Studies Have Shown A Spike In Breast Cancer Metastases 12 To 18 Months After A Lumpectomy Or Mastectomy
Cancer Coach- My mother had DCIS in 2012 and had a lumpectomy along with radiation for 6 weeks. Her mammograms have been clear, but she was just diagnosed with Stage IV Metastatic Breast Cancer that was found after a lymph node biopsy. The lymph node biopsied was above her collarbone and other lymph nodes around that area are enlarged on the scans. They did not find evidence that it had spread anywhere else after performing scans on head, chest and abdomen. Her bone scan was also negative.
We were all in disbelief She is ERneg/PRneg/HER2Postive and is scheduled to start chemo on 12/23. I have searched all over the internet , hoping to find someone with a similar diagnosis. We were surprised when a mammogram this week also shows that she is free from cancer in both breasts. Im assuming that a cancer cell got into her blood stream during the lumpectomy and her doctor agreed that this is probably what happened
I dont follow any one specific diet as a cancer survivor. I follow basic rules such as
For the basic direction for diet please watch Dr. Bill Lis Ted Talk- 18 mins.
Bisphosphonates may prevent bone metastasizes in Breast Cancer, study finds
Hang in there,
Living With Secondary Breast Cancer
You will see your cancer doctor or specialist nurse regularly during and after treatment. This means that any symptoms or problems can be managed early on. You may have regular scans to check how the cancer has responded to treatment.
You may need treatment at different times or have ongoing treatment with hormone therapy. There may be long periods when the cancer is controlled and you are getting on with day-to-day life.
We have more about well-being and coping in our information about living with secondary breast cancer.
You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation. Macmillan is also here to support you. If you would like to talk, you can:
What Are The Symptoms Of Metastatic Breast Cancer
Possible symptoms of metastatic breast cancer are listed below. Every womans experience of metastatic breast cancer is different. Symptoms depend on what part of the body is affected. They may develop over weeks or months.Its unlikely that a woman will have all of the symptoms listed below. Some symptoms may not be due to metastatic breast cancer at all.
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Lymph Node Surgery For Breast Cancer
If breast cancer spreads, it typically goes first to nearby lymph nodes under the arm. It can also sometimes spread to lymph nodes near the collarbone or near the breast bone. Knowing if the cancer has spread to your lymph nodes helps doctors find the best way to treat your cancer.
If you have been diagnosed with breast cancer, its important to find out how far the cancer has spread. To help find out if the cancer has spread outside the breast, one or more of the lymph nodes under the arm are removed and checked in the lab. This is an important part of staging. If the lymph nodes contain cancer cells, there is a higher chance that cancer cells have also spread to other parts of the body. More imaging tests may be done if this is the case.
Lymph node removal can be done in different ways, depending on whether any lymph nodes are enlarged, how big the breast tumor is, and other factors.
Stages Of Breast Cancer And What They Mean
Breast cancer stages are usually expressed on a scale of 0 to 4.
Stage 0 is considered non-invasive breast cancer, with no evidence that the cancer has spread beyond the part of the breast where it began to grow, including to nearby lymph nodes.
Stages 1 to 3 generally describe breast cancer that may have spread to other parts of the breast and nearby lymph nodes, with stages increasing with the size of tumors and extent of spread.
Cancer that remains localized to the breasts is the most treatable.
Breast cancer tumors can grow directly from breast tissue to other nearby locations, such as the chest wall or the skin of the breast. This is considered stage 3 breast cancer.
Stage 4 is metastatic breast cancer , meaning that cancer that originated in the breast has now spread to other parts of the body.
In stage 4 breast cancer, cancer cells can spread beyond the breasts by invading lymph nodes near the breast and traveling to other parts of the body via the lymphatic system.
Cancer cells also can move through the bloodstream to inhabit other organs and regions of the body.
The most common destinations for MBC or advanced breast cancer cells are the brain, bones, lungs, and liver.
The outcome for Stage 4 breast cancer that has metastasized, or spread to distant organs of the body, is considerably lower than for earlier stages, with a 28 percent 5-year survival rate.
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Symptoms Of Secondary Breast Cancer
Secondary breast cancer means that a cancer that began in the breast has spread to another part of the body. Secondary cancer can also be called advanced or metastatic cancer.
It might not mean that you have secondary breast cancer if you have the symptoms described below. They can be caused by other conditions.
Factors Associated With More Rapid Spread
Some types of breast cancer, as well as molecular subtypes, are more likely to spread and spread earlier than other types. Ductal carcinoma is more likely to spread than lobular carcinoma, among tumors that are the same size and stage.
While many breast cancers do not spread to lymph nodes until the tumor is at least 2 cm to 3 cm in diameter, some types may spread very early, even when a tumor is less than 1 cm in size.
