Feeling Unwell Or Tired
Many women do not feel as healthy after chemo as they did before. There is often a residual feeling of body pain or achiness and a mild loss of physical functioning. These changes may be very subtle and happen slowly over time.
Fatigue is another common problem for women who have received chemo. This may last a few months up to several years. It can often be helped, so its important to let your doctor or nurse know about it. Exercise, naps, and conserving energy may be recommended. If you have sleep problems, they can be treated. Sometimes fatigue can be a sign of depression, which may be helped by counseling and/or medicines.
Can Cancer Form In Other Parts Of The Breast
Cancers can also form in other parts of the breast, but these types of cancer are less common. These can include:
- Angiosarcomas. This type of cancer begins in the cells that make up the lining of blood or lymph vessels. These cancers can start in breast tissue or breast skin. They are rare.
- Inflammatory breast cancer. This type of cancer is rare and different from other types of breast cancer. It is caused by obstructive cancer cells in the skins lymph vessels.
- Paget disease of the breast, also known as Paget disease of the nipple. This cancer affects the skin of the nipple and areola .
- Phyllodes tumors. These are rare, and most of these masses are not cancer. However, some are cancerous. These tumors begin in the breasts connective tissue, which is called the stroma.
Receptor Status And Triple Negative Breast Cancer
Your pathology report and your healthcare providers may describe your breast cancer as estrogen receptor , progesterone receptor or human epidermal growth factor receptor-2 positive or negative. Or, they may say that your breast cancer is triple negative or triple positive.
Estrogen and progesterone receptors are proteins found in some cancer cells that allow a hormone to attach and feed the cancer cells. Hormone receptor status is reported as positive or negative and sometimes a percent is also provided. For example, 90% estrogen receptor positive. ER/PR+ breast cancers will, at a minimum, receive some form of hormone therapy such as Tamoxifen.
HER2 is a protein involved in normal cell growth, which may also be present on breast cancer cells. If too much of the HER2 protein is produced, the tumor is considered HER2+ . Breast cancers that are HER2+ will receive HER2 directed therapy such as Herceptin.
Triple positive breast cancer is positive for HER2, ER and PR. You will receive HER2 directed therapies as well as hormone therapy.
Triple negative breast cancer is negative for HER2, ER and PR. Therefore, HER2 directed therapy and hormone therapy are not utilized. Typical treatment is chemotherapy.
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Genetic Breast Cancer Testing Recommendations
Some inherited genes can mutate and increase the risk of breast cancer. The most important of these genes are BRCA1 and BRCA2. Genetic testing can find mutations in these genes and may be recommended for people with:
- A known family history of a BRCA mutation
- A family history of breast cancer at a young age
- Ashkenazi Jewish decent
- Women diagnosed with breast cancer at a young age , regardless of family history
Not every woman needs to be tested. A healthcare provider will be able to advise whether genetic testing would be appropriate.
Physical Emotional And Social Effects Of Cancer
In general, cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Music therapy, meditation, stress management, and yoga for reducing anxiety and stress.
Meditation, relaxation, yoga, massage, and music therapy for depression and to improve other mood problems.
Meditation and yoga to improve general quality of life.
Acupressure and acupuncture to help with nausea and vomiting from chemotherapy.
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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 Is Metaplastic Carcinoma
Also known as metaplastic breast cancer, metaplastic carcinoma is a rare type of invasive breast cancer with a unique characteristic: It contains a mix of two or more types of breast cancer cells, usually carcinoma combined with sarcoma. Metaplastic means that one form is turning into another. Various leading-edge techniques are used to analyze the exact genetics and biology of these confused cancers to find out if the tumor is more similar to carcinoma or sarcoma, since these two types of cancer have very different treatments.
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Mucinous Carcinoma Of The Breast
Mucinous carcinoma, also known as colloid carcinoma, is a rare form of invasive ductal carcinoma . About 2 percent of breast cancers are pure mucinous carcinoma, while up to 7 percent of breast cancers have some component of mucinous carcinoma cells.
With this type of cancer, the tumor consists of abnormal cells that appear to float in pools of mucus when looked at under a microscope.
Its typically a less aggressive type of cancer that has a lower probability of spreading to the axillary lymph nodes than some other types of IDC.
Mucinous carcinoma tends to be more common in post-menopausal women, with the average age at diagnosis being around 60 to 70 years of age.
