What Are The Warning Signs Of Breast Cancer
- A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
- A mass or lump, which may feel as small as a pea.
- A change in the size, shape, or contour of the breast.
- A blood-stained or clear fluid discharge from the nipple.
- A change in the look or feel of the skin on the breast or nipple .
- Redness of the skin on the breast or nipple.
- An area that is distinctly different from any other area on either breast.
- A marble-like hardened area under the skin.
These changes may be found when performing monthly breast self-exams. By performing breast self-exams, you can become familiar with the normal monthly changes in your breasts.
Breast self-examination should be performed at the same time each month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month.
Getting A Breast Biopsy
In a breast biopsy, the doctor takes out small pieces of breast tissue to check them for cancer cells. A biopsy is the only way to tell for sure if you have breast cancer.
There are many types of biopsies. Ask your doctor what kind you will need. Each type has risks and benefits. The choice of which type to use depends on your own case.
Sometimes, surgery is needed to take out all or part of the lump to find out if its cancer. This is often done in a hospital using local anesthesia . You might also be given medicine to make you sleepy.
Breast Cancer: What If You Did Nothing
Why some women with early-stage breast cancer choose to do nothing
The cover of this past weeks issue of TIME magazine features the torso of a woman, her hands shielding her breasts, and a single question: “What if I decide to just do nothing?” The question is jarring because we know what its referring to: the asker has breast cancer, and she wants to know if the best course of action is no action at all.
Its a radical idea, to do nothing when faced with a breast cancer diagnosis, particularly this month, when were surrounded by pink products and encouraged to join the fight to beat breast cancer. And when we know that breast cancer is the most common cancer diagnosis in Canadian women, and that 5,000 women in this country die each year from the disease, it seems astonishing that a woman would choose to wait and watch. But as TIME author Siobhan OConnor writes in her article, Why Doctors are Rethinking Breast Cancer Treatment,research suggests that some women with early-stage breast cancer are being over treated.
New research released in August brought this issue to public attention. The study, published in the journal JAMA Oncology, followed 100,000 diagnosed with ductal carcinoma in situ , also known as Stage 0 breast cancer, for 20 years. Researchers discovered that no matter the course of treatment the women had roughly the same chance of dying from breast cancer as the average woman does .
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What Is The Difference Between Radiation And Chemotherapy
Chemotherapy involves medications delivered by injections or taken in pill form. This type of treatment is circulated throughout the entire body and is generally prescribed by a medical oncologist. Radiation therapy, delivered by a radiation oncologist, uses radiotherapy beams focused on a very specific area of the body in order to deliver high doses of the treatment while reducing the risk of radiation exposure to healthy tissue.
What Is Stage Iv Breast Cancer
Stage IV is the most advanced stage of breast cancer. It has spread to nearby lymph nodes and to distant parts of the body beyond the breast. This means it possibly involves your organs such as the lungs, liver, or brain or your bones.
Breast cancer may be stage IV when it is first diagnosed, or it can be a recurrence of a previous breast cancer that has spread.
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Common Problems After Diagnosis And Treatment
All breast cancer treatments, including surgery, chemotherapy, radiotherapy and hormone therapy, can have the possibility of side effects. Each person may have a different experience of treatment related side effects. If you have concerns about this, nurse practitioners will be able to discuss this with you and arrange referrals to other services as appropriate.
Common side effects include
What About My Physical And Emotional Wellness
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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Theres No Such Thing As A Silly Question Or Too Many Questions
After reviewing and discussing the patients case in detail, the tumor board provides a consensus treatment recommendation. The plan is unique and based on many factors.
No one element alone staging, hormone sensitivity, HER2 status tells the whole story, says Morikawa. For example, two patients with the same stage cancer may not receive the same treatment recommendation.
In many, if not most, cases of early stage cancer, the patient will be a candidate for surgery to remove her primary tumor. Surgery may or may not be performed first.
In some cases, drug therapy like chemotherapy might be recommended to shrink a tumor before surgery is performed, explains Morikawa, noting that additional treatment recommendations could include hormone therapy, radiation therapy or a combination of therapies.
A number of factors will determine what additional therapies a patient might benefit from, and how soon those follow-up treatments should start.
Additional factors may also play a role in treatment planning, including:
Morikawas advice to every newly diagnosed breast cancer patient: Ask, ask, ask. Every concern is legitimate and every question deserves an answer.