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What Is Stage Iv Breast Cancer
Stage IV is the most advanced stage of breast cancer. It has spread to nearby lymph nodes and to distant parts of the body beyond the breast. This means it possibly involves your organs such as the lungs, liver, or brain or your bones.
Breast cancer may be stage IV when it is first diagnosed, or it can be a recurrence of a previous breast cancer that has spread.
Breast Cancer Cell Growth
Cancer begins when a normal breast cell undergoes a number of mutations in genes that control the growth of the cell. These mutations may occur over a long period of time, even decades, before a cancer cell forms.
A cancer cell must divide on average 30 times before it forms a mass that can be felt in the breast. Since tumor cells multiply and divide exponentiallyone cell becomes two, two cells become four, and so ona tumor will increase more rapidly in size the larger it is.
That said, not all cells are dividing at one time, and growth can be different at different stages in the formation of a tumor. Compared with many types of cancer, breast cancer has a “low growth fraction,” meaning that the proportion of cancer cells that are in an active cell cycle is low.
Some tumors, such as some leukemias and lymphomas, have much higher growth fractions .
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If Cancer Has Spread To The Lungs
The first symptoms of this may be a cough that doesn’t get better or breathlessness. If cancer cells settle on the outside of the lungs, they can irritate the membranes which cover the lungs . This causes fluid to build up and press on the lungs which can make you breathless. This is called apleural effusion. The fluid can be drained away to make your breathing easier.
Breathlessness can be frightening, but there are effective ways of managing it. When treatment – usually chemotherapy – starts to work, your breathing will improve.
What Are The Signs That Breast Cancer Has Spread
Metastatic breast cancer is a secondary cancer the cancerous cells originate in breast tissue and then travel to other parts of the body. The most common areas of breast cancer metastasis are the bones, lungs and liver.
Following an initial breast cancer diagnosis, a patient will receive a personalized monitoring plan for metastatic reoccurrence from their care team. Depending on the specific parts of the body affected, the symptoms of metastatic breast cancer can vary.
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How Does Cancer Spread Or Metastasize
The spread of cancer usually happens through one or more of the following steps:
- Cancer cells invade nearby healthy cells. When the healthy cell is taken over, it too can replicate more abnormal cells.
- Cancer cells penetrate into the circulatory or lymph system. Cancer cells travel through the walls of nearby lymph vessels or blood vessels.
- Migration through circulation. Cancer cells are carried by the lymph system and the bloodstream to other parts of the body.
- Cancer cells lodge in capillaries. Cancer cells stop moving as they are lodged in capillaries at a distant location and divide and migrate into the surrounding tissue.
- New small tumors grow. Cancer cells form small tumors at the new location
Tests At The Breast Cancer Clinic
If you have suspected breast cancer you’ll be referred to a specialist breast cancer clinic for further tests. This referral will be because of your symptoms or because your mammogram has shown an abnormality,
Mammogram and breast ultrasound
If you have symptoms and have been referred to a specialist breast unit by your GP, you’ll probably be invited to have a mammogram if you are over 35 years old. This is an X-ray of your breasts. You may also need an ultrasound scan.
If your cancer was detected through the BreastCheck screening programme, you may need another mammogram or ultrasound scan.
Ultrasound uses high-frequency sound waves to produce an image of the inside of your breasts. It helps to determine the nature of a lump or of the abnormality. It may be needed to find out if a lump in your breast is solid or contains liquid.
Your breasts are made up of thousands of tiny glands that produce milk. This glandular tissue contains a higher concentration of breast cells than other breast tissue, making it denser.
Dense breast tissue can make a mammogram difficult to read. Lumps or areas of abnormal tissue are harder to spot.
Younger women tend to have denser breasts. This is why mammography is not routinely performed in women under 35 years. As you get older, the amount of glandular tissue in your breasts decreases and is replaced by fat. This means your breasts become less dense.
Biopsy
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Looking For More Of An Introduction
If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:
- ASCO AnswersFact Sheet: Read a 1-page fact sheet that offers an introduction to metastatic breast cancer. This free fact sheet is available as a PDF, so it is easy to print.
- ASCO AnswersGuide:Get this free 52-page booklet that helps you better understand breast cancer. The booklet is available as a PDF, so it is easy to print.
- Cancer.Net Patient Education Video: View a short video led by an ASCO expert in metastatic breast cancer that provides basic information and areas of research.
Metastatic Breast Cancer Treatment And Planning
After a diagnosis of metastatic breast cancer, its helpful to take all the time you need to gather information and make decisions about your treatment. Learn about the medical specialists that may be involved in your care, treatment options, genetic testing, taking a break from treatment, and more.
SurgeryDoctors sometimes recommend surgery for metastatic breast cancer in order, for example, to prevent broken bones or cancer cell blockages in the liver. Learn more.
