Inflammatory Breast Cancer Ethnic Groups And New Research
Similarly to other breast cancers, the incidence rate of inflammatory breast cancer varies according to ethnic groups in the United States.
The rate of IBC is around 1.3 per 100,000 across all groups of women. However, African American women have a higher risk of 1.6 per 100,000. Asian and Pacific Islanders have the lowest risk of IBC at 0.7 per 100,000. Scientists still do not fully understand the differences in risk for breast cancer between different countries.
Furthermore, a diagnosis of IBC tends to be at a younger age than other breast cancers. The average age at diagnosis of IBC is the mid to late50s. Most women are post-menopausal at diagnosis. Interestingly, a high Body Mass Index is thought to significantly increase the odds of developing IBC.
The latest research is investigating the mammary tumor virus as a potential risk factor for Inflammatory Breast Cancer.
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:
Dormancy In Metastatic Melanoma
The time period between removal of the primary tumor and subsequent recurrence of disease is referred to as metastatic dormancy. In melanomas, a period of dormancy may end with the emergence of recurrent disease at a metastatic site and only rarely at the site of the primary tumor. Melanomas, as well as some other cancers, such as prostate and some types of breast cancer, often have very protracted courses in which metastatic disease does not manifest until years or even decades after removal of the primary tumor. Clinically localized melanoma can recur after disease-free intervals of 10 years or more . In fact, a subset of melanomas will have ultra-long dormancy with recurrence greater than 20 years later . Other tumor types, such as lung and pancreatic adenocarcinomas tend to follow a much swifter clinical course in which discovery of the primary tumor and subsequent metastasis is often a temporally contiguous event . While these differences in metastasis patterns may in part reflect differences in detection amongst different cancer types, it has also been proposed that such observations suggest that certain tumor types might gain full metastatic competency earlier in tumor progression .
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Why Werent These Escaping Cells Identified The First Time The Cancer Was Treated
Although scans of the body can detect if there is obvious spread to these other organs, for women with early stage breast cancer there rarely is anything that shows up on a scan. There is a limit to what scans can tell us: they wont show extremely tiny spots of cancer, and they definitely cant show us if there are individual cells circulating in the body. Neither will any blood test, or any other test for that matter. So the first time around we perform our surgery and give our treatmentschemotherapy, hormonal therapy, radiationwith the hope that if microscopic spread has already taken place, the treatments will scavenge those cells and kill them before they take up residence someplace in the body.
Unfortunately, these treatments dont work 100 percent of the time. So if cells have spread, and if the treatments we give dont affect them, the cancer cells can persist and take hold someplace, developing into metastases, or spread. This is why and how recurrence happens.
Annular Circular Skin Rash Cancer
Skin involvement is seen in up to one-third of those affected and may be the first and/or only clinical sign of disease. 7,9 Lesion morphology varies, presenting as multiple round papules, patches, or plaques that favor the face, neck, and areas of prior injury such as tattoos and scars. 7 Color ranges from red to purple to brown. 7 Annular .
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Signs That Warrant An Immediate Trip To A Doctor
Some common cancer signs that should result in a visit to the emergency room or to a doctor as soon as possible include:
- coughing up mucus tinged with blood
- blood in stools or urine
- lump in the breast, testicles, under the arm, or anywhere that it didnt exist before
- unexplained but noticeable weight loss
- severe unexplained pain in the head, neck, chest, abdomen, or pelvis
These and other signs and symptoms will be evaluated. Screenings, such as blood and urine tests and imaging tests, will be used if your doctor thinks its appropriate.
These tests are done both to help make a diagnosis as well as rule out various causes of your signs and symptoms.
When seeing a doctor, be prepared to share the following information:
- your personal medical history, including all symptoms you have experienced, as well as when they began
- family history of cancer or other chronic conditions
- list of all medications and supplements you take
Colon Cancer Skin Rash
x The prognostic value of tumor regression grade in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation therapy has been explored extensively. However, whether TRG is predictive of outcome in colon cancer following preoperative chemotherapy has not been reported. A total of 276 colon cancer patients who had undergone preoperative chemotherapy and surgery .
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When Can Metastatic Breast Cancer Occur
Most often, metastatic breast cancer arises months or years after a person has completed treatment for early or locally advanced breast cancer. This is sometimes called a distant recurrence.
Some people have metastatic breast cancer when they are first diagnosed . This is called de novo metastatic breast cancer.
Komen Perspectives
Conventional Stages Of Breast Cancer Progression: 0 Through Iv
As mentioned, there are five basic stages of breast cancer with a couple of sub-categories.
Stage 0
This is a bit of an unclear term which specialists use to describe the development of abnormal cells that are not yet invasive breast cancer. Indeed physicians consider Ductal Carcinoma in situ, or DCIS, stage 0 breast cancer.
