Testing The Tumor Cells For Hormone Receptors
A hormone receptor is a specialized protein located on the surface of or within a cell. The receptor binds to the female hormones estrogen and progesterone, which flow through the blood. Once bound, the hormone signals the cell to start growing and multiplying.
Many breast cancer tumors contain hormone receptors, often in large numbers. When hormone receptors are present, estrogen and/or progesterone can fuel the growth of the cancer. Such hormone-dependent cancers often respond well to hormone therapy, which differs from hormone replacement therapy . If neither estrogen receptors nor progesterone receptors are present, the cancer is said to be hormone-receptor-negative, and hormone therapy would likely be ineffective. Knowing whether the cancer cells have hormone receptors can be valuable to your medical team and your treatment plan.
How Can I Protect Myself From Breast Cancer
Follow these three steps for early detection:
- Get a mammogram. The American Cancer Society recommends having a baseline mammogram at age 35, and a screening mammogram every year after age 40. Mammograms are an important part of your health history. Recently, the US Preventive Services Task Force came out with new recommendations regarding when and how often one should have mammograms. These include starting at age 50 and having them every two years. We do not agree with this, but we are in agreement with the American Cancer Society and have not changed our guidelines, which recommend yearly mammograms starting at age 40.
- Examine your breasts each month after age 20. You will become familiar with the contours and feel of your breasts and will be more alert to changes.
- Have your breast examined by a healthcare provider at least once every three years after age 20, and every year after age 40. Clinical breast exams can detect lumps that may not be detected by mammogram.
Breast Cancer Lab Tests Identify Risk Diagnose And Guide Treatment
A variety of breast cancer tests can help determine a persons genetic risk for the disease as well as diagnose breast cancer in the early stages. Lab tests for breast cancer may also be used to:
- Analyze characteristics of the breast cancer to determine appropriate treatment options
- Determine whether breast cancer has metastasized
- Monitor the effectiveness of breast cancer treatments and identify any recurrence of breast cancer
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How Should I Check My Breasts
Take the time to get to know how your breasts normally look and feel through normal regular activities .
You dont need to use a special technique, but ensure you look at and feel your breasts regularly. Make sure this includes all parts of your breast, your armpit and up to your collarbone.
For women of all ages, it is recommended that you be breast aware. Breast awareness is being familiar with the normal look and feel of your breasts, so that you can identify any unusual changes .
How To Check For Breast Cancer
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
It’s important that every woman knows how to do a breast self-examination , as it can help in early detection of breast cancer, such as lumps, nipple changes, and more.
Being familiar with what is normal for you will make it easier to recognize any new developments. Furthermore, knowing what’s not normal for anyone can help prompt you to bring such issues to your doctor’s attention, should you notice them during your BSE.
This photo contains content that some people may find graphic or disturbing.
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How Do Tamoxifen Raloxifene Anastrozole And Exemestane Reduce The Risk Of Breast Cancer
If you are at increased risk for developing breast cancer, four medications tamoxifen , raloxifene , anastrozole , and exemestane may help reduce your risk of developing this disease. These medications act only to reduce the risk of a specific type of breast cancer called estrogen receptor-positive breast cancer. This type of breast cancer accounts for about two-thirds of all breast cancers.
Tamoxifen and raloxifene are in a class of drugs called selective estrogen receptor modulators . These drugs work by blocking the effects of estrogen in breast tissue by attaching to estrogen receptors in breast cells. Because SERMs bind to receptors, estrogen is blocked from binding. Estrogen is the fuel that makes most breast cancer cells grow. Blocking estrogen prevents estrogen from triggering the development of estrogen-receptor-positive breast cancer.
Anastrozole and exemestane are in a class of drugs called aromatase inhibitors . These drugs work by blocking the production of estrogen. Aromatase inhibitors do this by blocking the activity of an enzyme called aromatase, which is needed to make estrogen.
What Are Genomic Tests
Genomic tests analyze a sample of a cancer tumor to see how active certain genes are. The activity level of these genes affects the behavior of the cancer, including how likely it is to grow and spread. Genomic tests are used to help make decisions about whether more treatments after surgery would be beneficial.
While their names sound similar, genomic testing and genetic testing are very different.
Genetic testing is done on a sample of your blood, saliva, or other tissue and can tell if you have an abnormal change in a gene that is linked to a higher risk of breast cancer. See the Genetic Testing pages for more information.
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What To Think About
Genetic counselling before and after a BRCA test can help you understand the benefits, risks, and possible outcomes of testing.
- To find doctors who do gene tests and counselling, contact your local chapter of the Canadian Cancer Society at www.cancer.ca.
