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.
Early Signs Of Breast Cancer
Pinpointing breast cancer in its earliest stages isnt easy becauseare different for everyone. Sometimes there is a palpable lump or tenderness. Very often, there is neither. Generally, breast cancer shows no symptoms in the early stage.
However, there are certain changes in the breast that may indicate breast cancer in both men and women.
Whether you are a man or a woman, its important to become familiar with your breasts so you can recognize when changes occur and seek timely treatment. Know the facts and understand your risk factors for the disease, such as , by reviewing these frequently asked questions.
How Children May React To Your Breast Cancer
Children react differently depending on their age, character, stage of development and their relationship with you, so it can be hard to predict what will happen when you tell your children about your breast cancer.
Most of all, your children need to know that everyones doing all they can to make you better, that you still love and care for them, and that there are things they can do to help. Keeping to your usual boundaries and routines as much as possible can reassure them too.
Try to give them time and opportunities to talk about how they feel. Its best not to push them if they would rather not talk, especially at first, and they might only think of questions later. Your children may prefer to talk things over with their friends rather than with you, especially if they are older. If this is the case, it can be helpful to talk with friends parents first, so that everyone is saying the same thing.
You might find that your children ask the same questions over and over again. This is normal and is probably their way of getting reassurance and checking in with you. Try to be patient with them and consistent with your responses, using terms they understand.
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How Is Breast Cancer Diagnosed
Magnetic resonance imaging may be used to diagnose breast cancer.
Doctors often use additional tests to find or diagnose breast cancer. They may refer women to a breast specialist or a surgeon. This does not mean that she has cancer or that she needs surgery. These doctors are experts in diagnosing breast problems.
- Breast ultrasound. A machine that uses sound waves to make detailed pictures, called sonograms, of areas inside the breast.
- Diagnostic mammogram. If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.
- Magnetic resonance imaging . A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.
- Biopsy. This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies .
Getting More Help For You And Your Children
If your children seem low for long periods, or they are withdrawn or uninterested in what is going on around them, talk to your GP or treatment team. If necessary they can refer your children to a counsellor or to your local child and adolescent mental health service. Some people find group therapy with other young people can be helpful, or activity days such as those offered by Maggies Centres.
Specialist child and adolescent mental health services are NHS services that focus on the needs of children and young people. They are made up experts such as psychiatrists, psychologists and occupational therapists who work with children. Most local CAMHS have their own website, or you can ask your GP for more information. You can read about CAMHS on the YoungMinds website or by searching on nhs.uk
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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
You’re Experiencing Abnormal Tenderness Or Pain
You might experience some tenderness around your period, and that’s totally normal. If you’re experiencing persistent or severe pain, though, and you know it’s not due to your menstrual cycle, the American Cancer Society says it should be checked out. Even though breast cancers don’t normally cause pain and tenderness, it’s still a possibility.
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Genomic Tests To Predict Recurrence Risk
Doctors use genomic tests to look for specific genes or proteins, which are substances made by the genes, that are found in or on cancer cells. These tests help doctors better understand the unique features of each patients breast cancer. Genomic tests can also help estimate the risk of the cancer coming back after treatment. Knowing this information helps doctors and patients make decisions about specific treatments and can help some patients avoid unwanted side effects from a treatment that may not be needed.
The genomic tests listed below can be done on a sample of the tumor that was already removed during biopsy or surgery. Most patients will not need an extra biopsy or more surgery for these tests.
For patients age 50 or younger
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Recurrence score less than 16: Hormonal therapy is usually recommended, but chemotherapy is generally not needed
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Recurrence score of 16 to 30: Chemotherapy may be recommended before hormonal therapy is given
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Recurrence score of 31 or higher: Chemotherapy is usually recommended before hormonal therapy is given
For patients older than 50
The tests listed above have not been shown to be useful to predict risk of recurrence for people with HER2-positive or triple-negative breast cancer. Therefore, none of these tests are currently recommended for breast cancer that is HER2 positive or triple negative. Your doctor will use other factors to help recommend treatment options for you.
Other Types Of Breast Cancer
Other less common types of breast cancer include invasive lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Paget’s disease of the breast.
It’s possible for breast cancer to spread to other parts of the body, usually through the lymph nodes or the bloodstream. If this happens, it’s known as “secondary” or “metastatic” breast cancer.
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Grade Of Breast Cancer
The grade describes the appearance of the cancer cells.
- Low grade the cells, although abnormal, appear to be growing slowly.
- Medium grade the cells look more abnormal than low-grade cells.
- High grade the cells look even more abnormal and are more likely to grow quickly.
Want to know more?
- Breast Cancer Now: Secondary breast cancer
You Have Enlarged Lymph Nodes Around Your Collarbone
Your armpits aren’t the only subtle place you might experience lymph node swelling due to breast cancer. According to the Mayo Clinic, the same issue can also occur above or below your collarbonesa location most people don’t even realize they have a set of lymph nodes in the first place. And for more red flags that aren’t always so obvious, check out 40 Subtle Signs Your Body Is Telling You Something’s Seriously Wrong.