Here the malignant cancer cells are present in the lining of the breast d uct but have not yet invaded the surrounding breast tissue or spread beyond the duct. Almost 100% of DCIS is curable, but it obviously, does need treatment.
Early-stage breast cancer Stage 1
Stage 1 breast cancer is an early stage breast cancer. There is a considerable difference in medical opinion as to what exactly constitutes early stag e breast cancer. Also, how aggressive the treatment for Stage I breast cancer is another area of debate.
The standard definition of a stage 1 breast tumor is that a certain amount of breast cancer cells invade tissues and structures beyond the duct lining. However, no cancer cells have spread beyond the breast.
Furthermore, the tumor size is less than 2 cm in diameter. If physicians can detect and treat breast cancer before it grows beyond 2cm, the prognosis is very very good.
The average age of diagnosis of a stage 1 breast tumor is about 52 years old. In over 90% of cases, treatment tends to involve breast conservation surgery, followed by radiation therapy.
Chance of stage 1 cancer recurrence or spreading.
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How Quickly Breast Cancer Develops
You may have heard remarks that cancer has been present for five years before it is diagnosed, and this may sometimes be true.
The actual time it takes for breast cancer to grow from a single cancer cell to a cancerous tumor is unknown, as estimates based on doubling time assume that this is constant throughout the duration of tumor growth.
If doubling time were constant, cancer with a doubling time of 200 days would take 20 years to develop into a detectable tumor, and a doubling time of 100 days would take 10 years to be evident on exam.
In contrast, a breast tumor with a doubling time of 20 days would take only 2 years to develop.
Since the majority of studies have found the average doubling time to be between 50 days and 200 days, it’s likely that most breast cancers that are diagnosed began at least 5 years earlier .
Cellular And Tumour Mass Dormancy
Two different models of tumour dormancycellular and tumour mass dormancyhave been proposed. Cellular dormancy refers to the presence of solitary or small cell clusters of DTCs that exist in a G0/G1 growth-arrested state and result from quiescence, senescence or differentiation. An inability to properly adhere to the ECM,, reduced signalling through the phosphatidylinositol 3-kinase /AKT pathway and a low ratio of the extracellular signal-regulated kinase to the stress-induced kinase p38, are some of the plethoras of predominantly cell-intrinsic mechanisms that have been reported to induce cellular dormancy. On the other hand, escape from cellular dormancy has been shown to occur upon increased matrix stiffness through TGF1 expression, following the release of neutrophil extracellular traps by inflammatory neutrophils, and as a result of aberrant activation of the adhesion protein vascular cell adhesion protein 1 in indolent breast DTCs lodged in the bone marrow via engaging 41-expressing osteoclasts.
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What Are The Types Of Breast Cancer
Breast cancers are classified by the types of cells in which they develop, and whether they are invasive or noninvasive. Invasive cancers grow into nearby tissue while noninvasive tumors are slow-growing and remain localized.
Breast cancers are also grouped by the presence of mutations in certain genes such as HER2 and BRCA1 and whether they grow in response to estrogen and progesterone, the female hormones. Breast cancers that grow in response to hormones have proteins known as hormone receptors on them.
Breasts consist of milk glands and ducts, connective and fat tissue. Most breast cancers start in the milk-producing glands and ducts in the breast. The types of breast cancers include:
Spread Through The Bloodstream
Cancer cells can go into small blood vessels and then get into the bloodstream. They are called circulating tumour cells .
Researchers are looking at using circulating tumour cells to diagnose cancer instead of a tissue sample . And at whether they can test circulating cancer cells to predict which treatments will work better. They are also looking to detect circulating tumour DNA to help diagnose cancer and monitor treatment.
The circulating blood sweeps the cancer cells along until they get stuck somewhere. Often they get stuck in a very small blood vessel such as a capillary.
Then the cancer cell must move through the wall of the capillary and into the tissue of the organ close by. The cell can multiply to form a new tumour if:
- the conditions are right for it to grow
- it has the nutrients that it needs.
This is quite a complicated process and most cancer cells don’t survive it. Of the many thousands of cancer cells that reach the bloodstream, only a few survive to form a secondary cancer.
The white blood cells in our immune system find and kill some cancer cells. Others cancer cells might die because they get battered around by the fast flowing blood.
Cancer cells in the circulation may try to stick to platelets to form clumps to give themselves some protection. Platelets are blood cells that help the blood to clot. This could also help the cancer cells to move into the surrounding tissues.
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Risk Factors For Distant Recurrence
There are several risk factors that raise the risk of recurrence overall . These include:
- Tumour size: Larger tumours are more likely to recur than smaller ones both early and late.
- Positive lymph nodes: Tumours that have spread to lymph nodes are more likely to recur at any time than those that have not.
- Age at diagnosis: Breast cancer recurrence is more common in younger women.
