What Are The Symptoms Of Breast Cancer
If you have any symptoms that worry you, be sure to see your doctor right away.
Different people have different symptoms of breast cancer. Some people do not have any signs or symptoms at all.
Some warning signs of breast cancer are
- New lump in the breast or underarm .
- Thickening or swelling of part of the breast.
- Irritation or dimpling of breast skin.
- Redness or flaky skin in the nipple area or the breast.
- Pulling in of the nipple or pain in the nipple area.
- Nipple discharge other than breast milk, including blood.
- Any change in the size or the shape of the breast.
- Pain in any area of the breast.
Keep in mind that these symptoms can happen with other conditions that are not cancer.
If you have any signs or symptoms that worry you, be sure to see your doctor right away.
What Is Staging For Cancer
Staging is the process of learning how much cancer is in your body and where it is. Tests like biopsies, CTs and MRIs are done to help stage your cancer. Your providers need to know about your cancer and your health so that they can plan the best treatment for you.
Staging looks at the size of the tumor and where it is, and if it has spread to other organs. The staging system for breast cancer is called the TNM system, as described by the American Joint Committee on Cancer. It has three parts:
- T-describes the size/location/extent of the “primary” tumor in the breast.
- N-describes if the cancer has spread to the lymph nodes.
- M-describes if the cancer has spread to other organs .
Your healthcare provider will use the results of the tests you had to determine your TNM result and combine these to get a stage from 0 to IV.
What Is The Treatment For Her2
Specialized breast cancer treatments, known as targeted therapies, have been developed to treat breast cancers that express the HER2 protein. Targeted therapies are newer forms of cancer treatment that specifically attack cancer cells and do less damage to normal cells than traditional chemotherapy. Targeted therapies for HER2-positive breast cancer include the following:
- Trastuzumab is an antibody against the HER2 protein Adding treatment with trastuzumab to chemotherapy given after surgery has been shown to lower the recurrence rate and death rate in women with HER2-positive early breast cancers. Using trastuzumab along with chemotherapy has become a standard adjuvant treatment for these women.
- Pertuzumab also works against HER2-positive breast cancers by blocking the cancer cell’s ability to receive growth signals from HER2.
- Lapatinib is another drug that targets the HER2 protein and maybe given combined with chemotherapy. It is used in women with HER2-positive breast cancer that is no longer helped by chemotherapy and trastuzumab.
- T-DM1 or ado-trastuzumab emtansine is a combination of Herceptin and the chemotherapy medication emtansine. Kadcyla was designed to deliver emtansine to cancer cells by attaching it to Herceptin.
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How Is The Stage Determined
The staging system most often used for breast cancer is the American Joint Committee on Cancer TNM system. The most recent AJCC system, effective January 2018, has both clinical and pathologic staging systems for breast cancer:
- The pathologic stage is determined by examining tissue removed during an operation.
- Sometimes, if surgery is not possible right away or at all, the cancer will be given a clinical stage instead. This is based on the results of a physical exam, biopsy, and imaging tests. The clinical stage is used to help plan treatment. Sometimes, though, the cancer has spread further than the clinical stage estimates, and may not predict the patients outlook as accurately as a pathologic stage.
In both staging systems, 7 key pieces of information are used:
- The extent of the tumor : How large is the cancer? Has it grown into nearby areas?
- The spread to nearby lymph nodes : Has the cancer spread to nearby lymph nodes? If so, how many?
- The spread to distant sites : Has the cancer spread to distant organs such as the lungs or liver?
- Estrogen Receptor status: Does the cancer have the protein called an estrogen receptor?
- Progesterone Receptor status: Does the cancer have the protein called a progesterone receptor?
- HER2 status: Does the cancer make too much of a protein called HER2?
- Grade of the cancer : How much do the cancer cells look like normal cells?
In addition, Oncotype Dx® Recurrence Score results may also be considered in the stage in certain situations.
Stage Groups For Breast Cancer
Doctors assign the stage of the cancer by combining the T, N, and M classifications , the tumor grade, and the results of ER/PR and HER2 testing. This information is used to help determine your prognosis . The simpler approach to explaining the stage of breast cancer is to use the T, N, and M classifications alone. This is the approach used below to describe the different stages.