ChemotherapyChemotherapy is used in the treatment of metastatic breast cancer to damage or destroy the cancer cells as much as possible. Learn more.
Radiation TherapyYour doctor may suggest radiation therapy if youre having symptoms for reasons such as easing pain and controlling the cancer in a specific area. Learn more.
Hormonal TherapyHormonal therapy medicines are used to help shrink or slow the growth of hormone-receptor-positive metastatic breast cancer. Learn more.
Targeted TherapyTargeted therapies target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Learn more.
Local Treatments for Distant Areas of MetastasisLocal treatments are directed specifically to the new locations of the breast cancer such as the bones or liver. These treatments may be recommended if, for example, the metastatic breast cancer is causing pain. Learn more.
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When Metastatic Cancer Can No Longer Be Controlled
If you have been told your cancer can no longer be controlled, you and your loved ones may want to discuss end-of-life care. Whether or not you choose to continue treatment to shrink the cancer or control its growth, you can always receive palliative care to control the symptoms of cancer and the side effects of treatment. Information on coping with and planning for end-of-life care is available in the Advanced Cancer section of this site.
How Does Metastatic Breast Cancer Develop
In some women with breast cancer, cancer cells break away from the cancer in the breast. The cancer cells spread to other parts of the body in blood vessels or lymphatic vessels and form a new cancer deposit. This can happen before or after treatment for breast cancer.The original cancer in the breast is called the primary cancer. If breast cancer develops in another part of the body it is called a metastatic breast cancer or a metastasis.
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Biopsy Of An Enlarged Lymph Node
If any of the lymph nodes under the arm or around the collar bone are swollen, they may be checked for cancer directly with a needle biopsy, either a fine needle aspiration or a core needle biopsy. Less often, the enlarged node is removed with surgery. If cancer is found in the lymph node, more nodes will need to be removed during an axillary lymph node dissection .
Can You Do Anything To Prevent Or Slow The Spread Of Breast Cancer
Like any type of cancer, there are factors that can put you at higher risk. For breast cancer, these include things like smoking, unhealthy diet, lack of exercise and not performing monthly self-breast exams. Its also important to make sure and get your annual mammogram for breast cancer screening.
Other risk factors can include using hormone-based prescriptions, how many children youve had in the past, getting older and at what age you got your period and went through menopause.
In some instances, you cant necessarily prevent breast cancer, but you can sometimes slow it down, stop it from spreading or reduce the size of the tumor, says Dr. Roesch. You can do this by taking your medications as directed, following through with treatments, going to your appointments and being involved in your cancer care.
Youre in control of taking your medication correctly, eating a healthy diet, participating in an exercise program and managing stress. All of these things can contribute to a stronger physical body and better mental attitude both of which can have a positive impact on your breast cancer diagnosis.
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Additional Tools For Diagnosing Advanced Breast Cancer
The additional tools below are often used specifically for diagnosing advanced cancer:
Sentinel lymph node biopsy: This procedure removes sentinel lymph node cells during surgery for examination. When breast cancer spreads, it often heads first to the lymph nodes.
Chest X-ray: This detailed image of the chest may help doctors see whether cancer has spread to the bones.
Computed tomography scan: Also known as a CAT scan, this procedure takes detailed pictures of internal areas of the body using a computer linked to an X-ray machine. A dye may be used to help the organs show up more clearly in the images.
Bone scan: This procedure looks for bone metastasis, or cancer cells that have spread to the bone. A small amount of radioactive material is injected into the blood, then detected with a scanner.
Positron emission tomography scan: A PET scan is a detailed imaging tool that uses a radioactive drug, known as a tracer, to search for cancer cells within your body.
Imaging Tests To Find Out If Breast Cancer Has Spread
If you have been diagnosed with breast cancer, you might need more tests if your doctor thinks the cancer might have spread based on your symptoms, the results of your physical exam, or the size of your tumor. Not all women with breast cancer need these tests. Your doctor will talk with you about which of these tests you will need.
Chest x-ray: This test may be done to see if the cancer has spread to your lungs.
CT scan :A CT scan uses x-rays taken from different angles, which are combined by a computer to make detailed pictures of the inside of your body. This test is most often used to look at the chest and/or belly to see if breast cancer has spread to other organs. It can also be used to guide a biopsy needle into an area of concern.
MRI : This test makes detailed pictures using radio waves and strong magnets instead of x-rays. This test can be used to look at the breasts or other parts of the body. MRIs can be more uncomfortable than CT scans because they take longer, and you often need to lie in a narrow tube while the test is done.
Ultrasound:For an ultrasound, a wand that gives off sound waves is moved over the skin to take pictures of the inside of the body. A gel is often put on your skin first.
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