In Case Surgery Is Recommended For Treating Breast Cancer
Many women need surgery as a part of breast cancer treatment as their situation demands so. Ask an oncologist online and be sure if you really need the surgery at all. If you are not very sure, you can always seek online medical second opinion to understand if you are getting the right treatment or9. Can lumpectomy can be an option or is mastectomy the only option?10. How long one needs to be in the hospital after the breast cancer surgery and what are the precautions that need to be followed post surgery?11. Is getting breast reconstruction surgery mandatory after the surgery? What if one does not get this treatment done?12. What kind of lifestyle changes one needs to make after the surgery and during the whole treatment plan for it to be successful and how quickly is it possible to return to normal life
Is The Cancer In My Lymph Nodes
Whether your breast cancer has spread to your lymph nodes the filtering mechanisms in your armpits and elsewhere in the body that are part of the immune system is one of the most important predictors of the severity of your disease.
Involvement of the lymph nodes changes the treatment plan, says Dr. Abraham. When breast cancer cells have spread to the lymph nodes, we tend to discuss more aggressive treatment options, such as chemotherapy.
Should Breast Cancer Patients Have Their Lymph Nodes Removed
Lymph nodes are small glandular structures that filter tissue fluids. They filter out and ultimately try to provide an immune response to particles and proteins that appear foreign to them. There are thousands of these nodes scattered in groups throughout the body. Each cluster is more or less responsible for the drainage of a particular region of the body.
The lymph nodes under the arm are the dominant drainage recipients from the breast. When cancer cells break free from breast cancer, they may travel through the lymph tubes to the lymph nodes. There, the cancer cells may establish a secondary growth site. The presence of cancer cells in the lymph nodes proves that cancer cells have traveled away from the primary breast tumor. Therefore, the presence or absence of cancer cells in these regional nodes is an important indicator of the future risk of recurrence. This information is often important in making decisions about whether to use chemotherapy and what type of chemotherapy should be employed.
Unfortunately, removal of the lymph nodes also carries a potential risk of lymphedema, a condition that may cause the arm to swell. Lymphedema can occur early after surgery or many years later. It can be a difficult and disabling condition. Here again, there are tradeoffs in risk. When more lymph nodes are removed, more accurate information about tumor spread is obtained and the chance for tumor recurrence is less. But there is a greater incidence of lymphedema.
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What Are The Physical Side Effects
Receiving the radiation will not be painful. Side effects vary from person to person and depend on the site being treated. The most common side effects in the treatment of breast cancer are:
- Skin changes
- Uncomfortable sensations in the treated breast
Please talk to your doctor or nurse if you have concerns about side effects before you begin treatment or if you have questions about managing your side effects during treatment.
Even Though My Breast Tumor Does Not Have Hormone Receptors Should I Take Tamoxifen To Reduce The Risk Of A New Tumor
Following completion of your treatment for breast cancer, whether or not tamoxifen is prescribed should at least be addressed. In many cases, the primary breast cancer for which the patient is being treated may not be hormone-receptor positive. In these cases, tamoxifen is not generally part of the treatment protocol.
However, the Breast Cancer Prevention Trial demonstrated a significant reduction in the development of new cancers in the opposite breast in patients who were treated with tamoxifen. So, the possible use and benefits of tamoxifen should not be ignored. A thoughtful evaluation of all the factors in a particular case will lead to a recommendation which balances the benefits of tamoxifen against the potential risks. Your treatment team should address this issue with you.
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Questions To Ask Your Doctor Or Oncologist
If you have just been diagnosed with breast cancer or cancer re-occurrence and are relying on mainstream medicine for the most part, more than likely you have already made an appointment to see your primary doctor or oncologist about what to do next. And while getting the diagnosis itself can be one of the most frightening experiences of your life, moving forward, with the confusing path of treatment options can sometimes feel even worse.
There is a way out of all this frustration and overwhelm.
The first step is to clearly understand what is going on with your body and to understand what cancer is and what cancer is not. Believe it or not, you can get to the point where you Never Have to Fear Breast Cancer Again!
The second step to is to know your options as a patient.
And the third step is to reach out for guidance and support and become truly empowered along your healthy breast journey!
Your Rights as a Patient
Breast Cancer: Questions To Ask The Health Care Team
Have questions about breast cancer? Ask here.
ON THIS PAGE: You will find some questions to ask your doctor or other members of the health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.
Talking often with the health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment. You can also for a digital list and other interactive tools to manage your care. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.
