How Is Inflammatory Breast Cancer Treated
Inflammatory breast cancer is generally treated first with systemic chemotherapy to help shrink the tumor, then with surgery to remove the tumor, followed by radiation therapy. This approach to treatment is called a multimodal approach. Studies have found that women with inflammatory breast cancer who are treated with a multimodal approach have better responses to therapy and longer survival. Treatments used in a multimodal approach may include those described below.
Where Can Breast Cancer Spread
The most common places for breast cancer to spread to are the lymph nodes, bone, liver, lungs and brain. The symptoms you may experience will depend on where in the body the cancer has spread to. You might not have all of the symptoms mentioned here.
Remember other conditions can cause these symptoms. They don’t necessarily mean that you have cancer that has spread. But if you have;symptoms;that you are worried about,;discuss them with your GP, cancer specialist, or breast care nurse;so that you can be checked.
If You Want To Lower Your Risk Of A Future Breast Cancer Or Ovarian Cancer
Whether or not youve ever had breast cancer, knowing that you have a BRCA mutation means that you are at much greater risk of developing breast and possibly ovarian cancer in the future. The latest research offers these insights about strategies for lowering those risks:
- Preventive or “prophylactic” mastectomy, or removal of both breasts, has been found to reduce the risk of breast cancer in high-risk women by about 90%. After a diagnosis of one breast cancer in a woman with a genetic abnormality, the risk of her getting a new breast cancer is approximately 3% every year . Without a BRCA1 or BRCA2 mutation, the risk of developing a new breast cancer after one episode of breast cancer is only 1% per year.
- Preventive or prophylactic salpingo-oophorectomy, or removal of both ovaries and fallopian tubes, can reduce breast cancer risk by as much as 50% when it is done before menopause, because it takes away the bodys main source of the hormone estrogen. It also can greatly reduce ovarian cancer risk. The timing of removing the ovaries differs depending on whether a person has a BRCA1 or BRCA2 abnormality. For those with a BRCA1 abnormality, the recommended timing of removing both ovaries and fallopian tubes is between ages 35 and 40. For those with a BRCA2 abnormality, removing ovaries and fallopian tubes can be considered between ages 40 and 45.
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Should I Consider Genetic Testing
Genetic testing;may help determine if your cancer resulted from an inherited gene mutation.;Genetic counseling;may help you understand the risks, benefits and limitations of genetic testing in certain situations. A genetic counselor, doctor or other health care professional trained in genetics may help you and your family understand your test results and other findings, such as a genetic risk factor for another disease like diabetes or heart conditions.
Other Types Of Breast Cancer
Other less common types of breast cancer include invasive lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Paget’s disease of the breast.
It’s possible for breast cancer to spread to other parts of the body, usually through the lymph nodes or the bloodstream. If this happens, it’s known as “secondary” or “metastatic” breast cancer.
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Should You Tell Work About Your Breast Cancer
If you have breast cancer, does your boss really need to know? How about your co-workers?
Its your call. And it depends on whats best for you.
If youll need time off during treatment or reasonable accommodations, like being able to work from home, it may help to tell your boss or HR team. Co-workers youre close to could be a comfort.
But if youd rather keep it private, you can.
Heres how four women handled their breast cancer diagnosis at work.
Am I At Risk For Breast Cancer
Anyone can get breast cancer, but there are some things that can increase your risk, including
-
being a cisgender woman
-
inherited mutations to genes that are related to breast cancer
-
being more than 50 years old
-
a blood relative who has had breast or ovarian cancer
Having 1 or more risk factors does not mean youll definitely get breast cancer. And some people will get breast cancer without having any of these risks.
Many risk factors are out of your control, but there are some things you can do to help lower your chances of getting the disease. Talk with your doctor or nurse about breast cancer screenings and what you can do to stay healthy. ;
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How Much Do Tamoxifen And Raloxifene Lower The Risk Of Breast Cancer
Multiple studies have shown that both tamoxifen and raloxifene can reduce the risk of developing estrogen receptor-positive breast cancer in healthy postmenopausal women who are at high risk of developing the disease. Tamoxifen lowered the risk by 50 percent. Raloxifene lowered the risk by 38 percent. Overall, the combined results of these studies showed that taking tamoxifen or raloxifene daily for five years reduced the risk of developing breast cancer by at least one-third. In one trial directly comparing tamoxifen with raloxifene, raloxifene was found to be slightly less effective than tamoxifen for preventing breast cancer.
