cancer. However, if you experience any of the following breast cancer symptoms, even if they seem mild, see your doctor.
- A lump in the breast or armpit is the most common symptom of breast cancer. Patients often describe this as a ball or a nodule. Lumps may feel soft and rubbery or hard. Unless you have small breasts or the lump is very large, you probably wont be able to see it.
- Skin redness
- Nipple changes, including the nipple turning inward, pulling to one side or changing direction
- Ulcer on the breast or nipple
- Thickening of the skin, resulting in an orange-peel texture;
Though rare, men can also get breast cancer. The most common symptoms of male breast cancer are a lump, discharge or dimpling.
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Getting A Breast Biopsy
In a breast;biopsy, the doctor takes out small pieces of breast tissue to check them for cancer cells. A biopsy is the only way to tell for sure if you have breast cancer.
There are many types of biopsies. Ask your doctor what kind you will need. Each type has risks and benefits. The choice of which type to use depends on your own case.
Sometimes, surgery is needed to take out all or part of the lump to find out if its cancer. This is often done in a hospital using local anesthesia . You might also be given medicine to make you sleepy.
Why It Spreads And Recurs
You may be wondering why breast cancer cells travel at all. Or, why normal cells don’t spread around our bodies. Cancer cells differ from normal cells in many ways. One of these is that normal cells have what is known as “adhesion molecules.” These adhesion molecules act like glue and keep cells where they belong in a particular part of the body.
Normal cells also have “boundaries” or ways in which cells communicate with each other. This is like one country saying to another “you don’t belong here.” Cancer cells, in contrast, don’t respect these cellular communications, essentially ignoring the “fences” between different tissues.
Yet another confusing topic when talking about breast cancer spread is why it can happen years or even decades later. We know that, especially with estrogen receptor-positive breast cancers, cancer can seemingly disappear only to recur many years after the original tumor. Nobody is certain exactly how this happens, but there are theories about recurrence that suggest that some breast cancer cells are hardier than others and that these cancer “stem cells” are able to lie dormant even through treatment.
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Invasive Breast Cancer Symptoms
Most breast cancers start in the ducts, or the tubes that carry milk to the nipple, or in the lobules, the little clusters of sacs where breast milk is made. Invasive breast cancer refers to breast cancer that spreads from the original site to other areas of the breast, the lymph nodes or elsewhere in the body. In these cancers that form in the ducts or lobules, invasive ductal carcinoma ;or invasive lobular carcinoma , the cancer spreads from the ducts or lobules to other tissue. Depending on the stage, you may notice symptoms.
Invasive breast cancer symptoms may include:
- A lump or mass in the breast
- Swelling of all or part of the breast, even if no lump is felt
- Skin irritation or dimpling
- A lump or swelling in the underarm lymph nodes
Can Exercise Help Reduce My Risk Of Developing Breast Cancer
Exercise is a big part of a healthy lifestyle. It can also be a useful way to reduce your risk of developing breast cancer in your postmenopausal years. Women often gain weight and body fat during menopause. People with higher amounts of body fat can be at a higher risk of breast cancer. However, by reducing your body fat through exercise, you may be able to lower your risk of developing breast cancer.
The general recommendation for regular exercise is about 150 minutes each week. This would mean that you work out for about 30 minutes, five days each week. However, doubling the amount of weekly exercise to 300 minutes can greatly benefit postmenopausal women. The longer duration of exercise allows for you to burn more fat and improve your heart and lung function.
The type of exercise you do can vary the main goal is get your heart rate up as you exercise. Its recommended that your heart rate is raised about 65 to 75% of your maximum heart rate during exercise. You can figure out your maximum heart rate by subtracting your current age from 220. If you are 65, for example, your maximum heart rate is 155.
Aerobic exercise is a great way to improve your heart and lung function, as well as burn fat. Some aerobic exercises you can try include:
Remember, there are many benefits to working more exercise into your weekly routine. Some benefits of aerobic exercise can include:
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Questions To Ask Your Doctor About Breast Cancer
Its important to be able to have frank, open discussions with your cancer care team. They want to answer all of your questions, so that you can make informed treatment and life decisions.
