How Breast Cancer Spreads
Breast cancer can spread when the cancer cells get into the blood or lymph system and then are carried to other parts of the body.
The lymph system is a part of your body’s immune system. It is a network of lymph nodes , ducts or vessels, and organs that work together to collect and carry clear lymph fluid through the body tissues to the blood. The clear lymph fluid inside the lymph vessels contains tissue by-products and waste material, as well as immune system cells.
The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into:
- Lymph nodes under the arm
- Lymph nodes inside the chest near the breastbone
- Lymph nodes around the collar bone
If cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have traveled through the lymph system and spread to other parts of your body. Still, not all women with cancer cells in their lymph nodes develop metastases, and some women with no cancer cells in their lymph nodes might develop metastases later.
What Is Breast Cancer
Cells in the body normally divide only when new cells are needed. Sometimes, cells in a part of the body grow and divide out of control, which creates a mass of tissue called a tumor. If the cells that are growing out of control are normal cells, the tumor is called benign. If, however, the cells that are growing out of control are abnormal and don’t function like the body’s normal cells, the tumor is called malignant .
Cancers are named after the part of the body from which they originate. Breast cancer originates in the breast tissue. Like other cancers, breast cancer can invade and grow into the tissue surrounding the breast. It can also travel to other parts of the body and form new tumors, a process called metastasis.
How Common Is Breast Cancer In Canada
Breast cancer is one of the most common forms of cancer in women. Each year, more than 22,000 women develop breast cancer in Canada and more than 5,000 women die of the disease. Based on current rates, one in nine women in Canada is expected to develop breast cancer during her lifetime.
The risk of getting breast cancer goes up as women get older. The risk of developing breast cancer in the next 10 years is as follows:
- 13 out of 1,000 women in their 40s
- 23 out of 1,000 women in their 50s
- 29 out of 1,000 women in their 60s
- 31 out of 1,000 women in their 70s
Since 1999, the rate of new cases of breast cancer has stabilized, and death rates have steadily declined.
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Risks And Causes Of Breast Cancer
The exact cause of breast cancer is unknown, but factors that seem to increase risk include:
- gender being a woman
- getting older women over 50 years of age are invited to take part in yearly mammograms to screen for breast cancer
- heredity having several close family members who have had breast cancer
- previous history of breast cancer women who have had breast cancer have a greater risk of developing it again
- certain breast diseases some types of breast disease that are found through mammograms indicate an increased risk.
Cosmetic Implants And Breast Cancer Survival
The general agreement, based on , is that silicone breast implants do not increase the risk of breast cancer. A 2015 meta-analysis of 17 studies that included participants who had undergone cosmetic breast augmentation discovered no increase in the risk of breast cancer associated with the procedure. In fact, the research showed that the incidence among these participants was lower than expected.
In 2021, another study found that women with cosmetic implants have significantly lower rates of breast cancer than those who do not have them.
Meanwhile, a 2013 meta-analysis found that women who received a diagnosis of breast cancer after getting cosmetic breast implants may have a higher risk of dying from the disease.
However, this research did not factor in other variables that may influence breast cancer mortality, such as body mass index, age at diagnosis, or cancer stage at diagnosis. And at least one of the studies in the analysis looked at overall mortality, instead of breast cancer-specific mortality, thereby potentially skewing the results. As such, a person should consider the finding with caution.
most common type is ductal carcinoma, which begins in a milk duct. Another type is lobular carcinoma, which begins in a lobule, one of the tiny glands that produce milk.
Invasive breast cancer involves cancerous cells spreading to nearby tissue. It is then more likely that the cancer will spread to other parts of the body.
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What Type Of Psychological Treatment Is Helpful
A combination of individual and group treatment sometimes works best. Individual sessions with a licensed psychologist typically emphasize the understanding and modification of patterns of thinking and behavior.
Group psychological treatment with others who have breast cancer gives women a chance to give and receive emotional support and learn from the experiences of others. To be most effective, groups should be made up of women at similar stages of the disease and led by psychologists or other mental health professionals with experience in breast cancer treatment.
Whether aimed at individuals or groups, psychological interventions strive to help women adjust to their diagnoses, cope with treatment, and come to terms with the diseases impact on their lives. These interventions offer psychologists an opportunity to help women better understand breast cancer and its treatment. Psychologists typically ask women open-ended questions about their assumptions, ideas for living life more fully, and other matters. Although negative thoughts and feelings are addressed, most psychological interventions focus on problem-solving as women meet each new challenge.