- To find a genetic counsellor near you, contact the contact the Canadian Association of Genetic Counsellors at www.cagc-accg.ca.
- Breast Cancer Risk: Should I Have a BRCA Gene Test?
Types Of Blood Tests In Cancer Diagnosis
Doctors perform a complete blood count to test blood. A CBC measures the number of red blood cells, white blood cells, and platelets in a blood sample.
CBC results that are above or below normal ranges may signify a health problem. Doctors also look for any biomarkers that could indicate cancer activity.
Finally, doctors examine the various chemicals in the blood, such as:
Centers for Disease Control and Prevention recommend a few at-home options that individuals can use for cancer screening.
One of these tests is a screening for colon cancer. A healthcare professional provides a test kit to use at home for stool collection. The person then sends the sample to a lab for analysis. The lab contacts the individual if the results are abnormal and they need to visit a doctor for additional testing.
There is no specific test that diagnoses cancer at home with complete certainty. However, people can use self-checks to help spot any changes or abnormalities as early as possible.
Anyone who notices anything unusual during a self-check should speak with a doctor as soon as possible.
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How Is Breast Cancer Diagnosed
Magnetic resonance imaging may be used to diagnose breast cancer.
Doctors often use additional tests to find or diagnose breast cancer. They may refer women to a breast specialist or a surgeon. This does not mean that she has cancer or that she needs surgery. These doctors are experts in diagnosing breast problems.
- Breast ultrasound. A machine that uses sound waves to make pictures, called sonograms, of areas inside the breast.
- Diagnostic mammogram. If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.
- Breast magnetic resonance imaging . A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.
- Biopsy. This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies .
How Is Breast Cancer Detected
Once you notice changes in your breast, or as part of a routine breast screening, your doctor may use the following tests to look for breast cancer:
- Physical exam
- Mammogram: An X-ray of the breast
- Ultrasound: Imaging the breast using high-energy sound waves
- MRI: Imaging the breast using radio waves, magnetic fields and computer imaging more powerful and detailed than a mammogram, this test is recommended for women with above-average breast cancer risk
- Biopsy: Surgical removal of suspicious tissues for further examination
- Genetic screening: Women with elevated risk factors may undergo genetic screening to see if they have mutations that put them at higher risk for developing the disease.
If cancer is found, additional tests are performed to determine the type and stage of disease. These diagnostic tests include:
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Consent For Genetic Testing
Before getting a genetic test, you must first sign an informed consent document. This document confirms that you agree to be tested and you fully understand the tests benefits and risks.
Many testing centers require you to participate in a genetic counseling session before and after testing. Even if genetic counseling sessions are not required, its a good idea to ask for them. A genetic counselor can discuss the tests benefits and risks with you and give you additional information to review.
The main benefit of testing is knowledge. If your genetic test is negative for an abnormal BRCA1, BRCA2, or PALB2 gene that you know is present in your family, then you know you are not at high risk because of a mutation in any of those genes. But you could still be at high risk because of an abnormality in an inherited gene that has not yet been linked to breast cancer or ovarian cancer. This is especially possible if a close family member has been diagnosed with breast or ovarian cancer that is not linked with mutations in these three known genes. If your genetic test is positive, you can take steps to prevent breast or ovarian cancer or try to catch these cancers early if they do develop.
Magnetic Resonance Imaging Scans
A breast MRI uses magnetic energy and radio waves to create a detailed image of your breast tissue. An MRI can be especially useful if you have dense breast tissue.
During an MRI, you lie on a table that has hollow spaces for your breasts. The table eases into a large tube-shaped MRI machine. The scanning devices rotate around you. The scan is noisy, but it shouldnt hurt.
If youre uncomfortable in enclosed spaces an MRI may cause you some anxiety. If your doctor has asked for an MRI, let them know if youre claustrophobic or nervous. They can discuss ways to help lower your anxiety. They may also prescribe a muscle relaxer or anti-anxiety medication before the test.
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How To Get Brca Genetic Testing
Genetic counseling is recommended for those who are interested in being tested for breast cancer gene mutations. You can talk to a doctor about getting a referral to a genetic counselor, who can help determine whether genetic testing would make sense based on family history and risk factors. Since many genetic tests only look for one specific gene mutation, the counselor can often help determine which mutations to test for.
The genetic test itself simply involves taking a small sample of blood or saliva, which is sent to a lab for analysis. Results can take several weeks or months.
Genetic testing results are not always clear-cut:
- A test result can be positive, meaning that the patient does carry the gene mutation.