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What Can You Tell Me About My Tumor
In short, your doctor will be able to tell you what causes your specific type of cancer to grow, stabilize, or shrink. The majority of breast cancers are hormone-receptor positive, meaning estrogen and progesterone feed the cancer. These types of breast cancer are most often treated with a combination of antiestrogen therapy and a newer class of targeted therapies called CDK 4/6 inhibitors, which, Dr. Fasano says, have revolutionized advanced breast cancer treatments. Your tumor may be HER2-positive or triple-negative. In all cases, these distinctions help dictate your treatment: If its triple-negative and expresses the PDL1 protein, you may be a candidate for immunotherapy. If its HER2-positive, youll likely be a candidate for multiple HER2-targeted therapies.
How Much Experience Do You Have Treating My Type And Stage Of Breast Cancer
Oncologists who are experienced in not only treating breast cancer but in your specific type of breast cancer are typically better equipped to explain and deliver the full range of treatment options. You should feel comfortable asking your doctor about his or her experience. Doctors and the hospitals they may work for are not required by law to publish the survival rates of the patients they treat, but some choose to do so. Others may be willing to provide these statistics upon request.
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While Taking Decision On The Treatment Plan
Once breast cancer is diagnosed one must seek consultation from the best doctor for cancer and start treatment immediately so that the problem does not aggravate. If visiting a doctor physically is not possible, you can ask an oncologist online.4. What are the different treatment choices available for breast cancer?5. Is it good to take part in some kind of clinical trial for breast cancer?6. What will be the length of the treatment and how will be the whole process like? Moreover, where will be the treatment done?7. Are there any kinds of side effects of the treatment for breast cancer? Suggest ways for preparing for the treatment of breast cancer.8. Are there chances of cancer making a comeback even after the whole treatment process?
What Type Of Medical Team Do I Need For The Most Accurate Breast Cancer Diagnosis And Treatment
A well-coordinated team, which includes input from multiple specialists, is the best way to diagnose and treat breast cancer. Oncologists are physicians who specialize in cancer care and will be involved in your care and will often coordinate your care with your primary care provider. Pathologists , radiologists, and surgeons will often be involved in the care, as well. Advice from the entire team must be available during biopsies and any tumor-clearing surgery to ensure the best chance of a favorable outcome for the patient.
How important is the role of the pathologist reading my slides?
The pathologist evaluating the slides made from fine-needle aspiration biopsies, core biopsies, and tissue slides of the breast must have a great deal of experience and special training. It is important that the pathologist reliably determine the presence or absence of cancer and distinguish cancer from other conditions such as hyperplasia with atypia . The pathologist also orders and interprets special studies on your cancer tissue to determine the precise characteristics of the cancer cells, such as whether the cancer expresses hormone receptors. These results are used to further specify the type of breast cancer and optimize treatment decisions. The remainder of the treatment will be based on the pathologist’s diagnosis.
Have my slides been reviewed by more than one pathologist?
Can I have my biopsy reviewed by a pathologist at another diagnostic center?
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Will My Breast Cancer Treatment Affect My Ability To Have A Baby
Women of childbearing age who are being treated for breast cancer may be concerned about the impact on their ability to conceive a child in the future. Treatments such as chemotherapy, radiation therapy or a combination of the two may affect fertility.
Chemotherapy may affect the functioning of the ovaries, reducing the number or quality of eggs. These anti-cancer drugs may also cause infertility in women who havent started menopause . The likelihood of infertility may depend on the type of chemotherapy drugs used, the dose given and your age.
Radiation therapy kills cancer cells by stopping or reducing their growth and division. Because radiation sometimes passes through healthy tissues, organs near the cancer site may be affected, potentially causing temporary or permanent infertility, especially if the radiation was delivered directly to the pelvic region.
You may want to consider your options for preserving fertility before starting treatment and discuss your questions and concerns with your oncologist.
How Big Is My Tumor
Tumor size is another factor that will determine your course of treatment. Your doctor uses the size of your tumor to stage, or further categorize your cancer .
The tumors dimensions are estimated by a physical exam, a mammogram, an ultrasound or an MRI of the breast. The precise size wont be known until a pathologist studies the tumor after surgical removal.
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Will I Need Radiation
Most oncologists generally recommend radiation treatment for all breast cancer patients who undergo only removal of the tumor .
For women who undergo whole-breast removal, radiation may be recommended for those who are considered high-risk, especially those with tumors larger than 5 centimeters and with more than four cancerous lymph nodes.
I Have A Ductal Carcinoma In Situ A Type Of Localized Cancer Why Have I Been Advised To Have A Mastectomy When Other Women With Invasive Breast Cancer Have Lumpectomies
Ductal carcinoma in situ sometimes presents a difficult dilemma. Most patients with DCIS can undergo successful breast-conservation therapy but not all. The diagnosis implies that this is an “early” form of cancer in the sense that the cancer cells have not acquired the ability to penetrate normal tissue barriers or spread through the vascular or lymphatic channels to other sites of the body. It is important to realize that breast cancer is a wide spectrum of diseases, and no comparisons should be made just on the basis that someone you know has “breast cancer” and shares a different treatment approach with you.
