If You Are Age 55 Or Over:
Mammograms are recommended every other year. You can choose to continue to have them every year.
Clinical breast exams and self-exams are not recommended. But you should be familiar with your breasts and tell a health care provider right away if you notice any changes in how your breasts look or feel.
About The Medical Reviewer
Dr. Burstein graduated from Harvard College before earning his MD at Harvard Medical School. He also received a PhD in cellular immunology and a master’s degree in the history of science from Harvard. He trained in internal medicine at Massachusetts General Hospital before his oncology fellowship at DFCI. In 1999, he joined the staff of DFCI and Brigham and Women’s Hospital, where he is a clinician and clinical investigator in the Breast Oncology Center.
Choosing To Stop Treatment Or Choosing No Treatment At All
For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.
Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but its important to talk to your doctors and you make that decision. Remember that even if you choose not to treat the cancer, you can still get;supportive care;to help with pain or other symptoms.
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Considering Complementary And Alternative Methods
You may hear about alternative or complementary methods that your doctor hasnt mentioned to treat your cancer or relieve symptoms. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.
Complementary methods refer to treatments that are used along with your regular medical care. Alternative treatments are used instead of a doctors medical treatment. Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be harmful.
Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known about the method, which can help you make an informed decision.;
Herbal Products Used For Prevention Of Breast Cancer
Figure 2.
Some important members of different classes of phytoestrogens .
Naturally occurring phenolic compounds namely phenolic acids, flavonoids, tannins, quinones, anthocyanins, and others play an important role in cancer prevention and/or treatment . These phenolic compounds are ubiquitous and rich in medicinal herbs and dietary plants. Several phenolic compounds contribute toward inhibiting carcinogenesis mechanism and show chemopreventive activities by their diverse range of biological activities .
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Avoid Birth Control Pills Particularly After Age 35 Or If You Smoke
Birth control pills have both risks and benefits. The younger a woman is, the lower the risks are. While women are taking birth control pills, they have a slightly increased risk of breast cancer. This risk goes away quickly, though, after stopping the pill. The risk of stroke and heart attack is also increased while on the pill particularly if a woman smokes. However, long-term use can also have important benefits, like lowering the risk of ovarian cancer, colon cancer and uterine cancer not to mention unwanted pregnancy so theres also a lot in its favor. If youre very concerned about breast cancer, avoiding birth control pills is one option to lower risk.
What Is Stage 4 Breast Cancer
Stage 4 breast cancer is also called metastatic breast cancer or advanced breast cancer. In this stage, cancer that developed in your breast has spread to other areas of your body.
Cancer cells might have traveled through your lymphatic system to your lungs, bones, liver, brain, or other organs.
Stage 4 is the most serious and life threatening stage of breast cancer. Most often, stage 4 breast cancer develops long after a person has first been diagnosed with cancer. In rare cases, the cancer may have progressed to stage 4 at the time a person is first diagnosed.
Facing stage 4 breast cancer can be challenging. But following your doctors recommended treatment plan and practicing healthy lifestyle habits can help to improve your outcome. It may significantly increase your lifespan and improve your quality of life.
Breast Cancer Healthline is a free app for people who have faced a breast cancer diagnosis. The app is available on the App Store and . Download here.
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Does Having Breast Cancer Shorten Life Expectancy
Women with breast cancer whose tumour is detected early can survive as long as those without the disease. Analysis of the latest figures shows that if a cancer was small, low grade and had not spread to the lymph nodes, women were given a normal life expectancy if they remained clear for five years after treatment.
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Certain Factors Affect Prognosis And Treatment Options
The prognosis and treatment options depend on the following:
- The stage of the cancer .
- The type of breast cancer.
- Estrogen receptor and progesterone receptor levels in the tumor tissue.
- Human epidermal growth factor type 2 receptor levels in the tumor tissue.
- Whether the tumor tissue is triple negative .
- How fast the tumor is growing.
- How likely the tumor is to recur .
- A womans age, general health, and menopausal status .
- Whether the cancer has just been diagnosed or has recurred .
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How Are Clinical Trials Helping To Improve Treatments
Scientists continue to conduct clinical trials to develop and test treatments for breast cancer.
These trials may help them develop new treatment options and learn which types of people are most likely to benefit from available treatments. Over time, this might lead to more effective and personalized treatment plans.