- A negative test result indicates that they do not have that particular known gene mutation. It does not, however, rule out the possibility of having mutations in other genes. It also does not rule out the possibility of developing breast cancer. Most breast cancer cases are not hereditary, so everyone should still have an early detection plan.
- Genetic test results can also be uncertain or ambiguous. An ambiguous test result means that a mutation has been found on the gene, but it is not yet known whether that particular mutation has any effect on the chances of developing breast cancer.
- Someone is either negative or positive. Over time, a person cannot go from being negative to being positive or vice versa for the specific gene mutations they were tested for.
Can I Have Cancer If My Blood Tests Are Mostly Normal
I have had pelvic/lower abdominal pain for about 8 months now. It is a continuous pain, some occasional blood in my stools. My Dad had Colon cancer at aged 50 and died at 56. My sister has polyps removed reguarly. I am 49 and had an early menopause. My blood tests are normal except for a high mean heamoglobin count? I had a sigmoid flex but it was clear. I have no idea what it could be but am worried it is an undetected cancer? Anyone have any thoughts on this? My GP does not seem concerned.
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What Are Screening Tests
The goal of screening tests for breast cancer is to find it before it causes symptoms . Screening refers to tests and exams used to find a disease in people who dont have any symptoms. Early detection means finding and diagnosing a disease earlier than if youd waited for symptoms to start.
Breast cancers found during screening exams are more likely to be smaller and still confined to the breast. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis of a woman with this disease.
When Should I See A Doctor
It is important to remember that most breast changes are not caused by cancer, and the signs and symptoms can be caused by other medical conditions. However, if you have noticed any symptoms or changes in your breasts, it is important that you see your doctor without delay so that the changes can be checked. This may include a physical examination or imaging of your breasts. Early detection gives the best possible chance of survival if you are diagnosed with breast cancer.
It is important to remember that breast awareness does not replace having regular mammograms and other screening tests as recommended by your doctor. Some people diagnosed with breast cancer have signs or symptoms. However, some women have no signs/symptoms and the breast cancer is found during a screening mammogram.
In order to detect breast cancer early, it is recommended that all women between 50-74 years attend regular screening mammograms every two years. These are offered for free by BreastScreen Australia. Women aged 40-49 and 75 years and older are also eligible for free mammograms if they choose to attend. In deciding whether to attend a screening mammogram, women in these age groups can speak with their doctor and should also consider the potential benefits and downsides of screening mammograms for them.
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Why It Is Done
A BRCA gene test is done to find out if you have BRCA gene changes that increase your risk of breast and ovarian cancer.
The results of a BRCA gene test can help you find out how high your cancer risk is. If it is high, you might decide to take steps to lower your risk. There are several things you might do, such as:
- Have checkups and tests more often.
- Have surgery to remove your breasts.
- Have surgery to remove your ovaries.
- Take medicines that may help prevent breast cancer.
If you have a family member who has breast or ovarian cancer, you may want to ask that family member to have a gene test first. If your relative’s test finds a changed BRCA gene, you and other family members can then be tested for that specific gene change. But if your family member’s test is negative, it is not likely that you carry the gene change.
What If You Have Early
If you have early-stage breast cancer but no symptoms to suggest the cancer has spread, you should not get an imaging test to look for cancer in other places in your body. The chance that your cancer has spread is very small. Studies show that breast cancer spreads to the liver and bones in fewer than 6 out of 100 people. And this is usually in patients with stage III breast cancer.
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When And How To Get Tested
Breast cancer can happen at any age. In most cases, it occurs in women over the age of 50. All women are encouraged to speak to their doctor or nurse practitioner about getting tested for breast cancer.
If you are 30 to 69 years old and confirmed high risk
The Ontario Breast Screening Program recommends getting a mammogram with an MRI or ultrasound every year.
High-risk status is based on a family or medical history of breast cancer and must be confirmed by a doctor or genetic counsellor. Breast cancer testing for women at high risk is covered by OHIP.
Talk with your doctor if you think you have family or medical history related to breast cancer or other criteria that may place you at high risk.
If you are 50 to 74 years old
The Ontario Breast Screening Program recommends getting a mammogram every two years. You dont need a doctors referral and the service is covered by OHIP.
To book an appointment, contact your nearest Ontario Breast Screening Program location or call 1-800-668-9304.
If you are over 74 years old
Speak with your health care provider about getting tested for breast cancer.
If you choose to get tested, you will need a referral for a mammogram from your doctor or nurse practitioner. This service is covered by OHIP with a referral.
If you do not have a doctor or nurse practitioner, you can find one through Health Care Connect at 1-800-445-1822.