What Kind Of Treatment Follow
The major goal of follow-up is, if possible, to detect and treat recurrences in the irradiated breast or lymph nodes and new cancers developing later in either breast before they can spread to other parts of the body. Theroutine use of bone scans, chest x-rays, blood tests and other tests to detect the possible spread to other organs in patients without symptoms does not appear to be useful. Your physician will determine a follow-upschedule for you. This may include a physical exam every few months for the first several years after treatment and then every six to 12 months or so after that. Annual follow-up mammograms are an important part of your care. If symptoms or clinical circumstances suggest a recurrence, diagnostic tests such as blood tests, ultrasound,computed tomography , magnetic resonance imaging , chest x-ray , or bone scan may be needed.
Radiation Therapy And Mastectomy
Most women who have a mastectomy dont need radiation therapy if theres no cancer in the lymph nodes.
In some cases, radiation therapy is used after mastectomy to treat the chest wall, the axillary lymph nodes and/or the lymph nodes around the collarbone.
For a summary of research studies on mastectomy versus lumpectomy plus radiation therapy and overall survival in early breast cancer, visit the Breast Cancer Research Studies section.
For a summary of research studies on radiation therapy following mastectomy for invasive breast cancer, visit the Breast Cancer Research Studies section.
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.
If you have previously had chemotherapy, you may be offered different chemotherapy drugs this time.
If you were already taking hormone therapy when your cancer returned, your doctor may consider switching you to a different drug.
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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A Breast Surgeon Explains Breast Cancer Screenings Advanced Treatment Options And Why Early Detection Is So Important
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About one in eight women will be diagnosed with breast cancer at some point in their lives, according to the American Cancer Society . If that sounds like a lot, its because it is: Breast cancer is the most common cancer in women, aside from skin cancers.
While the prevalence of breast cancer is high in the United States, the survival rate is equally high90% of patients beat the cancer. Increased awareness and advanced treatment methods have taken what was once a grim diagnosis and turned it into a treatable disease in many cases. The key is catching it early.
If you are diagnosed early and follow through with the proper treatments, the prognosis is actually very good, says Dr. Luona Sun, a breast surgeon at NewYork-Presbyterian/Columbia University Irving Medical Center and assistant professor of surgery at Columbia University Vagelos College of Physicians and Surgeons. I tell my patients, dont be scared of the diagnosis itself, but fully recognize the facts and proactively participate in your treatments.
Health Matters spoke to Dr. Sun to get the facts about breast cancer and understand why early detection is so important for fightingand beatingbreast cancer. Here are six facts she wants people to know.
Survival Rates For Breast Cancer
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
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Who Should Get Screened
- If you are age 50 to 74, the Ontario Breast Screening Program recommends that most women in your age group get screened every 2 years with mammography.
- If you are age 30 to 69 and meet the eligibility criteria for the High Risk Ontario Breast Screening Program, the program recommends that you get screened every year with both mammography and breast magnetic resonance imaging .
To find out when and where to get screened, and learn about mammograms, the Ontario Breast Screening Program and more, go to the Screening for Breast Cancer page.
Cancer Cure And All Clear
Many people who have cancer want to know if theyre cured. You may hear words like cure and all clear in the media.
Cured means theres no chance of the breast cancer coming back. However, its not possible to be sure that breast cancer will never come back. Treatment for breast cancer will be successful for most people, and the risk of recurrence gets less as time goes on. Recurrence, unfortunately, can happen even many years after treatment, so no one can say with certainty that youre definitely cured.
All clear, or in remission which is another term you may have heard used, means theres no obvious sign of cancer at the moment.
If your breast cancer has spread to other parts of your body this will affect your prognosis. Secondary breast cancer can be treated, sometimes for many years, but not cured. Find out more about secondary breast cancer.
In order to be as clear as possible, your treatment team is more likely to talk about your chances of survival over a period of time or the possibility of remaining free of breast cancer in the future.
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Myth #: If Youre Diagnosed With Metastatic Breast Cancer You Did Something Wrong Or Didnt Get The Right Treatment The First Time
When some people hear stage IV breast cancer, they assume something must have been missed along the way to let the cancer get that far. There is a misconception that breast cancer always develops in orderly steps from stages I to II, III, and then IV and that theres plenty of time to catch it early. People with MBC can face misguided assumptions that they must have skipped mammograms or self-exams, or they didnt control risk factors such as not exercising enough, watching their weight, or eating healthy. But a person can do everything right and still get MBC. Although regular screenings increase the odds of diagnosing breast cancer at an earlier stage, they cant guarantee it.