How Long Is Chemo For Breast Cancer
Chemotherapy is often administered after surgery to remove any undetected breast cancer cells. Chemotherapy can also help reduce your risk of the cancer returning.
Chemotherapy should usually be given within 30 days of surgery and less than 120 days from the initial diagnosis. One study showed women who started chemotherapy two months after surgery had a 19 percent lower chance to survive compared to women who began chemotherapy a month after surgery.
Treatment comes in cycles that can occur once a week or once every three weeks. Following a period of recovery, this process can continue for up to six months. Women with more aggressive forms of cancer may receive chemotherapy for longer than that.
Not all stages of cancer require chemotherapy. Depending on the results of pathology from surgery, your doctor will decide the best plan for adjuvant treatment. You may also be a candidate for hormonal therapy.
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What Size Is My Tumor And Why Does That Matter
Treatment options for breast cancer partly depend on how small or large your tumor is, if the cancer has spread to the lymph nodes and if the cancer is found in other parts of your body. The larger the tumor, the more likely it is that the breast cancer is lymph node-positive, meaning the axillary lymph nodes contain cancer. Sentinel node biopsy is the most common way to determine whether cancer cells have spread beyond the breast.
Tests To Determine Specific Types Of Treatment
You’ll also need tests that show whether the cancer will respond to specific types of treatment.
The results of these tests can give your doctors a more complete picture of the type of cancer you have and how to treat it.
In some cases, breast cancer cells can be stimulated to grow by hormones that occur naturally in your body, such as oestrogen and progesterone.
If this is the case, the cancer may be treated by stopping the effects of the hormones or by lowering the level of these hormones in your body. This is known as hormone therapy.
During a hormone receptor test, a sample of cancer cells will be taken from your breast and tested to see if they respond to either oestrogen or progesterone.
If the hormone is able to attach to the cancer cells using a hormone receptor, they’re known as hormone-receptor positive.
While hormones can encourage the growth of some types of breast cancer, other types are stimulated by a protein called human epidermal growth factor receptor 2 .
These types of cancers can be diagnosed using a HER2 test and are treated with medicine that blocks the effects of HER2. This is known as targeted therapy.
Want to know more?
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When You Wake Up
At first you may be wearing a mask or have small tubes into your nose to give you oxygen. You might feel dizzy and sluggish to begin with.
You have a blood pressure cuff on your arm and a little clip on your finger to measure your pulse and oxygen level.
Once you are more awake, your nurse will take you back to the ward. They will measure your blood pressure and check your dressings regularly.
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.
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What Stage Is My Cancer And What Does It Mean
Breast cancer staging is a way to describe the severity or extent of your cancer. Knowing the cancer stage will help your care team recommend a personalized treatment plan specific to your disease. Breast cancer diagnosed as stage 1 or stage 2 is considered early stage, while stages 3 and 4 are considered advanced.
What Treatment Will I Have
There are many different treatments for breast cancer. You will be advised by your specialist team what the best treatment options are for you, and you will have the opportunity to discuss them in detail. These treatments may include
Breast cancer surgery
The breast cancer surgery we offer includes mastectomy, with or without breast reconstruction, breast-conserving surgery using oncoplastic surgical techniques, breast reconstruction, and complex cancer and revisional reconstructive surgery.
Chemotherapy is sometimes used as the first treatment and sometimes after surgery. We have dedicated units at both sites for patients receiving chemotherapy.
Our breast cancer radiotherapy services are provided by a multidisciplinary team of highly skilled and innovative staff at the Royal Derby Hospital.
Secondary breast cancer care
We provide a highly specialised service in dedicated clinics for patients with secondary breast cancer. Patients have access to a wide range of healthcare professionals who contribute to the medical, nursing, and supportive management of care. This includes dedicated clinical nurse specialists for secondary breast cancer who provide information, advice, and support within the hospital and liaise with local services.
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How Quickly Do I Need To Make A Decision About Breast Cancer Treatment
Treatment for breast cancer generally should start soon after diagnosis, but in most cases, it wont hurt to wait a few weeks to begin treatment. Even more important than beginning treatment immediately is to understand and evaluate all your treatment options with your care team and loved ones, and then decide whats best for you.
Outcomes Of Breast Cancer In Patients Who Use Alternative Therapies As Primary Treatment
This was a medical chart review by Chang et al, published in the American Journal of Surgery in 2006. It examined breast cancer patients who refused conventional chemotherapy, or delay its initiation, in order to use CAM. The authors calculated each patients prognosis at the time of diagnosis. In total, 33 women were included. The results were grim:
- Eleven patients initially refused surgery. Ten of these patients experienced progressive disease. Five ultimately had surgery. In the six others, the cancer had already metastasized, so surgery would have offered no benefit.
