Questions To Ask The Doctor
- Do you know the stage of the cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- Based on the stage of the cancer, how long do you think Ill live?
- Do you know if my cancer has any of these proteins: estrogen receptor, progesterone receptor, or the HER2 protein?
- What does it mean if my cancer has any of these proteins?
- What will happen next?
There are many ways to treat breast cancer.
Surgery and radiation are used to treat cancer in a specific part of the body . They do not affect the rest of the body.
Chemotherapy, hormone treatment, targeted therapy, and immunotherapy drugs go through the whole body. They can reach cancer cells almost anywhere in the body.
Doctors often use more than one treatment for breast cancer. The treatment plan thats best for you will depend on:
- The cancer’s stage and grade
- If the cancer has specific proteins, like the HER2 protein or hormone receptors
- The chance that a type of treatment will cure the cancer or help in some way
- Your age
- Other health problems you have
- Your feelings about the treatment and the side effects that come with it
What Causes Breast Cancer
Medical researchers are learning about what happens inside cells that may cause cancer. They have identified changes in certain genes within breast cells that can be linked to a higher risk for breast cancer. Breast cells contain a variety of genes that normally work cooperatively with a woman’s natural hormones, diet, and environment to keep her breasts healthy. Certain genes routinely keep breast cells from dividing and growing out of control and forming tumors. When these genes become altered, changes occur and a cell no longer can grow correctly.
Genetic changes may be inherited from a parent or grandparent may accumulate throughout a person’s lifetime. Breast cancer usually begins in a single cell that changes from normal to malignant over a period of time.
Presently, no one can predict exactly when cancer will occur or how it will progress. When breast cancer is diagnosed even if detected at the earliest stage it is not yet possible to predict which cancer cells will be treated successfully and which will continue to grow and spread quickly to other parts of the body.
The only way to find out for sure if a breast lump or abnormal tissue is cancer is by having a biopsy. The suspicious tissue that is removed by a surgeon or radiologist during a biopsy is examined under a microscope by a pathologist who makes the diagnosis. If your biopsy result is positive, it means that the tumor or tissue from the suspicious area contains cancer and you will need treatment.
What Are The Treatments For Breast Cancer
Treatments for breast cancer include
- Surgery such as
- A mastectomy, which removes the whole breast
- A lumpectomy to remove the cancer and some normal tissue around it, but not the breast itself
What Are The Types Of Breast Cancer
The most common types of breast cancer are:
- Infiltrating ductal carcinoma. This cancer starts in the milk ducts of the breast. It then breaks through the wall of the duct and invades the surrounding tissue in the breast. This is the most common form of breast cancer, accounting for 80% of cases.
- Ductal carcinoma in situ is ductal carcinoma in its earliest stage, or precancerous . In situ refers to the fact that the cancer hasn’t spread beyond its point of origin. In this case, the disease is confined to the milk ducts and has not invaded nearby breast tissue. If untreated, ductal carcinoma in situ may become invasive cancer. It is almost always curable.
- Infiltrating lobular carcinoma. This cancer begins in the lobules of the breast where breast milk is produced, but has spread to surrounding tissues in the breast. It accounts for 10 to 15% of breast cancers. This cancer can be more difficult to diagnose with mammograms.
- Lobular carcinoma in situ is a marker for cancer that is only in the lobules of the breast. It isn’t a true cancer, but serves as a marker for the increased risk of developing breast cancer later, possibly in both or either breasts. Thus, it is important for women with lobular carcinoma in situ to have regular clinical breast exams and mammograms.
Thermal Ablation Or Cryoablation
Thermal ablation or cryoablation can be used alone or in combination with surgery. These procedures involve destroying cancer cells by either heating or freezing them. For example, radiofrequency ablation involves inserting a needle into individual tumours in the liver and destroying them with heat. RFA is a specialist treatment and not widely available. Your treatment team can tell you if it may be suitable for you.
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Screening For Breast Cancer
Women aged between 50 and 74 are invited to access free screening mammograms every two years via the BreastScreen Australia Program.
Women aged 40-49 and 75 and over are also eligible to receive free mammograms, however they do not receive an invitation to attend.
It is recommended that women with a strong family history of breast or ovarian cancer, aged between 40 and 49 or over 75 discuss options with their GP, or contact BreastScreen Australia on 13 20 50.
Sentinel Lymph Node Biopsy
In a sentinel lymph node biopsy , the surgeon finds and removes the first lymph node to which a tumor is likely to spread . To do this, the surgeon injects a radioactive substance and/or a blue dye into the tumor, the area around it, or the area around the nipple. Lymphatic vessels will carry these substances along the same path that the cancer would likely take. The first lymph node the dye or radioactive substance travels to will be the sentinel node.