One 2018 trial found that chemotherapy doesnt benefit most women with early stage breast cancer that is hormone-positive and HER2-negative. These women may benefit from surgery and hormone therapy instead.
Researchers in many other trials are also trying to determine whether certain combinations of therapies work better in certain types of breast cancer, report the authors of a 2019 review .
Scientists are also studying ways to improve breast cancer screening and diagnosis to detect breast cancer in the earliest stage possible.
For example, the tomosynthesis mammographic imaging screening trial is evaluating the potential benefits of 3-D mammography.
This is a new technology that produces images from different angles around the breast to build a multidimensional picture.
There is no natural cure for breast cancer. Medical treatments are necessary to remove, shrink, or slow the growth of tumors.
That said, you may use certain complementary therapies and lifestyle changes alongside standard medical treatments to help:
- control symptoms of breast cancer
- ease side effects of treatment
- improve quality of life
For example:
A History Of Breast Cancer Or Breast Lumps
Women who have previously had breast cancer are more likely to have it again than those who have no history of the disease.
Having some types of noncancerous breast lump increases the chance of developing cancer later on. Examples include atypical ductal hyperplasia or lobular carcinoma in situ.
Individuals with a history of breast, ovarian, fallopian tube, or peritoneal cancer
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Time To Treatment With Metastatic Breast Cancer
There is little research looking at the optimal time until treatment for metastatic breast cancer, though it appears that waiting more than 12 weeks has been linked with lower survival. In general, however, the goal of treatment with MBC is different than early stage disease. For most people, treatment for early-stage disease is aggressive, with the goal to reduce the risk of recurrence. With MBC, the goal is often to use the least amount of treatment necessary to control the disease.
More Precise Radiation Treatments
Similarly, radiation treatments have improved. Newer technology allows radiation oncologists to plan therapy that targets the breast but avoids the heart.
We can outline areas at risk slice by slice on a CT scan, and then we can outline what we want to miss, like the heart, says Reshma Jagsi, M.D., D.Phil., professor and deputy chair of radiation oncology at U-M.
Add to that a surprising low-tech solution: Have the patient hold her breath. This pushes the lung up, which moves the heart farther away from the breastbone, adding another layer of protection.
An analysis of more than 1,000 breast cancer patients treated with radiation at U-M found these approaches led to excellent outcomes in terms of both preventing recurrence and reducing cardiac events.
Radiation courses are getting shorter, too. Instead of coming for daily treatments for six weeks, some patients now come for only three weeks. They get higher daily doses of radiation but less dose overall. And that has also translated into fewer side effects.
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Finding Social And Emotional Support
Its critical to find a strong source of social support, whether its your friends and family, or a support group with other people with breast cancer. While the journey is challenging, you dont have to navigate stage 4 breast cancer alone.
Ask your healthcare provider if theres an in-person support group where you receive treatments. You can also find online and social media groups to join.
Your healthcare provider can also provide more information about the specifics of your cancer, treatment options, and support programs in your area. If youre not sure where to look for an in-person group, a counselor or social worker can also help.
What Are The Side Effects Of Hormone Therapy
The side effects of hormone therapy depend largely on the specific drug or the type of treatment . The benefits and harms of taking hormone therapy should be carefully weighed for each person. A common switching strategy used for adjuvant therapy, in which patients take tamoxifen for 2 or 3 years, followed by an aromatase inhibitor for 2 or 3 years, may yield the best balance of benefits and harms of these two types of hormone therapy .
Hot flashes, night sweats, and vaginal dryness are common side effects of all hormone therapies. Hormone therapy also may disrupt the menstrual cycle in premenopausal women.
Less common but serious side effects of hormone therapy drugs are listed below.
Tamoxifen
- Breathing problems, including;painful breathing, shortness of breath, and cough
- Loss of appetite
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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.
Metastatic Breast Cancer: You Are Not A Statistic
Dr. Kelly Shanahan is the medical director of METUP, an organization committed to changing the landscape of metastatic cancer through direct action. Shes also living with metastatic breast cancer, or as she puts it, shes dying for a cure.
Shes seen and heard all the breast cancer statistics, but she doesnt let those numbers control her life. As Shanahan points out, statistics apply to large populations, they dont apply to individuals. Shes living beyond the average life expectancy for her cancer; I might live two months, I might live 25 years. And Im going for that 25 years, she tells SurvivorNet.