Other Types Of Bone Cancers
There are several other types of cancers that can develop in the bones. These include:
- Multiple myeloma, which starts in the bone marrow, a soft tissue found within the bones
- Leukemia, the umbrella term for cancers that affect blood cells, usually white blood cells
- Non-Hodgkin lymphoma, which starts in the lymph cells, a part of the immune system
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Kinds Of Breast Cancer
The most common kinds of breast cancer are
- Invasive ductal carcinoma. The cancer cells begin in the ducts and then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.
- Invasive lobular carcinoma. Cancer cells begin in the lobules and then spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.
Other Types Of Breast Cancer
There are some other less common types of invasive breast cancer.
Invasive lobular breast cancer
About 1 in 10 invasive breast cancers start in the lobes of the breast. This type can sometimes be difficult to diagnose on a mammogrambecause of the way it grows. Some women may need an MRI scan.
Inflammatory breast cancer
This is when cancer cells grow along and block the tiny channels in the skin of the breast. The breast then becomes inflamed and swollen. Inflammatory breast cancer is rare.
Pagets disease of the breast
This is a condition that causes a red, scaly rash on the skin of the nipple. Women with Pagets disease of the breast may have DCIS or invasive breast cancer.
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What Is Carcinoma In Situ
A carcinoma in situ is the very early stage of a cancer when the abnormal cancer cells are confined to their original site. At this stage no tumour has grown and no cancer cells have spread. It may be that many cancers remain at this dormant stage for months, or even years, before they start to grow and spread into a proper cancer. This may be because the cells of the carcinoma in situ do not have the ability to stimulate new blood vessels. If they cannot stimulate new blood vessels to grow then the cancer itself cannot grow or spread.
It is thought that one or more of the cells in a carcinoma in situ may then mutate after some time . This then gives them the ability to make chemicals to stimulate new blood vessels. The cancer then grows and spreads as described above.
A carcinoma in situ contains only a small number of cells and is usually too small to be detected by scans or X-rays. However, some screening tests may detect a carcinoma in situ. For example, some cells from an abnormal cervical screening test, looked at under the microscope, may show carcinoma in situ. These cells can then be destroyed by treatment which prevents cancer from developing. Sometimes a small sample taken from a part of the body may show a carcinoma in situ.
Types Of Invasive Breast Cancer
Most breast cancers are invasive, meaning the cancer has spread from the original site to other areas, like nearby breast tissue, lymph nodes or elsewhere in the body. Invasive breast cancer cells break through normal breast tissue barriers and spread to other parts of the body through the bloodstream and lymph nodes. The two most common types of invasive breast cancer are invasive ductal carcinoma and invasive lobular carcinoma.
Invasive ductal carcinoma
The most common type of breast canceraccounting for roughly 70 to 80 percent of all casesis called invasive ductal carcinoma . IDC is a cancer that starts in a milk duct and grows into other parts of the breast. With time, it may spread further, or metastasize, to other parts of the body.
Invasive lobular carcinoma
Invasive lobular carcinoma is the second most common type, accounting for roughly 5 to 10 percent of all breast cancers. ILC starts in lobules and then spreads into nearby breast tissue. Like IDC, it may metastasize. However, this cancer is harder to detect on mammograms and other exams than IDC. One in five women with ILC have both breasts affected.
Inflammatory breast cancer
Pagets disease of the breast
Angiosarcoma of the breast
Other, even more rare, types of invasive breast cancer include adenoid cystic carcinoma, low-grade adenosquamous carcinoma, medullary carcinoma, mucinous carcinoma, papillary carcinoma and tubular carcinoma.
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Prognostic Impact Of Tumor
It has been previously reported that tumor-specific expression of the rate-limiting enzyme, 3-hydroxy-3-methylglutharyl-coenzyme A reductase , in the mevalonate pathway is associated with more favorable tumor parameters in breast cancer. In the present study, it is examined the prognostic value of HMGâCoAR expression in a large cohort of primary breast cancer patients with long-term follow up.
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What Are Some Common Side Effects Of Chemotherapy Used In Breast Cancer
Chemotherapy attacks cancer cells, but it can also attack healthy cells in your hair and gut. Chemotherapy side effects depend on the individual, the type of chemotherapy, the dosage and schedule, and the chemotherapy regimen being used.