After the substance has been injected, the sentinel node can be found either by using a special machine to detect radioactivity in the nodes, or by looking for nodes that have turned blue. To double check, both methods are often used. The surgeon cuts the skin over the area and removes the node containing the dye or radioactivity.
The few removed lymph nodes are then checked closely for cancer cells by a pathologist. Sometimes, this is done during the surgery. Because there is a chance that other lymph nodes in the same area will also have cancer if cancer is found in the sentinel lymph node, the surgeon may go ahead with a full axillary dissection to remove more lymph nodes while you are still on the operating table. If no cancer cells are seen in the node at the time of the surgery, or if they are not checked by a pathologist at the time of the surgery, they will be examined more closely over the next several days.
Based on the studies that have looked at this, skipping the ALND may be an option for:
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Signs And Symptoms Of Breast Cancer
In its early stages, breast cancer may not cause any symptoms. In many cases, a tumor may be too small to be felt, but an abnormality can still be seen on a mammogram.
If a tumor can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancer.
Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:
- a breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
- breast pain
- changes to the appearance of the skin on your breasts
- a lump or swelling under your arm
If you have any of these symptoms, it doesnt necessarily mean you have breast cancer. For instance, pain in your breast or a breast lump can be caused by a benign cyst.
Still, if you find a lump in your breast or have other symptoms, you should see your doctor for further examination and testing.
Tumor Heterogeneity And Evolution Of Breast Cancer
Breast cancer tumor heterogeneity is one of the hallmarks of malignancy, which includes intertumor heterogeneity observed in breast cancers from different individuals and intratumor heterogeneity caused by the presence of heterogeneous cell populations within an individual tumor., , , , Breast cancer intratumor heterogeneity is the main hurdle in the development of effective treatments and personalized medicine., , , , , , The intratumor heterogeneity was first described by Rudolf Carl Virchow, one of the founders of modern pathology, in mid and late 19th century. For quite a while, breast cancer phenotypic heterogeneity was used to classify breast cancers based on histological types. The clinical implications of tumor heterogeneity were well-recognized early in the process, and breast cancer was one of the first solid tumor types, in which the clinical and treatment implications of heterogeneity for cellular phenotypes were established by analyzing the expression of the estrogen receptors. With the rapid advances in molecular biology and genomics techniques, intratumor heterogeneity at the functional, genetic, and cellular levels has begun to be appreciated, and the identification of intrinsic molecular subtypes based on global gene expression profiling studies in breast cancer was pioneered with a rather rapid translation of this knowledge into clinical management of breast cancer., , ,
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Exercise And Secondary Breast Cancer In The Liver
Some people with secondary breast cancer in the liver have no symptoms while others have a combination of pain, sickness, loss of appetite, hiccups, tiredness and fatigue. While physical activity may help reduce some symptoms its important to listen to your body and not push yourself too hard. Gentle, regular activity, such as walking, is often most effective.
If youre currently having treatment you may need to exercise at a slightly lower level. Stop straight away if it hurts or feels like youre working too hard.
When choosing your exercise, try to focus on aerobic activities such as walking, swimming or cycling. Activities such as dancing and gardening can also be beneficial. You could also include some light toning or conditioning exercises such as stretching or low-impact yoga. The most important thing is to choose something you can safely enjoy.
Can Cancer Form In Other Parts Of The Breast
Cancers can also form in other parts of the breast, but these types of cancer are less common. These can include:
- Angiosarcomas. This type of cancer begins in the cells that make up the lining of blood or lymph vessels. These cancers can start in breast tissue or breast skin. They are rare.
- Inflammatory breast cancer. This type of cancer is rare and different from other types of breast cancer. It is caused by obstructive cancer cells in the skins lymph vessels.
- Paget disease of the breast, also known as Paget disease of the nipple. This cancer affects the skin of the nipple and areola .
- Phyllodes tumors. These are rare, and most of these masses are not cancer. However, some are cancerous. These tumors begin in the breasts connective tissue, which is called the stroma.
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Cancer Cells Keep Changing
Once a cancer has formed, the cells don’t remain the same, but rather continued mutations may occur. This, in fact, is why resistance develops to chemotherapy and targeted therapy drugs in time. The cancer cell develops a mutation that allows it to bypass the damaging effects of these treatments.
That cancer cells change is very important in treatment. For example, a breast cancer that is estrogen-receptor positive may be estrogen-receptor negative when it recurs or spreads. It also helps explain whey cancer cells in different parts of a tumor may be different. This is referred to as “heterogenicity” and is important in diagnosis and treatment as well.