Thanks to Alice F. Chang, PhD, and Sandra B. Haber, PhD, who assisted with this article.
How Is Breast Cancer Diagnosed
During your regular physical examination, your doctor will take a thorough personal and family medical history. He or she will also perform and/or order one or more of the following:
- Breast examination: During the breast exam, the doctor will carefully feel the lump and the tissue around it. Breast cancer usually feels different than benign lumps.
- Digital mammography: An X-ray test of the breast can give important information about a breast lump. This is an X-ray image of the breast and is digitally recorded into a computer rather than on a film. This is generally the standard of care .
- Ultrasonography: This test uses sound waves to detect the character of a breast lump whether it is a fluid-filled cyst or a solid mass . This may be performed along with the mammogram.
Based on the results of these tests, your doctor may or may not request a biopsy to get a sample of the breast mass cells or tissue. Biopsies are performed using surgery or needles.
After the sample is removed, it is sent to a lab for testing. A pathologist a doctor who specializes in diagnosing abnormal tissue changes views the sample under a microscope and looks for abnormal cell shapes or growth patterns. When cancer is present, the pathologist can tell what kind of cancer it is and whether it has spread beyond the ducts or lobules .
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Describes Bottling Up Her Feelings And Fears About Not Living To See Her Children Grow Up
Two women described coping very much alone and one of them said she told very few people. Another found her family’s reaction difficult to cope with .
Some women discussed dealing with the reactions of others, including pity, distance and unease. A few said they felt left behind while other people were progressing with their lives.
Treatment For Breast Cancer
Treatment options for breast cancer include surgery, radiotherapy, chemotherapy and hormone therapy. Usually, more than one is used. Treatment for breast cancer in men is similar to the treatment for breast cancer in women.
Treatment depends on several factors, including:
- whether you have had your menopause
- the type of breast cancer you have
- the size of your breast tumour in relation to your breast
- the stage of your breast cancer
- the grade of your cancer cells
- the results of tests on your cancer cells
- your age, general health and personal preferences.
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Getting Used To Changes
Research has shown that the sooner you confront the physical changes to your body, the easier you may find it to gain confidence in the way you look. However, some people wont have had the chance or courage to do this early on.
If you have a partner, letting them see the surgical scars and changes to your body sooner may also make being intimate easier in the long term.
The first few times you look at yourself might make you feel unhappy and shocked, and you may want to avoid looking at yourself again. However, the initial intense feelings you may have will lessen over time as you get more used to how you look now.
Emotional Effects Of Breast Cancer Treatment
Once treatment begins, its normal to have a range of emotions. Maybe on some days youre feeling sad or anxious, or on other days, quiet and resolved.
People have different ways of responding emotionally as treatment progresses. Some people loudly celebrate the end of a treatment phase. Others close a treatment chapter from a more reflective, quiet space. Worries about the future, side effects, or what it means when you finish treatment may be on your mind. Getting the information you need, when you need it, can help you feel stronger and more confident.
As you begin treatment, its important to know that many breast cancer medicines cause side effects that can feel like stress, anxiety, or depression. Some treatments directly affect your emotions, while others may impact sleep, desire for food or sex, and other things that could put anyone in a bad mood. Understanding the source of any negative feelings can help you and your care team know how to treat them.
, and , including surgery from donor sites in other parts of the body. Surgery can also include removal and, for some, removal of the ovaries to reduce the risk of future cancer. When youre facing, undergoing, and recovering from breast surgery and surgery on any other parts of your body, its completely normal to have a lot of emotions, some of them intense.
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What Are The Warning Signs Of Breast Cancer
- A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
- A mass or lump, which may feel as small as a pea.
- A change in the size, shape, or contour of the breast.
- A blood-stained or clear fluid discharge from the nipple.
- A change in the look or feel of the skin on the breast or nipple .
- Redness of the skin on the breast or nipple.
- An area that is distinctly different from any other area on either breast.
- A marble-like hardened area under the skin.
These changes may be found when performing monthly breast self-exams. By performing breast self-exams, you can become familiar with the normal monthly changes in your breasts.
Breast self-examination should be performed at the same time each month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month.
What Are The Signs And Symptoms Of Breast Cancer
The signs and symptoms of breast cancer include:
- A new lump or thickening in or near the breast or in the armpit
- A change in the size or shape of the breast
- A dimple or puckering in the skin of the breast. It may look like the skin of an orange.