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Stage Of Breast Cancer
When breast cancer is diagnosed, your doctors will give it a stage. The stage describes the size of the cancer and how far it has spread, and is used to predict the outlook.
Ductal carcinoma in situ is sometimes described as stage 0. Other stages of breast cancer describe invasive breast cancer and include:
- stage 1 the tumour measures less than 2cm and the lymph nodes in the armpit are not affected. There are no signs that the cancer has spread elsewhere in the body
- stage 2 the tumour measures 2 to 5cm, 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 to 5cm and may be attached to structures in the breast, such as skin or surrounding tissues, and the lymph nodes in the armpit are affected. 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, talk to your doctor.
How Breast Cancer Pain May Feel
If breast cancer is the cause of breast pain, it will often be present in only one breast, whereas benign breast pain is often on both sides.
Breast cancer pain can be persistent and very specific, usually hurting in just one spot. But, breast cancer can be present in your breast before it causes pain. If you have other symptoms of breast cancer, such as nipple retraction, sudden swelling of your breast, or sudden skin changes, consult your doctor for a clinical breast exam.
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How It Is Done
The health professional taking a sample of your blood will:
- Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
- Clean the needle site with alcohol.
- Put the needle into the vein. More than one needle stick may be needed.
- Attach a tube to the needle to fill it with blood.
- Remove the band from your arm when enough blood is collected.
- Put a gauze pad or cotton ball over the needle site as the needle is removed.
- Put pressure on the site and then put on a bandage.
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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Causes Of Breast Cancer
Doctors do not know the exact causes of breast cancer. But there are risk factors that can increase your chance of developing it.
Having one or more risk factors does not mean you will get breast cancer. Also, having no risk factors does not mean you will not develop it.
Breast cancer is likely to be caused by a combination of different risk factors, rather than just one.
You Have A Reddish Or Purple Nipple
Noticing your nipple change colors isn’t a great sign. According to Holly Pederson, MD, director of medical breast services at the Cleveland Clinic, it could be a symptom of cancer and could also involve flaking and irritation. “Cancer can originate in the nipple,” she told WebMD. “The nipple will look reddish or purplish it doesn’t look normal. It’s actually the tumor cells invading the nipple that cause the skin to look different if it is breast cancer.”
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How Does Breast Cancer Start
Breast cancer occurs when cells in the breast grow out of control. Different kinds of breast cells develop into different . Most breast cancers begin in the breast ducts or lobules . These are known respectively as invasive ductal carcinoma and invasive lobular carcinoma. Other less common types of breast cancer include inflammatory breast cancer and ductal carcinoma in situ.
Though breast cancer is most common in women, men can develop it as well. A mans lifetime risk of breast cancer is about 1 in 883. This year, the American Cancer Society estimates that about 2,620 men will be diagnosed with breast cancer.
Breast Exam By Your Doctor
The same guidelines for self-exams provided above are true for breast exams done by your doctor or other healthcare professional. They wont hurt you, and your doctor may do a breast exam during your annual visit.
If youre having symptoms that concern you, its a good idea to have your doctor do a breast exam. During the exam, your doctor will check both of your breasts for abnormal spots or signs of breast cancer.
Your doctor may also check other parts of your body to see if the symptoms youre having could be related to another condition.
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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.
Contraceptive pill
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.
Telling Your Children You Have Breast Cancer
Some parents avoid telling their children for fear of upsetting them or having to answer difficult questions. But children are able to pick up on changes and may know when somethings upsetting or worrying you.
If a child feels left out, they may start to think theyve done something wrong or create a story that could be far worse than the truth. Many children feel they cant tell you their worries, and retreat into themselves.
Children need to feel they can trust their parents, and being honest helps them do that. Keeping it a secret may also be tiring and difficult to maintain. There is also a risk that if you dont tell them, they will find out another way.
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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.
Diagnosis Of Breast Cancer
To determine if your symptoms are caused by breast cancer or a benign breast condition, your doctor will do a thorough physical exam in addition to a breast exam. They may also request one or more diagnostic tests to help understand whats causing your symptoms.
Tests that can help diagnose breast cancer include:
- Mammogram. The most common way to see below the surface of your breast is with an imaging test called a mammogram. Many women ages 40 and older get annual mammograms to check for breast cancer. If your doctor suspects you may have a tumor or suspicious spot, they will also request a mammogram. If an abnormal area is seen on your mammogram, your doctor may request additional tests.
- Ultrasound. A breast ultrasound uses sound waves to create a picture of the tissues deep in your breast. An ultrasound can help your doctor distinguish between a solid mass, such as a tumor, and a benign cyst.
Your doctor may also suggest tests such as an MRI or a breast biopsy.
If you dont already have a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.
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