In addition to some of the side effects mentioned above, chemotherapy used in breast cancer can cause the following more common side effects:
Easy bruising or bleeding
Chemotherapy effects can be bothersome, but sometimes necessary to receive effective treatment. Thankfully, however, there are other medications and strategies that can be used to help manage certain side effects. If youre receiving chemotherapy and you experience a bothersome side effect, make sure to mention it to your cancer specialist so they can help manage it.
If side effects are too bothersome or cannot be tolerated, your chemotherapy regimen may be altered, paused, or completely stopped.
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What Is Ductal Carcinoma In Situ
Ductal carcinoma in situ is a very early form of breast cancer thats confined to the milk ducts, which is why its called ductal. Carcinoma is the name for any cancer that begins in cells that line the inner or outer surfaces of tissues, such as the breast ducts. In situ is a Latin term meaning in its original place. DCIS is the most common form of noninvasive breast cancer.
DCIS is classified as low, intermediate, or high grade. Grades are based on what the cells look like under a microscope. The lower the grade, the more closely DCIS resembles normal breast cells. The higher the grade, the more different it is from normal cells. DCIS can sometimes involve the nipple, causing it to look red and scaly. This is a rare form of cancer known as Pagets disease of the breast .
In some women, DCIS may not progress to invasive cancer in their lifetime. This has fueled debate about DCIS about whether women with low-risk disease need any treatment, or if they could be safely checked with annual mammograms and breast exams to see if the cancer is progressing. Currently, the standard treatment for DCIS includes surgery, often a lumpectomy.
Nonsurgical Invasive Ductal Carcinoma Treatment
Radiation. Radiation therapy might be part of your treatment plan if you are undergoing a lumpectomy. Studies show that lumpectomy followed by radiation can be as effective in treating IDC as mastectomy. We dont usually treat patients with radiation after a mastectomy unless theres some cancer in the lymph nodes, Wright says.
Chemotherapy. Deciding on whether to treat invasive ductal breast cancer with chemotherapy, or chemo, depends on features of the tumor cells themselves their genes and proteins. The more the doctor can learn about the characteristics of the cancer cells, the easier it is to determine what type of chemotherapy is likely to be effective.
Hormone therapy. Breast cancers with positive hormone receptors can be treated with estrogen or progesterone. These medications come in pill form, and may be prescribed for several years.
Biologic therapy. This approach uses antibodies or small molecule drugs to activate your bodys immune system to fight the invasive ductal cancer cells.
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Life Style And Dietary Cause
Sedentary life style, high dietary intake of fat obesity particularly in postmenopausal women may cause breast cancer. The use of alcohol is also another one cause of breast cancer. The risk increases with the amount of alcohol consumed. Women who consume two to five alcoholic beverages per day have a risk about one and a half times that of nondrinkers for the development of breast cancer.
Paget Disease Of The Breast
up to 4 percent of all breast cancer cases.
Paget disease is a rare cancer that forms in the milk ducts and spreads to the skin of the nipple and areola, the skin around the nipple. According to the National Cancer Institute , this type of breast cancer is usually accompanied by DCIS or an invasive tumor within the breast.
The symptoms of Paget disease are often mistaken at first for skin conditions, like eczema or dermatitis. However, the symptoms wont respond to topical treatments.
The typical symptoms of Paget disease include:
- redness, flaking or crusting around the nipple and areola
- a tingling or itching sensation around the nipple area
- thickened skin on or near the nipple
- a flattened nipple
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Breast Cancer Cell Lines
Part of the current knowledge on breast carcinomas is based on in vivo and in vitro studies performed with cell lines derived from breast cancers. These provide an unlimited source of homogenous self-replicating material, free of contaminating stromal cells, and often easily cultured in simple standard media. The first breast cancer cell line described, BT-20, was established in 1958. Since then, and despite sustained work in this area, the number of permanent lines obtained has been strikingly low . Indeed, attempts to culture breast cancer cell lines from primary tumors have been largely unsuccessful. This poor efficiency was often due to technical difficulties associated with the extraction of viable tumor cells from their surrounding stroma. Most of the available breast cancer cell lines issued from metastatic tumors, mainly from pleural effusions. Effusions provided generally large numbers of dissociated, viable tumor cells with little or no contamination by fibroblasts and other tumor stroma cells.Many of the currently used BCC lines were established in the late 1970s. A very few of them, namely MCF-7, T-47D, MDA-MB-231 and SK-BR-3, account for more than two-thirds of all abstracts reporting studies on mentioned breast cancer cell lines, as concluded from a Medline-based survey.
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