Another major misconception: If youre diagnosed with metastatic cancer after being treated for an early-stage breast cancer, you must have chosen the wrong treatment regimen or it wasnt aggressive enough. But between 20% and 30% of people with an earlier-stage breast cancer will eventually go on to develop MBC and theres often no good explanation as to why. And it can happen to anyone. Treatments can reduce the risk of recurrence, but they cant eliminate it.
As Illimae of Houston notes: that a stage IV diagnosis equals negligence on the part of the patient. In my case, it had spread before I ever felt a lump. I felt it Saturday and saw my doc on Monday, I ignored nothing, sometimes it just happens that fast.
Complementary And Alternative Medicine
Complementary and alternative medicine are medicines and health practices that are not standard cancer treatments. Complementary medicine is used in addition to standard treatments, and alternative medicine is used instead of standard treatments. Meditation, yoga, and supplements like vitamins and herbs are some examples.
Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor about the risks and benefits before you start any kind of complementary or alternative medicine.
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Next Steps After Screening For Breast Cancer
The next steps after a breast cancer screening depend on your results. No follow-up steps are needed if nothing was detected on your mammogram or breast MRI.
If the mammogram or MRI shows something the doctors want to see more closely, theyll let you know what it might mean and what you should do next.
Risk Of Late Recurrence Is Underestimated
A survey led by the Canadian Breast Cancer Network found that women often underestimate their risk of late recurrence. In the survey, only 10% were aware of the risk of recurrence after five years of tamoxifen therapy, and 40% felt that they were cured after hitting the five-year mark.
Many breast cancer survivors underestimate their risk of late recurrence.
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Myth #: People With Metastatic Breast Cancer Have A Short Amount Of Time Left
While some people mistakenly think MBC is curable, at the other extreme are those who assume its an immediate death sentence. But there is a big difference between stage IV incurable cancer, which MBC is, and terminal cancer, which can no longer be treated. A person isnt automatically terminal when she or he gets a metastatic diagnosis. Although MBC almost certainly will shorten someones life, it often can be managed for years at a time.
As Illimae of Houston points out: Stage IV is not an immediate death sentence. It feels that way at first but many have months/years of reasonably decent condition. Brain mets are not necessarily the end either. When found early and treated, especially with minimal disease in the body, life can resume to a fairly normal state.
Mermaid007 adds: hen I was diagnosed with bone mets I felt I needed to go home and get my affairs in order when here I am 4 and half years later.
Why Are Some Cancers Diagnosed Late
There can be several reasons for delays in cancer diagnosis, for example:
- People might not be aware of possible cancer signs and symptoms, such as feeling tired for no reason, or having a cough that doesnt go away.
- People might struggle to get an appointment at a convenient time or be worried about taking up doctor time.
- Some people might put off speaking to their GP because of worries about what they might find.
- There can be delays in referring patients for tests, or in getting an appointment at the hospital.
- Not all diagnosis journeys are straightforward. Doctors might investigate other possibilities before making a cancer diagnosis.
When it comes to your body, remember youre in charge. If you do spot something unusual, dont put it off. Speak to your doctor, even if its something youve mentioned before. In most cases it wont be cancer but if it is, finding it early can make a real difference.
In the UK, national screening programmes can help diagnose cancers at an early stage, when treatment is more likely to be successful. Cancer screening is for people without symptoms, so if youve noticed a change, dont wait for screening. Tell your doctor as soon as possible.
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Getting Checked What’s Involved
Some people put off visiting their GP practice because they think theyll be wasting their time. Your doctor wont think that they want to see you if youre worried about potential symptoms. The symptoms might not be due to cancer. But if it is, the earlier its picked up the higher the chance of successful treatment.
Its always best to get checked early. Your concerns will be listened to and depending on your symptoms they will:
- Be able to reassure you
- Examine the area you are concerned about
- Refer you to the hospital for further tests if necessary.