Both tamoxifen and raloxifene have been approved for use to reduce the risk of developing breast cancer in women at high risk of the disease. Tamoxifen is approved for use in both premenopausal women and postmenopausal women . Raloxifene is approved for use only in postmenopausal women.
Less common but more serious side effects of tamoxifen and raloxifene include blood clots to the lungs or legs. Other serious side effects of tamoxifen are an increased risk for cataracts and endometrial cancers. Other common, less serious shared side effects of tamoxifen and raloxifene include hot flashes, night sweats, and vaginal dryness.
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.
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Causes Of Breast Cancer
Doctors do not know the exact causes of breast cancer. But there are risk factors;that can increase your chance of developing it.
Having one or more risk factors does not mean you will get breast cancer. Also, having no risk factors does not mean you will not develop it.
Breast cancer is likely to be caused by a combination of different risk factors, rather than just one.
Remember: Mammograms Save Lives
In recent years, theres been growing debate about the best age to start getting mammograms and how often. General guidelines are geared toward average-risk women who are not obese, dont smoke, dont drink alcohol daily and have no family history of breast cancer, Dr. Eddleman says. But its important to keep in mind that many women do not have average risk.
Dr. Eddleman recommends women start annual clinical breast exams and mammograms at age 40. Mammograms save lives, he says, and finding a malignancy on a mammogram rather than by touch can help treat cancer sooner, before it spreads.
Thats when you want it diagnosed, when you can see it on a mammogram and you cant feel it, because that means its usually small, he says. The smaller it is, the more treatable and more successful the treatment is.
We offer mammography screenings and comprehensive breast services at several locations across the Triangle. Learn more about our programs at the UNC Breast Center in Chapel Hill and the UNC REX Comprehensive Breast Care Program in Wake County.
David Eddleman, MD, is a breast surgeon and medical director of breast surgery at REX Breast Care Specialists, with locations in Raleigh, Cary and Wakefield.
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Surgery For Breast Cancer
Most women with breast cancer have some type of surgery. Common types of breast surgery are lumpectomy, mastectomy, and taking out lymph nodes from the underarm. Women who have a mastectomy may also decide to have the breast shape rebuilt, either at the same time or later on.
Choosing between lumpectomy and mastectomy
Lumpectomy only takes out the lump and a little bit around it. It lets you keep most of your breast. The downside is that youll most likely need radiation treatment after surgery. But some women who have a mastectomy also need radiation afterward.
When choosing between a lumpectomy and mastectomy, be sure to get all the facts. At first you may think that a mastectomy is the best way to get it all out. Some women tend to choose mastectomy because of this. But in most cases, lumpectomy is just as good as mastectomy. Talk to your cancer care team. Learn as much as you can to make the right choice for you.
Reconstructive surgery
If you have a mastectomy, you may want to think about having your breast shape rebuilt. This is called breast reconstruction. Its not done to treat the cancer. Its done to build a breast shape that looks a lot like your natural breast.
If youre going to have a mastectomy and are thinking about having reconstruction, you should talk to a plastic surgeon before the mastectomy is done. Your breast can be rebuilt at the same time the mastectomy is done or later on.
Side effects of surgery
What Are The Symptoms Of Breast Cancer
Breast pain can be a symptom of 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.
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Rally Your Support Team
Which friends and family members will be there to help you through your diagnosis, treatment and beyond? Whos going to take you to doctor appointments? Who can you call when youre feeling blue? Who can watch your kids or help with meal planning?
Just like with you, its good for your support team to know what to expect. By having these conversations with your friends and family early, youll gain a better sense of where you can expect help and where you may still need some support. Its good for your support team too, as theyll be less prone to surprises.