- Three patients refused to allow sampling of lymph nodes to evaluate disease spread. One of these patients developed recurrent disease in the lymph nodes.
- Ten patients refused local control of the tumor site. Two patients developed recurrences in the same location, and two developed metastatic disease.
- Nine patients refused chemotherapy, raising their estimated 10-year mortality from 17% to 25%
Consistent with the study above, the vast majority of breast cancer patients who refuse surgical intervention developed progressive disease. Even delaying surgery increased risks and overall mortality. Outcomes were better for patients that accepted surgery, but refused adjuvant treatments, like chemotherapy. However, even this strategy significantly raised 10-year mortality estimates.
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Who Gets Breast Cancer
Breast cancer is the most common cancer among women other than skin cancer. Increasing age is the most common risk factor for developing breast cancer, with 66% of breast cancer patients being diagnosed after the age of 55.
In the US, breast cancer is the second-leading cause of cancer death in women after lung cancer, and it’s the leading cause of cancer death among women ages 35 to 54. Only 5 to 10% of breast cancers occur in women with a clearly defined genetic predisposition for the disease. The majority of breast cancer cases are “sporadic, meaning there is no definitive gene mutation.
Ask About Genetic Testing
Discuss genetic testing with your doctors early on in your diagnosis. Genetic testing isnt recommended for everyone. Doctors and insurers refer to a set of parameters known as the National Comprehensive Cancer Network guidelines that include factors like your age, family history of cancer, type of cancer, and ethnicity to make the call.
If testing finds you have a germline mutation, this will determine the overall treatment plan, including the type of breast surgery recommended, says Dr. Barcenas.
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Learn About Your Treatment Options
Treatments vary a lot depending on the type of breast cancer and on the tumor stage. While surgery is almost always necessary, chemotherapy and radiation may or may not be depending on a number of factors. If you had a mastectomy, for example, you may not need radiation. If you have an estrogen-positive tumor, you may not require chemotherapy. There are so many different combinations of treatments, says Dr. Rosenblatt. Its a very complicated discussion with a team of physicians.
Ask your doctor how your various treatment options change your prognosis and the potential complications or side effects. Its also a good idea to ask about the logistics and timing of the treatment plan, suggests Carlos Barcenas, MD, an oncologist in the Department of Breast Medical Oncology at MD Anderson Cancer Center. That helps you to plan ahead and organize your work or study schedule and support system accordingly, he says.
Looking At The Tissue Sample
The tissue sample removed during a biopsy is called a specimen. The medical staff who perform your biopsy place the specimen in a container with a fluid to preserve it. They label the container with your name and other details. A pathologist then describes how it looks to the naked eye. This includes the color, size, and other features. This is called a gross or macroscopic examination. The gross description includes the following information:
The label written by the doctor who took the specimen
What was done to the specimen
The sample may be needed for other tests based on what your doctor thinks the disease may be before the biopsy, called a suspected diagnosis. Molecular tests find genes that might be active, changed, or missing. Other gene or protein tests may be needed to identify which treatments will work. The pathologist or a technician will prepare a part of the specimen for these tests.
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What Is A Core
Core needle biopsy is the procedure to remove a small amount of suspicious tissue from the breast with a larger core needle. It is usually performed while the patient is under local anesthesia, meaning the breast is numbed. During the procedure, the doctor may insert a very small marker inside the breast to mark the location of the biopsy. If surgery is later required, the marker makes it easier for the surgeon to locate the abnormal area. Even if no further treatment such as surgery is needed, the marker allows a breast imaging radiologist to see on future mammograms where the biopsy was done.
The radiologist or surgeon performing the core-needle biopsy may use specialized imaging equipment to guide the needle to the desired site. As with fine-needle aspiration, this may involve ultrasound.
During an ultrasound-guided core needle biopsy, the patient lies down while the doctor holds the ultrasound against the breast to direct the needle. On the other hand, during a stereotactic-guided core-needle biopsy, the doctor uses x-ray equipment and a computer to guide the needle. Typically, the patient is positioned lying on the stomach on a special table that has an opening for the breast, and the breast is compressed, similar to a mammogram.
Occasionally, no imaging equipment is used, but this is typically only in cases where the lump can be felt through the skin. This type of procedure is called a freehand core-needle biopsy.