What Is Stage 4 Breast Cancer
Also known as metastatic breast cancer, the cancer in this stage has spread beyond the breast, underarm and internal mammary lymph nodes to other parts of the body near to or distant from the breast. The cancer has spread elsewhere in the body. The affected areas may include the bones, brain, lungs or liver and more than one part of the body may be involved.
At stage 4, TNM designations help describe the extent of the disease. Higher numbers indicate more extensive disease. Most commonly, stage 4 breast cancer is described as:,
- T: T1, T2, T3 or T4 depends on the size and/or extent of the primary tumor.
- N1: Cancer has spread to the lymph nodes.
- M1: The disease has spread to other sites in the body.
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What Are The Complications Of Breast Cancer Recurrence
Breast cancer that comes back can be harder to treat. The same therapy isnt always effective again. Tumors can develop a tolerance to certain treatments like chemotherapy. Your healthcare provider will try other therapies. You may be able to try drugs under development in clinical trials.
If breast cancer spreads to other parts of the body, your healthcare providers still treat it like breast cancer. For instance, breast cancer cells that move to the lungs cause breast cancer in the lungs not lung cancer. Metastatic breast cancer is more difficult to treat than cancer in only one part of the body.
Myth #: Metastatic Breast Cancer Is Curable
Whether metastatic breast cancer is someones first diagnosis or a recurrence after treatment for earlier-stage breast cancer, it cant be cured. However, treatments can keep it under control, often for months at a time. People with MBC report fielding questions from family and friends such as, When will you finish your treatments? or Wont you be glad when youre done with all of this? The reality is they will be in treatment for the rest of their lives.
A typical pattern is to take a treatment regimen as long as it keeps the cancer under control and the side effects are tolerable. If it stops working, a patient can switch to another option. There may be periods of time when the cancer is well-controlled and a person can take a break. But people with MBC need to be in treatment for the rest of their lives.
As Breastcancer.org Community member Vlnprh of Wisconsin comments: The vast majority of people have no idea what MBC treatment involves. They somehow think that you will undergo something similar to early-stage patients surgery, radiation, chemo, whatever and then be done. They want to see you as a pink-tutu-wearing cheerleader jumping up and down declaring that you have beaten this disease
Amarantha of France writes: The one I get over and over is, How long will you be on this chemo? I mean doesn’t it end sometime? Yes, it ends when it stops working and then we go on to another treatment lather, rinse, repeat I guess until we run out of options.
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How Can I Prevent Breast Cancer Recurrence
Healthcare providers dont know why some people experience breast cancer recurrence. A recurrence isnt your fault. You didnt do anything wrong to cause it or fail to do something more to prevent it.
Certain medications may reduce the risk of breast cancer recurrence in people who have early stage breast cancer. For estrogen-receptive breast cancer, hormonal therapies including tamoxifen or aromatase inhibitors block either the activity of estrogen or the bodys production of estrogen. Chemotherapy may also be recommended to reduce risk of breast cancer recurrence.
Early diagnosis may make it easier to treat a recurrence. Follow your healthcare providers recommendations for mammograms and other screenings. You should also perform regular breast self-exams. Get familiar with how your breasts look and feel so you can see your provider quickly if you notice changes. And remember that most breast changes occur for reasons other than cancer.
Playing An Active Role
You play an active role in making treatment decisions by understanding your breast cancer diagnosis, your treatment options and possible side effects.
Together, you and your health care provider can choose treatments that fit your values and lifestyle.
The National Academy of Sciences released the report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis in 2013. Susan G. Komen® was one of 13 organizations that sponsored this study.
The report identified key ways to improve quality of care:
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What Is Yale Medicines Approach To Detecting And Treating Breast Cancer In Men
Our radiologists are uniquely qualified to diagnose even the rarest forms of breast cancer, including male breast cancerearly and accurately. Our radiologists who subspecialize in breast imaging are among the most highly skilled leaders in the field. They are nationally and internationally recognized for their skill in diagnosing breast cancer. Additionally, our radiologists conduct research on 3D mammography and dense breast imaging, which is advancing the field of radiology.
A man with a breast-related complaint will be scheduled for a diagnostic mammogram and ultrasound within a few days, Dr. Andrejeva-Wright says. If a suspicious mass is seen, then a needle biopsy is scheduled soon after. If a diagnosis of breast cancer is made, our intake specialists coordinate all necessary appointments with the patient as soon as possible, so that treatment can begin quickly.