Here are some questions that you can use to help better understand your cancer and your treatment options. Dont be afraid to take notes and tell the doctors or nurses when you dont understand what theyre saying. You might want to bring another person with you when you see your doctor and have them take notes to help you remember what was said.
Not all of these questions will apply to you, but they should help get you started. Be sure to write down some questions of your own. For instance, you might want more information about recovery times or you may want to ask about nearby or online support groups where you can talk with other women going through similar situations. You may also want to ask if you qualify for any;clinical trials.
Keep in mind that doctors arent the only ones who can give you information. Other health care professionals, such as nurses and social workers, can answer some of your questions. To find out more about speaking with your health care team, see The Doctor-Patient Relationship.
Breast Cancer: Symptoms And Signs
Have questions about breast cancer? Ask here.
ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.
The majority of women with breast cancer do not have any body changes or symptoms when they are first diagnosed with breast cancer.
The following signs and symptoms should be discussed with a doctor. Many times, the cause of a symptom may be a different medical condition that is not cancer.
A lump that feels like a hard knot or a thickening in the breast or under the arm. It is important to feel the same area in the other breast to make sure the change is not a part of healthy breast tissue in that area.
Change in the size or shape of the breast
Nipple discharge that occurs suddenly, is bloody, or occurs in only 1 breast
Physical changes, such as a nipple turned inward or a sore located in the nipple area
Skin irritation or changes, such as puckering, dimpling, scaliness, or new creases
A warm, red, swollen breast with or without a rash with dimpling resembling the skin of an orange, called peau dorange
Pain in the breast, particularly breast pain that does not go away. Pain is not usually a symptom of breast cancer, but it should be reported to a doctor.
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When Youre Told You Have Breast Cancer
- Exactly what type of breast cancer do I have?
- How big is the cancer? Where exactly is it?
- Has the cancer spread to my lymph nodes or other organs?
- Whats the stage of the cancer? What does that mean?
- Will I need any other tests before we can decide on treatment?
- Do I need to see any other doctors or health professionals?
- What is the hormone receptor status of my cancer? What does this mean?
- What is the HER2 status of my cancer? What does this mean?
- How do these factors affect my treatment options and long-term outlook ?
- What are my chances of survival, based on my cancer as you see it?
- Should I think about genetic testing? What are my testing options? Should I take a home-based genetic test? What would be the reasons for and against testing?
- How do I get a copy of my pathology report?
- If Im concerned about the costs and insurance coverage for my diagnosis and treatment, who can help me?
Second Opinions For Breast Cancer
Detecting breast cancer can be a complicated process, so health professionals always encourage patients to undergo different tests and get a second opinion prior to beginning any treatment to ensure an accurate diagnosis. Breast tumors and other abnormalities aren’t always cancerous, so breast imaging tests, like mammograms and breast MRI’s, examine deep breast tissue and are necessary to properly diagnose cancer. A second opinion can also help patients determine the best path for treatment, as different specialists can provide different insights for treatment options. Patients should keep records of all visits and diagnoses to maintain evidence for a malpractice lawsuit if a misdiagnosis occurs.
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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
What Clinical Trials Are Available For Women With Inflammatory Breast Cancer
NCI sponsors clinical trials of new treatments for all types of cancer, as well as trials that test better ways to use existing treatments. Participation in clinical trials is an option for many patients with inflammatory breast cancer, and all patients with this disease are encouraged to consider treatment in a clinical trial.
Descriptions of ongoing clinical trials for individuals with inflammatory breast cancer can be accessed by searching;NCIs list of cancer clinical trials. NCIs list of cancer clinical trials includes all NCI-supported clinical trials that are taking place across the United States and Canada, including the NIH Clinical Center in Bethesda, MD. For information about how to search the list, see Help Finding NCI-Supported Clinical Trials.
People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from NCIs Cancer Information Service;at 18004CANCER ;and in the NCI booklet Taking Part in Cancer Treatment Research Studies. Additional information about clinical trials is available online.
Anderson WF, Schairer C, Chen BE, Hance KW, Levine PH. Epidemiology of inflammatory breast cancer . Breast Diseases 2005; 22:9-23.
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