Breast Cancer Risk Factors You Can Control
- Physical activity. The less you move, the higher your chances.
- Weight and diet. Being overweight after menopause raises your odds.
- Alcohol. Regular drinking — especially more than one drink a day — increases the risk of breast cancer.
- Reproductive history.
- You donât have a full-term pregnancy.
Still, most women who are at high risk for breast cancer donât get it. On the other hand, 75% of women who develop breast cancer have no known risk factors. Learn more about the risk factors for breast cancer.
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Grade Of Breast Cancer
The grade describes the appearance of the cancer cells.
- Low grade the cells, although abnormal, appear to be growing slowly.
- Medium grade the cells look more abnormal than low-grade cells.
- High grade the cells look even more abnormal and are more likely to grow quickly.
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How Do They Start
Cancer cells appear through a series of genetic and epigenetic changes. Some of these changes may be either inherited or more often, caused by carcinogens in our environment. In general, solid tumors, contain multiple mutations. Interestingly, the metastatic process that is the main culprit for the high mortality of advanced cancers is thought to be caused mostly by epigenetic changes as no specific genetic alterations have been found in metastases. It also helps explain a genetic predisposition to cancer. A genetic predisposition does not mean you will get cancer, but, simplistically, if a few mutations are already in place, it will likely take fewer acquired mutations for a cell to become cancerous.
The process of normal cells becoming cancer often goes through stages in which the cell becomes progressively more abnormal appearing. These stages may include hyperplasia, dysplasia, and finally cancer. You may also hear this described as differentiation. Early on a cell may look much like normal cells of that organ or tissue, but as progression occurs, the cell becomes increasingly undifferentiated. This is, in fact, why sometimes the original source of cancer cannot be determined.
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What Are The Signs Of Breast Cancer
A woman who has breast cancer may have no problems, or she may find a painless lump in her breast. If women examine their breasts monthly, they can help find lumps or other changes that a doctor should examine.
Most breast lumps are not cancer, but all lumps should be checked out by a doctor to be sure. Breast lumps that are not cancer may be scar tissue or cysts or they can be due to normal breast changes associated with hormone changes or aging.
Girls who are beginning puberty might notice a lump underneath the nipple when their breasts start developing. Usually, this is a normal. You can ask a parent or your doctor about it to be sure.
Surgery For Endometrial Cancer
Most women with endometrial cancer have some kind of surgery.
A hysterectomy takes out the uterus and cervix. Its the most common way to treat endometrial cancer. There are many ways to do this surgery. Sometimes the ovaries and fallopian tubes are taken out at the same time. Nearby lymph nodes may also be taken out to see if they contain cancer cells.
Ask your doctor what kind of surgery you will need. Each type has pros and cons.
Side effects of surgery
Any type of surgery can have risks and side effects. Ask the doctor what you can expect. If you have problems, let your doctors know. Doctors who treat women with endometrial cancer should be able to help you with any problems that come up.
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Your Race And Ethnicity
White and Black women have the highest risk of developing breast cancer in their lifetime. Asian/Pacific Islander and Hispanic/Latina womens breast cancer rates fall in between two major groupings while American Indian and Alaska Native women are on the lowest end of risk.
While white women are more likely to develop breast cancer than Black women overall, they tend to be diagnosed at an older age . Black women have the highest breast cancer rates among women under age 40. Black women make up a higher percentage of triple-negative breast cancer cases.
What to do: If your race or ethnicity places you at higher risk, make sure you follow all screening recommendations to improve your chances of catching cancer early.
Major Signaling Pathways In Breast Cancer Development And Progression
There are remarkable parallels between normal development and cancer progression at the molecular level., Normal human development is tightly controlled by complex signaling pathways, which allow cells to communicate with each other and their surrounding environment., Not surprisingly, many of these same signaling pathways are dysregulated or hijacked by cancer cells and CSCs. In essence, cancer is driven by genetic and epigenetic alterations that allow cells to escape the mechanisms that normally control their proliferation, survival and migration. Many of these alterations map to signaling pathways that govern cell proliferation and division, cell death, cell differentiation and fate, and cell motility. Thus, activating mutations of proto-oncogenes can cause hyperactivation of these signaling pathways, whereas inactivation of tumor suppressors eliminates critical negative regulators of signaling. Here, we will focus on the predominant signaling pathways that regulate normal mammary gland development and breast cancer stem cell functions, namely estrogen receptor signaling, HER2 signaling and canonical Wnt signaling.
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