As a doctor and a patient, Shanahan says her greatest hope remains with research, which is why shes an activist for improving clinical trials and an advocate for metastatic-specific research.
I know that the only thing that is going to save my life and the life of my fellow sisters and brothers with metastatic breast cancer is research, she says.
Theres no denying that the campaign has brought needed attention and money to the disease. And there are very few organizations in all of the non-profit world that have had as much of an impact as the Breast Cancer Research Foundation; you know them if youve ever seen that pink breast cancer ribbon, which you most likely have.
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The Stages Of Breast Cancer And Your Treatment Options
Compared to most other cancers, staging breast cancer is more complex. And when it comes to treating breast cancer, there isnt a one-size-fits-all approach. Your treatment plan should be created especially for you and be coordinated across specialists and thats where your cancer care team comes in.
At HealthPartners, we believe cancer treatment and care is best managed by a group of doctors and specialists in whats known as multidisciplinary conferences. This is where breast surgeons, oncologists, radiologists, pathologists and other members of your care team gather to discuss the best treatment sequence for you.
Below we dive into the treatment options your care team might recommend at various breast cancer stages.
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Histological Grade And Ki67
Histological grade information was available from the ICD-O-3 code and categorized as low , intermediate and high according to the Elston-Ellis modification of the Scarff-Bloom-Richardson grading system . Women with anaplastic carcinoma were excluded, leaving n=24,137 women for the analysis . Ki67 has been recorded routinely since 2011 and was categorized as low , intermediate or high according to cutoffs in the Norwegian treatment guidelines .
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Which Treatment Is Right For Me
Choosing the treatment that is right for you may be hard. Talk to your cancer doctor about the treatment options available for your type and stage of cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments.
Sometimes people get an opinion from more than one cancer doctor. This is called a second opinion. Getting a second opinionexternal icon may help you choose the treatment that is right for you.
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Insurance And Scheduling Problems
Some people find that the surgeon they’ve chosen under their insurance company isn’t available for longer than they would like to wait, or that it’s difficult to coordinate a surgeon and plastic surgeon on the same day in a reasonable amount of time. This can be more difficult some places than others. With the larger cancer centers, you may have a coordinator who will assist you in setting up appointments. In the community, you may need to do most of the legwork yourself.
Regardless, it’s important to be your own advocate. If you’re having difficulty, make sure to work with your insurance company. Sometimes they may cover a second or third tier provider if it’s the only option available for scheduling your surgery promptly . With some procedures, prior authorization is needed before scheduling can take place.
There are many breast cancer organizations that can assist you as well as help you make decisions. Support groups and online support communities are also an excellent option when it comes to questions and challenges along the way.
There are many options as well for those who are underinsured or uninsured, but again, it’s usually up to you to do the legwork. Programs such as the SAGE program are available, as well as many other assistance programs that can help with anything from transportation to childcare. Talking to a social worker at your cancer center can be invaluable in learning about your options.
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From Cured To Stage 4
Others, like Teri Pollastro, a 54-year-old stage 4 patient from Seattle, respond surprisingly well.
Diagnosed with early stage ductal carcinoma in situ in 1999, Pollastro underwent a mastectomy but did not receive chemotherapy, radiation or tamoxifen, since her cancer was ER negative.
âThey used the C-word with me, they told me I was cured,â she said. âEvery time I went back to my oncologist, he would roll his eyes at me when I had questions.â
In 2003, Pollastro switched to Seattle Cancer Care Alliance where she saw Dr. Julie Gralow, a breast cancer oncologist and clinical researcher at Fred Hutchinson Cancer Research Center. Gralow discovered Pollastroâs cancer had metastasized to her liver.
âMy husband and I were in shock,â said Pollastro of her mets diagnosis. âYou donât go from being cured to stage 4.â
Pollastro went on Herceptin, a type of immunotherapy for women with HER2-positive metastatic breast cancer, and did six months of chemotherapy.
âI felt better right away with the treatment,â she said. âBut the problem is, it stopped . Thatâs what you can expect with mets. And thereâs always some residual cancer. And that starts percolating.â
And along with mets, she also had to deal with many misconceptions regarding her disease.
The Mercer Island, Washington, mother of two, who often counsels newly diagnosed patients, sometimes even found it difficult to relate to early stage breast cancer survivors.
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