- Treatments received and response to treatments: Both chemotherapy and hormonal therapy reduce the risk of recurrence
- Tumour Characteristics: More aggressive cancers are more likely to recur than less aggressive tumours , especially in the first five years. We also take into account the receptor status and an estimate of proliferation .
There are also factors that do not appear to affect the risk of recurrence. Recurrence rates are the same for women who have a mastectomy or lumpectomy with radiation and are also the same for women who have a single vs. double mastectomy.
Stage Iv Breast Cancers May Be Recurrences Following Initial Treatment
Up to 5% of initial breast cancer diagnoses are of the most advanced or metastatic stage. However, this number has significantly reduced with the implementation of widespread breast cancer screening programs.
Metastatic breast cancer can appear to be a rapid deterioration of a disease that has been present for some time undetected.
But metastatic breast cancer can also be the result of a recurrence of breast cancer after successful initial treatment. Sometimes the terms local and regional recurrence indicate a return of breast cancer to the original tumor site or elsewhere in the breast or contralateral breast.
If the cancer returns in other areas of the body it is a distant metastasis or distant recurrence.
For more detail on Stage IV survival rates, recurrence rates and treatment please see our new post HERE.
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Time To Chemotherapy After Surgery
After surgery for early-stage breast cancer, many women also have adjuvant chemotherapy .
The period of time between surgery and chemotherapy depends somewhat on how well someone does with surgery since the surgical site needs to be relatively well-healed before chemotherapy begins. But once the incision are healed, what is the optimal time to begin this treatment?
Treatment For Locally Advanced Breast Cancer
Treatment for locally advance breast cancer is likely to include a treatment that affects the whole body .
This might be chemotherapy, hormone therapy or targeted therapy.
Chemotherapy
If you have previously had chemotherapy, you may be offered different chemotherapy drugs this time.
Hormone therapy
If the cancer is oestrogen receptor positive you may be offered hormone therapy.
If you were already taking hormone therapy when your cancer returned, your doctor may consider switching you to a different drug.
Targeted therapy
Targeted therapies are a group of drugs that block the growth and spread of cancer.
The most widely used targeted therapies are for HER2 positive breast cancer. However, other targeted therapies are available to treat locally advanced breast cancer that is HER2 negative.
Radiotherapy and surgery
You may be offered radiotherapy if cancer cells are found in the lymph nodes above or below the collarbone, under the breastbone or between the ribs. Its not usually possible to remove the cancer using surgery in this situation.
If the recurrence has affected the muscles on the chest wall, surgery may be offered as well as radiotherapy.
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Inflammatory Breast Cancer: The Diagnosis
So, frequently in the diagnosis of IBC a PET scan is utilized.
Furthermore, larger sample excisional biopsies are often necessary. A skin biopsy can find evidence of invasive breast cancer cells, but this is not always the case.
Inflammatory breast cancer has a tendency to grow in layers, so it may be quite a while before a palpable lump actually appears. Furthermore, if a lump develops it might appear quite suddenly.
Around 30% of inflammatory breast cancers never develop an actual breast lump.
Recent studies have pointed to the potential advantages of new diagnostic techniques, such as fluorodeoxyglucose positron emission tomography .
Dilemmas Of Stage Iv Breast Cancer
Indeed, there are many serious and personal questions involving stage IV breast cancer. So, overall survival is less likely, and gains from intensive breast cancer treatment are unfortunately rather modest. A serious consideration is, therefore, quality of life during the course of treatment.
These decisions tend to be a dynamic process, based on individual cases, between patients and physicians. Respect needs to be given to the expectations for treatment, the status of the disease and the patient wishes.
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I Think We Have A Happy Oncologist
Patty: Please accept me smypathy. I have read many of your posts about you and Jack. I can not image how hard this is for you and yet you are still here helping the rest of us. You are a very special lady.
He has this attitude that this is something he can cure this. He keeps saying “it’s a very aggressive cancer” yet we’re really really going to hope? I wish he would tell me the truth and stop dancing around the diagonise. I would rather her be comfortable and happy then this miserable and in pain from the “treatments”.
Love Linda – Norwalk, OH
What Investigations Are Necessary For Staging Breast Cancer
Breast cancer staging almost always involves a bone scan, as breast cancer is highly prone to metastasize to the bones.
During this test, medics inject a small amount of a radioactive substance into the bloodstream, where it eventually collects in the bones. A radiation scanner is then able to detect accumulations of tracer substance in the bones.
If breast cancer spreads beyond the breast, 25% of the time it goes into bones first.
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Newly Diagnosed Or Worried About A Symptom
In the days or weeks after a diagnosis of secondary breast cancer, you may feel in turmoil and find it hard to think clearly.
You can read our information for people newly diagnosed with secondary breast cancer, including where to find support.
If you havent been diagnosed but are worried about a symptom, find out more about the signs and symptoms of secondary breast cancer.