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What Happens After Breast Cancer

Returning To Normal Activities

What Happens After Breast Cancer Surgery – New Options for Breast Reconstruction | Dr. Luke Cusimano

When youre home from hospital, try to do a little more physical activity each day. Try not to set yourself big tasks and remember to get a good amount of rest. Your body needs time and energy to recover.

You’ll usually be advised not to lift or carry anything heavy until your wounds have fully healed. If you take things gently at first, you should be able to return to most of your normal activities within a few weeks of your operation but this will vary from person to person and will depend on the type of surgery youve had.

Your breast care nurse or surgeon will be able to provide advice on practical issues such as driving, returning to work and leisure activities.

What Factors Can Affect The Timing Of Breast Reconstruction

One factor that can affect the timing of breast reconstruction is whether a woman will need radiation therapy. Radiation therapy can sometimes cause wound healing problems or infections in reconstructed breasts, so some women may prefer to delay reconstruction until after radiation therapy is completed. However, because of improvements in surgical and radiation techniques, immediate reconstruction with an implant is usually still an option for women who will need radiation therapy. Autologous tissue breast reconstruction is usually reserved for after radiation therapy, so that the breast and chest wall tissue damaged by radiation can be replaced with healthy tissue from elsewhere in the body.

Another factor is the type of breast cancer. Women with inflammatory breast cancer usually require more extensive skin removal. This can make immediate reconstruction more challenging, so it may be recommended that reconstruction be delayed until after completion of adjuvant therapy.

Even if a woman is a candidate for immediate reconstruction, she may choose delayed reconstruction. For instance, some women prefer not to consider what type of reconstruction to have until after they have recovered from their mastectomy and subsequent adjuvant treatment. Women who delay reconstruction can use external breast prostheses, or breast forms, to give the appearance of breasts.

Getting Used To Changes

Research has shown that the sooner you confront the physical changes to your body, the easier you may find it to gain confidence in the way you look. However, some people wont have had the chance or courage to do this early on.

If you have a partner, letting them see the surgical scars and changes to your body sooner may also make being intimate easier in the long term.

The first few times you look at yourself might make you feel unhappy and shocked, and you may want to avoid looking at yourself again. However, the initial intense feelings you may have will lessen over time as you get more used to how you look now.

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Q: How Else Can Survivors Prepare For Life After Treatment

A: Survivors can ask their oncologist for an end of treatment summary that outlines the original diagnosis, including the cancer type, stage, and the treatments received. These details will be important to future health care providers throughout their lifetime. This information should also clearly state the proposed schedule for follow-up visits and recommended scans and other testing to monitor the person’s recovery, also called a “survivorship care plan.”

Another very helpful resource is a support group. It allows survivors to share experiences and advice and receive support from individuals who have had similar experiences and who are outside their usual circle of family or friends.

Meanwhile, some may find it useful to look for more information about survivorship after their specific type of cancer or information on coping, using web-based materials such as those available on Cancer.Net. Others may turn to literature, hobbies, or their faith to help them move forward. The important message is that life may be forever changed by the experience of having cancer, and those changes deserve careful attention and respect.

Ask Your Doctor For A Survivorship Care Plan

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Talk with your doctor about developing a survivorship care plan for you. This plan might include:

  • A suggested schedule for follow-up exams and tests
  • A schedule for other tests you might need in the future, such as early detection tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
  • A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
  • Diet, physical activity, and other lifestyle modification suggestions

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Radiotherapy To Part Of The Breast

Less commonly, some women are given radiotherapy to part of the breast instead of the whole breast. There are different ways of doing this.

Your cancer doctor or specialist nurse will explain if any of the following treatments are options for you. They will tell you what the possible side effects are and any risks involved.

It is important to have information about all your treatment options. They can explain how these treatments compare with external radiotherapy.

Late Effects Of Radiotherapy For Breast Cancer

Radiotherapy to the breast may cause side effects that happen months or years after radiotherapy. They are called late effects.

Newer ways of giving radiotherapy are helping reduce the risk of these late effects happening. If you are worried about late effects, talk to your cancer doctor or specialist nurse.

The most common late effect is a change in how the breast looks and feels.

Radiotherapy can damage small blood vessels in the skin. This can cause red, spidery marks to show.

After radiotherapy, your breast may feel firmer and shrink slightly in size. If your breast is noticeably smaller, you can have surgery to reduce the size of your other breast.

If you had breast reconstruction, using an implant before radiotherapy, you may need to have the implant replaced.

It is rare for radiotherapy to cause heart or lung problems, or problems with the ribs in the treated area. This usually only happens if you had treatment to your left side.