- A nipple turned inward into the breast
- Nipple discharge other than breast milk. The discharge might happen suddenly, be bloody, or happen in only one breast.
- Scaly, red, or swollen skin in the nipple area or the breast
- Pain in any area of the breast
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Risk Factors You Can Change
- Not being physically active. Women who are not physically active have a higher risk of getting breast cancer.
- Being overweight or obese after menopause. Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.
- Taking hormones. Some forms of hormone replacement therapy taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives also have been found to raise breast cancer risk.
- Reproductive history. Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
- Drinking alcohol. Studies show that a womans risk for breast cancer increases with the more alcohol she drinks.
Research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones due to night shift working also may increase breast cancer risk.
Changes To Your Body After Surgery
Most women have surgery as part of their treatment. The first time you look at your body after the operation can be difficult. After surgery your breast/chest area is likely to be bruised and swollen, but this will improve over time.
For some women, surgery doesnt affect how they feel about themselves, but many others find the changes more difficult to accept. Your confidence and self-esteem may be affected and you may feel unfeminine or unattractive.
Some women feel lop-sided or incomplete. You may feel very self-conscious, for example if youre in a communal changing room, particularly at first.
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Speak With A Fertility Specialist Asap If Youre Diagnosed With Breast Cancer
If you are interested in having children, its imperative that you speak with a fertility specialist as soon as you receive a breast cancer diagnosis. Your health is the priority, but fertility preservation has made it increasingly possible for cancer survivors to retain their ability to bear children even if a cancer treatment renders them infertile. Freezing your eggs or embryos, as well as other preservation methods, can make it possible to conceive a baby via IVF or via a gestational carrier once you are on the road to recovery and good health.
Contact RRC to learn more about your fertility prospects after a cancer diagnosis.
The Importance Of Communication
Good communication is important in relationships between people with cancer and those who care about them. A lack of communication often leads to isolation, frustration, and misunderstandings.
Talking about feelings and personal needs with honesty, sincerity, and openness lowers the stress on relationships. If you are having a hard time talking with people, or if others do not seem to want to communicate with you, consider joining a support group or talking with a counselor or social worker.
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What Affects Survival
Your outlook depends on the stage of the cancer when it was diagnosed. This means how big it is and whether it has spread.
The type of cancer and grade of the cancer cells can also affect your survival. Grade means how abnormal the cells look under the microscope.
Your general health and fitness also affect survival, the fitter you are, the better you may be able to cope with your cancer and treatment.
Another factor that can affect survival is whether the cancer cells have receptors for particular cancer drugs.
What Are Late Effects
Most women have side effects during treatment for breast cancer and for a few weeks after treatment ends. Usually, these side effects get better slowly and then stop. But sometimes side effects do not go away. Or they can develop months or years after treatment.
There are two commonly used terms for these side effects:
- Long-term effects Long-term effects begin during, or shortly after, treatment. They last for more than 6 months after treatment has finished. They may go away on their own, with symptoms getting better over 1 or 2 years after treatment. Or they may be permanent.
- Late effects Late effects are a delayed reaction to treatment. They do not appear during treatment, but can happen months or even years later.
In this information, we use the term late effects to describe both long-term and late effects.
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Breast Cancer Can Negatively Impact Mental Health
If you or a loved one has been diagnosed with breast cancer, you know firsthand that a diagnosis can have long-lasting mental health effects. From anxiety about the future to the stress of treatment, its totally normal to feel a mix of intense emotions after a breast cancer diagnosis.
While normal, this turmoil can cause long-term mental health challenges. Studies show that a majority of people with breast cancer will subsequently develop symptoms of PTSD, and these symptoms tend to last longer than a year. Even after successful treatment, fear of recurrence affects many women and can be so severe it negatively impacts their quality of life.
After a breast cancer diagnosis, a womans relationship with her body might change as well. While life-saving, mastectomies can , impact their relationships to their sexuality, and have a negative effect on overall mental health.
Chemotherapy And Your Feelings
Chemotherapy is given to kill cancer cells that are growing or dividing quickly. Both chemotherapy itself and some medicines taken with it can affect your emotions. Some people feel moody or sad while taking chemotherapy. Steroids, often given with chemotherapies to protect you from allergic reactions, can make you feel jumpy, overly energetic, annoyed, angry, or anxious. Steroids can also affect your sleep.
Other side effects of chemotherapy indirectly affect mood:
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