Most patients are anxious to learn the exact stage of the cancer. If you have surgery as the first treatment for your cancer, your doctor will generally confirm the stage of the cancer when the testing after surgery is finalized, usually about 5 to 7 days after surgery. When systemic treatment is given before surgery, which is typically with medications and is called neoadjuvant therapy, the stage of the cancer is primarily determined clinically. Doctors may refer to stage I to stage IIA cancer as “early stage” and stage IIB to stage III as “locally advanced.” Stage 0: Stage zero describes disease that is only in the ducts of the breast tissue and has not spread to the surrounding tissue of the breast. It is also called non-invasive or in situ cancer . Stage IA: The tumor is small, invasive, and has not spread to the lymph nodes . Stage IB: Cancer has spread to the lymph nodes and the cancer in the lymph node is larger than 0.2 mm but less than 2 mm in size. There is either no evidence of a tumor in the breast or the tumor in the breast is 20 mm or smaller .
Stage IIA: Any 1 of these conditions:
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Metastatic Breast Cancer Symptoms
Metastatic breast cancer symptoms depend on the part of the body to which the cancer has spread and its stage. Sometimes, metastatic disease may not cause any symptoms.
- If the breast or chest wall is affected, symptoms may include pain, nipple discharge, or a lump or thickening in the breast or underarm.
- If the bones are affected, symptoms may include pain, fractures, constipation or decreased alertness due to high calcium levels.
- If tumors form in the lungs, symptoms may include shortness of breath or difficulty breathing, coughing, chest wall pain or extreme fatigue.
- If the liver is affected, symptoms may include nausea, extreme fatigue, increased abdominal girth, swelling of the feet and hands due to fluid collection and yellowing or itchy skin.
- If breast cancer spreads to the brain or spinal cord and forms tumors, symptoms may include pain, confusion, memory loss, headache, blurred or double vision, difficulty with speech, difficulty with movement or seizures.
Breast Thickening Or Pain
Your breast may feel thicker, or you may feel pain in part or all of it, per the CDC. Both symptoms are often signs of a less serious conditionbirth control pills may make breasts denser, and fibrosis can cause pain, especially around a person’s period, per the NCI. But talk to a healthcare provider to rule out cancer.
Experiencing any of these changes can be scary, but it’s important to remember that most aren’t due to breast cancer. And if you get a diagnosis, know there are many treatment options already available, with more in the works. Just make sure to see a healthcare provider ASAPearly diagnosis and treatment are crucial for a better outcome.
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Lobular Carcinoma In Situ
Lobular carcinoma in situ refers to an area of abnormal cells confined to the breasts milk-producing glands.
Because these cells do not spread to surrounding tissues, doctors do not lobular carcinoma situ to be cancer. However, it can increase the chances of developing other types of invasive breast cancer.
This condition rarely causes symptoms. Doctors lobular carcinoma in situ during a breast biopsy for another problem in the breast area. In some cases, tiny white specs of calcium called microcalcifications appear on a routine mammogram.
Determining Breast Cancer Stage
In breast cancer, stage is based on the size and location of the primary tumor, the spread of cancer to nearby lymph nodes or other parts of the body, tumor grade, and whether certain biomarkers are present.
The TNM system, the grading system, and the biomarker status are combined to find out the breast cancer stage.
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What Tests Assess Her2
There are two approved tissue testing methods for HER2 status. In 2013, the American Society of Clinical Oncologists and the College of American Pathologists issued an updated joint clinical practice guideline about HER2 testing for breast cancer. The two approved methods currently used in the U.S. to test for HER2 are
- immunohistochemistry and
- in-situ hybridization .
IHC testing uses specially labeled antibodies to show how much of the HER2 protein is present on the cancer cell surface, while ISH testing measures the number of copies of the HER2 gene inside each cell.
There are two main types of ISH tests:
- fluorescence and
- bright-field ISH.
Fluorescence in situ hybridization is referred to as FISH. Both of these tests are performed on the tumor sample that is removed at the time of surgery.
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What Is Stage 0 Dcis
Stage 0 breast cancer, ductal carcinoma in situ is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. In Stage 0 breast cancer, the atypical cells have not spread outside of the ducts or lobules into the surrounding breast tissue. Ductal Carcinoma In Situ is very early cancer that is highly treatable, but if its left untreated or undetected, it can spread into the surrounding breast tissue.