Tell your cancer doctor if you notice any problems with your breathing, or have any pain in the chest area.

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Who Is On My Radiation Therapy Team

A highly trained medical team will work together to provide you with the best possible care. This team may include the following health care professionals:

Radiation oncologist. This type of doctor specializes in giving radiation therapy to treat cancer. A radiation oncologist oversees radiation therapy treatments. They work closely with other team members to develop the treatment plan.

Radiation oncology nurse. This nurse specializes in caring for people receiving radiation therapy. A radiation oncology nurse plays many roles, including:

  • Answering questions about treatments

  • Monitoring your health during treatment

  • Helping you manage side effects of treatment

Medical radiation physicist. This professional helps design treatment plans. They are experts at using radiation equipment.

Dosimetrist. The dosimetrist helps your radiation oncologist calculate the right dose of radiation.

Radiation therapist or radiation therapy technologist. This professional operates the treatment machines and gives people their scheduled treatments.

Other health care professionals. Additional team members may help care for physical, emotional, and social needs during radiation therapy. These professionals include:

  • Social workers

Learn more about the oncology team.

What Are Possible Side Effects Of Radiation Therapy

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There are usually no immediate side effects from each radiation treatment given to the breast. Patients do not develop nausea or hair loss on the head from radiation therapy to the breast.

Most patients develop mild fatigue that builds up gradually over the course of therapy. This slowly goes away one to two months following the radiation therapy. Most patients develop dull aches or sharp shooting pains in the breast that may last for a few seconds or minutes. It is rare for patients to need any medication for this. The most common side effect needing attention is skin reaction. Most patients develop reddening, dryness anditching of the skin after a few weeks. Some patients develop substantial irritation.

Skin care recommendations include:

  • Keeping the skin clean using gentle soap and warm but not hot water
  • Avoiding extreme temperatures while bathing
  • Avoiding trauma to the skin and sun exposure
  • Avoiding shaving the treatment area with a razor blade
  • Avoiding use of perfumes, cosmetics, after-shave or deodorants in the treatment area
  • Using only recommended unscented creams or lotions after daily treatment

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How Long After Cancer Diagnosis Does Treatment Start

In general, most breast cancer treatments should start soon after a diagnosis. What does soon mean? This depends on the type of cancer, how aggressive it is, if additional testing is needed and if you plan to seek a second opinion.

A few days or a week may go by without treatment as your doctors put a plan in place. If this occurs, you may feel antsy and wonder if those lost days will cause your cancer to spread. Most cancers grow slowly, though, so waiting a short amount of time wont typically alter the outcome.

Are Lymph Nodes Removed During A Lumpectomy

Women with invasive breast cancer typically have one or more lymph nodes taken from the underarm area during a lumpectomy. These nodes, called the sentinel nodes, are the first lymph nodes to which cancer cells would travel if they were to leave the breast. This is done so that your doctor can check to see if the cancer has spread.

Women with DCIS undergoing lumpectomy do not need to have lymph nodes removed.

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What Happens After Your Breast Biopsy: Results And Long

If you have found a breast lump through self examination, or have been told by a doctor that you have a shadow on your routine mammography screening you may require a breast biopsy. Of course, further tests such as a second mammogram or a breast ultrasound will be carried out to fully discover the extent of your condition. However, if any of these tests show that the structure or appearance of the breast lump could potentially be cancerous, a biopsy will be requested to confirm whether or not there are cancerous cells. This can be a daunting prospect, but we hope to give you more of an insight here into what you can expect after a breast biopsy.

Learn About Your Diagnosis And Treatment Options

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After your diagnosis, educate yourself so you can be confident about your decisions. Ask a close friend or family member to learn with you, attend your appointments, and be your advocate. A second set of ears and another point of view is invaluable when you are dealing with your new diagnosis.

Find the right cancer center, , and surgeon for you. Look for doctors who are affiliated with a National Cancer Institute-designated Cancer Center, board certified in their specialty, and experienced in treating breast cancer. Then, make a consultation appointment and ask about support groups. Most cancer centers can put you in contact with survivors to learn about their experiences.

Before making a final decision, consider getting a second opinion. Second opinions can validate your original plan and reinforce your confidence in your first doctor. They can give you more insight into your cancer and your treatment options. You can search www.healthgrades.com for an oncologist, as well as search for doctors who treat breast cancer specifically.

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How Long Will I Have To Take It

This will depend on your individual circumstances, but letrozole is usually taken for five to ten years.

Some people start taking letrozole after a few years of taking the hormone therapy drug tamoxifen.