However, the millions of cells forming the DCIS have accumulated a series of errors in their DNA programs that allow them to grow out of control. There are varying degrees of disturbance, called “grades,” of the normal cellular patterns. Low grades are usually more favorable, and high grades are less favorable.
The DCIS cells originate from the inside of the breast gland ducts . As they multiply, the cells fill and spread through the normal ducts of the breast glandular tissue. With many DNA errors already in place and millions of these cells exposed to the usual risks of additional DNA damage, a few cells will ultimately become invasive. This invasive change is the real risk of DCIS.
Your treatment team should be able to discuss the pros and cons of the different approaches and actively include you in the decision process.
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What Are The Possible Side Effects Of Each Treatment Option
Breast cancer treatments may cause temporary side effects that go away soon after treatment is completed, as well as longer-term side effects that last months or years. Below is a list of the side effects associated with each treatment option.
Surgery: Surgical procedures for breast cancer may cause short-term pain or discomfort in the treated area. Also, the muscles of the arm may feel weak, and the skin in the breast area may feel tight. Surgery involving the lymph nodes may also cause swelling in the arm, a condition known as lymphedema.
Radiation therapy: Many breast cancer patients who undergo radiation therapy experience skin irritation and breast pain. These conditions usually begin within a few weeks of starting treatment and go away on their own within six months after treatment ends. For some patients, however, these symptoms may not develop until several months or years after treatment. Another common radiation-related side effect is fatigue, especially in the later weeks of treatment and for some time afterward.
Chemotherapy: Certain chemotherapy drugs may cause potential side effects like nausea, vomiting, fatigue, nerve damage, sore mouth, diarrhea, constipation and decreased blood counts.
Targeted therapy: Side effects for HER2-positive targeted therapy drugs are typically mild, but serious side effects are possible and may include nausea, vomiting, diarrhea, fatigue, mouth sores and rashes.
Has My Tumor Been Sent For Testing
We often send the tumor for a genomic profile analysis, Dr. Fasano says. This analysis tells us if there are any mutations in the tumor, which could help us decide what future therapies we can use to treat the cancer. Also, if a tumor has a particular mutation, it may make someone eligible for a clinical trial.
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What To Ask Your Oncologist About Breast Cancer
An oncologist is a doctor who is qualified to diagnose and treat individuals who have cancer. Breast cancer is one of the most common types of cancers in women. Men can also develop breast cancer, but it is less common than in women. If you are diagnosed with breast cancer, you should take the time to educate yourself about the disease. Talking to your doctor is important because it can help you make informed decisions about your health care.
Were Her2 Tests Performed On My Tissue Sample
HER2 is a type of growth signal receptor, or antenna that may be present on your breast cancer cells. About 25 percent of breast cancers are HER2-positive, meaning the cancer cells make too much of a protein called HER2/neu, which indicates that the cancer may be more aggressive. If your cancer is HER2-positive, this helps doctors better predict whether the cancer may respond to certain targeted therapies.
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What Is A Sentinel Lymph Node Biopsy And What Are Its Benefits And Risks
A sentinel node biopsy takes advantage of a peculiar physiologic and anatomical finding. Although there may be many lymph nodes in a particular drainage region, it appears that only one or two are the first recipients of the regional fluids.
This means that if any nodes will be involved by tumor spread, the sentinel node will be the first. It also means in general that if the sentinel node is not involved, then no other nodes will be affected. Therefore, only the sentinel node needs to be removed. There are techniques for removing just the sentinel nodes. A sentinel node biopsy allows the pathologist to more intensively study this node and apply specialized techniques that are capable of detecting even a few cancer cells.
What Is My Estrogen Receptor And Progesterone Receptor Status
Your bodys hormones such as estrogen and progesterone may play a role in how your breast cancer progresses.
Normal cells are equipped with receptors that allow them to receive information from circulating hormones, similar to the way your phone picks up satellite signals. Cancer cells may also have hormone receptors, letting them tap into your bodys normal cell growth-regulating system.
Your ER/PR status is determined by testing a sample of breast cancer cells removed during a biopsy. If your breast cancer cells have estrogen and progesterone receptors if theyre ER/PR-positive then theyre capable of detecting estrogens signal and using it to fuel growth. If the cancer cells lack these receptors meaning theyre ER-/PR-negative they cant hear the growth-signaling message.
About 70% of breast cancer patients have positive ER/PR hormone status.
While being ER/PR-positive sounds bad, theres actually a benefit. Doctors can take advantage of the receptors presence. They can use an anti-estrogen drug that blocks the receptors and blocks estrogens growth signal. Or they can use other drugs like aromatase inhibitors that lower your bodys estrogen levels to deprive the cancer cells of fuel.
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