How To Check Your Breasts
Theres no special way to check your breasts and you do not need any training.
Checking your breasts is as easy as TLC:
- Touch your breasts: can you feel anything new or unusual?
- Look for changes: does anything look different to you?
- Check any new or unusual changes with a GP
Everyone will have their own way of touching and looking for changes.
Get used to checking regularly and be aware of anything thats new or different for you.
Check your whole breast area, including up to your collarbone and armpits.
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What Are The First Signs Of Inflammatory Breast Cancer
Inflammatory breast cancer can be challenging to catch because it doesnt often cause a lump like more common forms of breast cancer. Instead, the first signs are related to inflammation in your affected breast. These symptoms make it easy to confuse IBC for a less serious condition, like an infection.
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Other Treatments For Early
Surgery is rarely used as a standalone treatment for breast cancer. Oncologists often recommend a combination of radiation therapy, chemotherapy, hormone therapy, and/or targeted therapy after surgery. The exact combination not only depends on the stage but also the hormone status and HER2 status of the cancer.
Breast Lumps Or Lumpiness
Many women find their breasts feel lumpy. Breast tissue naturally has a bumpy texture.
Some women have more lumpiness in their breasts than others. In most cases, this lumpiness is no cause to worry.
If the lumpiness can be felt throughout the breast and feels like your other breast, then its likely normal breast tissue.
Lumps that feel harder or different from the rest of the breast or that feel like a change should be checked. This type of lump may be a sign of breast cancer or a benign breast condition .
See a health care provider if you:
- Find a new lump that feels different from the rest of your breast
- Find a new lump that feels different from your other breast
- Feel something thats different from what you felt before
If youve had a benign lump in the past, dont assume a new lump will also be benign. The new lump may not be breast cancer, but its best to make sure.
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Soothe Skin And Nails
Cancer treatment can make your skin dry, itchy, or red. Radiation therapy can also make you more sensitive to the sun. Ask your cancer care team what products to use. Theyâll know which over-the-counter choices are mild and gentle. Here are some other things they might suggest:
- Use a fragrance-free moisturizer and soap
- Avoid tight clothes and underwire bras
- Keep skin clean to prevent infection
- Wear sunscreen with an SPF of 30 or higher on your body and lips
You might notice some nail changes. They could crack or turn yellow. Your cuticles may swell and hurt. To help, you can:
- Cut your nails short
Find The Right Breast Cancer Specialist For You In Colorado
At Rocky Mountain Breast Specialists, we treat patients with breast cancer of all stages throughout Colorado. Our breast cancer specialists are up-to-date on the latest treatments for various types of cancer. We’re also actively participating in clinical research to help find new and better ways to care for breast cancer patients. Our dedicated team is available to help you if you need it.
If you would like to schedule an initial consultation or would like a second opinion about breast cancer treatment options, request an appointment at the location most convenient for you.
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How Is Breast Cancer Staged
Breast cancer in men and women is staged the same, into five groups. This article will focus on early/moderate stage breast cancer in women. Learn more about male breast cancer here.
Staging is based on:
- The size of your tumor on the mammogram and what is found after surgery.
- Any evidence of spread to other organs .
- Surgery to test if your lymph nodes have cancer cells.
Staging is important because it helps guide your treatment options. Stages 0, I, and II are early or moderate stages.
The staging system is very complex. Below is a summary of the staging system. Talk to your provider about the stage of your cancer.
- Stage 0 :
- Lobular carcinoma in situ : abnormal cells line a gland in the breast. This is a risk factor for future cancer, but this is not thought to be cancer itself.
- Ductal carcinoma in situ : abnormal cells linea duct in the breast. Women with DCIS have a higher risk of getting invasive breast cancer in that breast. Treatment options are similar to patients with Stage I breast cancers.
What Are The Common Signs And Symptoms Of Breast Cancer
The following early signs and symptoms of breast cancer can happen with other conditions that are not cancer related.
- New lump in the breast or underarm
- Thickening or swelling of part of the breast
- Irritation or dimpling of breast skin
- Redness or flaky skin in the nipple area of the breast
- Pulling in of the nipple or pain in the nipple area
- Nipple discharge other than breast milk, including blood
- Any change in the size or the shape of the breast
- Pain in any area of the breast
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