If youre taking letrozole to treat breast cancer that has come back or spread to another part of the body, youll usually take it for as long as its keeping the cancer under control.

What Should I Expect From A Surgical Biopsy

As with a core-needle biopsy, a surgical biopsy is done while the patient is under local anesthesia. Typically, this test is performed in a hospital setting where an IV and medications are administered to make the patient drowsy.

The surgeon makes a one- to two-inch cut on the breast and then removes all or part of the abnormal lump and often a small amount of normal-looking tissue, known as the margin. If the lump cannot be easily felt but can be seen on a mammogram or ultrasound, a radiologist may insert a thin wire to mark the suspicious spot prior to the surgeon performing the biopsy. Once again, a marker is usually placed internally at the biopsy site at the conclusion of the procedure.

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When May Mastectomy Be The Best Surgical Option

A mastectomy may be the best surgical option when:

  • There are 2 or more tumors in different areas of the breast .
  • The tumor is large and neoadjuvant therapy will not be given.
  • The tumor has spread throughout the breast .
  • The mammogram showed large areas of suspicious calcifications in the breast.
  • The tumor is located just below the nipple and the cosmetic look after lumpectomy will not be good.
  • The surgeon cannot get negative margins after multiple attempts by lumpectomy.
  • Radiation therapy cant be given.

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Don’t Be Afraid To Rock The Boat

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Arnim says cancer patients are often reluctant to speak up when they are upset about something, out of a conscious or subconscious fear that their doctors or other medical caregivers will abandon them.

“The tendency when someone is feeling vulnerable and scared is to put up with something rather than rock the boat,” she says. “But even though your instincts may be telling you to keep quiet, it is important to speak up.”

Rocking the boat also means not accepting everything your doctors tells you as gospel. If you feel the need for a second or even third opinion on any aspect of your cancer care, get one.

This advice is equally true for people who suspect they have cancer or some other serious problem, but have been told nothing is wrong, Kennedy says.

“If a doctor is dismissive or hard to communicate with, or tells you nothing is wrong when your gut tells you it is, you need to find another doctor,” she says.

Forty-seven-year-old Julie Gomez learned this lesson the hard way. The Houston woman saw a long line of doctors for a painful stomach problem for almost a decade before her rare gastrointestinal cancer was finally diagnosed.

“I was told I had acid reflux or that I ate too fast,” she says. “One doctor did all the right tests, and actually saw something on the scan but told me he just didn’t believe it. That was eight years before I was finally diagnosed.”

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What Happens After Breast Cancer Surgery

You may be a candidate for a lumpectomy if:

  • Cancer only affects one area of your breast.
  • A tumor is relatively small compared to your breast size
  • Your provider is confident you will have enough remaining tissue to reshape your breast after removing the tumor.
  • You are able to complete radiation therapy.

After A Diagnosis Of Breast Cancer

After finding out you have breast cancer, you may feel shocked, upset, anxious or confused. These are normal responses. Talk about your treatment options with your doctor, family and friends. Seek as much information as you need. It is up to you how involved you want to be in decisions about your treatment.

Breast cancer is the most common cancer in Australian women , with 17,354 women diagnosed in 2016. Although rare, breast cancer can also affect men. Early breast cancer can be treated successfully and for most women breast cancer will not come back after treatment.

To ensure that you receive the best care, your specialist will arrange for a team of health professionals based on your needs and preferences

Learn more about the best breast cancer care for each step of your treatment:

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When Do I Need To Come In For More Tests

At first, follow-up visits with your doctor will be scheduled every few months. Then theyll gradually decrease. The longer youve been cancer-free, the less often youll need to come in for appointments.

Have your calendar ready so you can mark which days you need to come in or when you should be calling to schedule a new appointment.

Also, ask your doctor what tests will be done at each appointment and if any preparation is necessary. Youll likely need a variety of different tests and exams, but it depends on your particular case.

Here are a few examples of follow-up tests that you may receive:

What About My Physical And Emotional Wellness

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Eating a healthy diet including a variety of foods will ensure you have what your body needs to cope with treatment and recovery. Regular physical activity can improve your recovery and reduce side effects such as fatigue.

  • Don’t be afraid to ask for professional and emotional support.
  • Consider joining a cancer support group.
  • Learn to ignore unwanted advice and “horror stories”.
  • Live day-to-day and remember that every day is likely to be different.

Complementary therapies can work alongside medical treatments and some have been shown to improve quality of life or reduce pain. There is no evidence that these therapies can cure or prevent cancer. Some have not been tested for side effects, may work against other medical treatments and may be expensive. Talk with your doctor about using complementary therapies. If you have any concerns or questions, please contact your doctor.

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