Schedule Time To Meet The First Members Of Your Breast Cancer Treatment Team
After a breast cancer diagnosis, waiting for answers can be overwhelming. All you might be able to think about is I have breast cancer. Now what?. But know that answers are on the way. In fact, we can offer you an appointment within 48 hours of a diagnosis at two of our metro locations.
If youve been working with your primary care doctor or a radiologist up to this point, your doctor may want to connect you with either a nurse navigator or a breast surgeon right away. Who youll see first depends on your breast cancer diagnosis. Either way, youll typically meet these two members of your care team first.
Oncology nurse navigator
Nurse navigators specialize in coordinating your care. They can help you make informed decisions throughout your cancer journey. Your nurse navigator can help you schedule your appointments, manage your treatments and make sure youre getting all the support you need throughout the treatment process.
Breast surgeon
Surgery is often one of the first steps in the breast cancer treatment process. Breast surgeons specialize in removing lumps and cancerous tissues from breasts. How long from breast cancer diagnosis to surgery day? Its usually just a few weeks.
How do you find a breast surgeon?
Your primary care doctor can provide you with recommendations. Your oncology nurse navigator can also help you explore your options and schedule your appointment. If you want to do your own research along the way, thats a great idea, too.
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Second Opinions For Breast Cancer
Detecting breast cancer can be a complicated process, so health professionals always encourage patients to undergo different tests and get a second opinion prior to beginning any treatment to ensure an accurate diagnosis. Breast tumors and other abnormalities aren’t always cancerous, so breast imaging tests, like mammograms and breast MRI’s, examine deep breast tissue and are necessary to properly diagnose cancer. A second opinion can also help patients determine the best path for treatment, as different specialists can provide different insights for treatment options. Patients should keep records of all visits and diagnoses to maintain evidence for a malpractice lawsuit if a misdiagnosis occurs.
I Found A Lump In My Breast What Should I Do
Maybe it happened in the shower. Or during an intimate moment with your partner. You could have been putting on lotion before bed. And there it isa breast lump. Finding one is understandably anxiety-provoking for women.
But before you jump to conclusions, stop and breathe.
Although the most common symptom of breast cancer is a lump or mass, many breast lumps are either benign or a symptom of a condition unrelated to cancer. So how do you tell the difference, and will it disappear on its own?
David Eddleman, MD, medical director of breast surgery at REX Breast Care Specialists, explains what to do if you find a lump.
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Foods That May Lower Breast Cancer Risk
Keep in mind that many factors are associated with breast cancer development. While improving your diet can improve your overall health and reduce your cancer risk in general, its only one piece of the puzzle.
Even with a healthy diet, you still need regular breast cancer screenings like mammograms and manual checks. After all, early detection and diagnosis significantly increase survival rates. Talk to your healthcare provider for advice about breast cancer screenings.
All the same, research suggests that these foods may lower your risk of this disease.
Why It Spreads And Recurs
You may be wondering why breast cancer cells travel at all. Or, why normal cells don’t spread around our bodies. Cancer cells differ from normal cells in many ways. One of these is that normal cells have what is known as “adhesion molecules.” These adhesion molecules act like glue and keep cells where they belong in a particular part of the body.
Normal cells also have “boundaries” or ways in which cells communicate with each other. This is like one country saying to another “you don’t belong here.” Cancer cells, in contrast, don’t respect these cellular communications, essentially ignoring the “fences” between different tissues.
Yet another confusing topic when talking about breast cancer spread is why it can happen years or even decades later. We know that, especially with estrogen receptor-positive breast cancers, cancer can seemingly disappear only to recur many years after the original tumor. Nobody is certain exactly how this happens, but there are theories about recurrence that suggest that some breast cancer cells are hardier than others and that these cancer “stem cells” are able to lie dormant even through treatment.
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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.
Diagnosis Of Breast Cancer
Women who have symptoms usually begin by seeing their GP. They will examine you and refer you to a breast clinic. You should get an appointment within 2 weeks.
Some women are referred through the NHS;breast screening;programme. Breast screening is a way of finding breast cancer at an early stage, when it is too small to be felt or seen.
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