What Can You Do For Your General Wellbeing
It’s important for women with breast cancer to take good care of themselves. Here are some ways to actively enhance your treatment and to do something good for yourself:
- Get regular exercise, if possible
- Eat things that agree with you and that you enjoy
- Find the right balance of activity and relaxation
- Get as much restful sleep as you can
- Generally do things you enjoy
A personalized exercise program is another way to reduce exhaustion and improve sleep, lightening your mood and seeing your body in a more positive way again. You can also take part in special sports activities offered as part of follow-up care after cancer treatment. It’s important to enjoy exercise, feel good while you’re doing it, and avoid overdoing it.
Many people think that certain diets can prevent cancer or speed up recovery. But reliable research on how nutrition influences breast cancer hasn’t yet found any direct effects on the risk of getting it or on how it progresses.
Mastectomy With Breast Reconstruction Surgery
You can have breast reconstruction at the same time as the mastectomy, or anytime after. This type of surgery is done by a plastic surgeon with experience in reconstruction surgery. The surgeon uses an implant or tissue from another part of your body to create a breast-like shape that replaces the breast that was removed. The surgeon may also make the form of a nipple and add a tattoo that looks like the areola .
There are two main types of breast reconstruction surgery:
Breast reconstruction with an implant is often done in steps. The first step is called tissue expansion. This is when the plastic surgeon places a balloon expander under the chest muscle. Over many weeks, saline will be added to the expander to stretch the chest muscle and the skin on top of it. This process makes a pocket for the implant.
Once the pocket is the correct size, the surgeon will remove the expander and place an implant into the pocket. This creates a new breast-like shape. Although this shape looks like a breast, you will not have the same feeling in it because nerves were cut during your mastectomy.
Breast implants do not last a lifetime. If you choose to have an implant, chances are you will need more surgery later on to remove or replace it. Implants can cause problems such as breast hardness, pain, and infection. The implant may also break, move, or shift. These problems can happen soon after surgery or years later.
Talking To Family And Friends About Your Illness
Women who have breast cancer are often concerned about how the disease will affect their relationship with their partner and if they are mothers their children. The stress of treatment often makes sexual needs a lower priority for a while. It can affect your daily routine and require a lot of decisions and planning. All this can give rise to conflicts. It’s important to keep talking to your partner. If you have reached your limits you can get psychological counseling or support, either individually, or as a couple.
Whether children are still very young or already grown up, many mothers find it difficult to talk to their children or grandchildren about their disease. It might stir up memories of the first time they were diagnosed and the same fears may resurface, along with new worries as well. But even if you would rather protect your children from this situation, children do sense when something is wrong. So it is a good idea to speak openly with them about the cancer coming back and about the fact that there may be more treatment to come, and that you may once again need to rest more often.
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Second Cancers After Breast Cancer
Breast cancer survivors can be affected by a number of health problems, but often a major concern is facing cancer again. Cancer that comes back after treatment is called a recurrence. But some cancer survivors develop a new, unrelated cancer later. This is called a second cancer.
Women whove had breast cancer can still get other cancers. Although most breast cancer survivors dont get cancer again, they are at higher risk for getting some types of cancer, including:
- A second breast cancer
- Salivary gland cancer
- Melanoma of the skin
- Acute myeloid leukemia
The most common second cancer in breast cancer survivors is another breast cancer. The new cancer can occur in the opposite breast, or in the same breast for women who were treated with breast-conserving surgery .
Local Recurrence After Lumpectomy
Local recurrence after lumpectomy can most often be treated successfully.
Treatment generally includes surgery, usually a mastectomy. Radiation therapy may be given if it wasnt part of the initial breast cancer treatment.
Treatment may also include chemotherapy, hormone therapy and/or HER2-targeted therapy.
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What’s The Risk Of Recurrence
Everyone who has had breast cancer has some risk of recurrence, but its typically low.;;
In general, the more time that goes by, the lower the risk of recurrence. Cancer is most likely to recur in the first two years after treatment, and once people get to five years of living cancer-free after treatment, its considered to be a significant milestone to be celebrated. Recurrence after that five year markrare, but possibleis called late recurrence.;
Theres still so much that is unknown about cancer recurrence, but researchers have found some patterns in recent years that point to clues about why it happens. These factors might be linked to a higher risk of breast cancer recurrence:;
- Having high blood sugar
- Not eating enough fruits and vegetables
- Having had a surgical site infection after your surgery
Certain characteristics of your original cancer also might mean a higher risk of recurrence, such as:
- A tumor of more than five centimeters across
- Cancer cells that are HER2-positive;
- Cancer cells that are triple negative;
- Cancer cells in four or more axillary lymph nodes at the time of surgery
- Cancer cells in the chest muscles or breast skin
You might be at higher risk for late recurrence if you had:
- A tumor of more than two centimeters
- A high number of affected lymph nodes
- A hormone receptor-positive cancer
- A HER2-negative cancer
- Hormone therapy for only a short time after surgery;
What Are Risk Factors For Breast Cancer Recurrence
Anyone with a breast cancer diagnosis can have a recurrence. Your risk of cancer recurrence depends on several factors:
- Age: Women who develop breast cancer before age 35 are more likely to get breast cancer again.
- Cancer stage: Cancer stage at the time of diagnosis correlates with the risk of the cancer being able to recur. Several factors determine cancer stage: tumor size, cancer grade and cancer spread to lymph nodes or other parts of the body. Cancer grade indicates how unusual cancer cells look in comparison to healthy cells.
- Cancer type: Aggressive cancers like inflammatory breast cancer and triple-negative breast cancer are harder to treat. Theyre more likely to come back and spread.
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Recovering From Breast Surgery
Will I have pain?
Most people have some pain after surgery.
Talk with your doctor or nurse before surgery about ways to control pain after surgery. Also, tell them if your pain control is not working.
How long before I can return to normal activities?
|Breast-Sparing Surgery||Most women are ready to return to most of their usual activities within 5 to 10 days.|
|Mastectomy||It may take 3 to 4 weeks to feel mostly normal after a mastectomy.|
|Mastectomy with Reconstruction||Your recovery will depend on the type of reconstruction you have. It can take 6 to 8 weeks or longer to fully recover from breast reconstruction.|
What other problems might I have?
|You may not like how your breast-like shape looks.If you have an implant:
If you have flap surgery, you may lose strength in the part of your body where a muscle was removed.
What other types of treatment might I need?
If you chose to have breast sparing surgery, you will usually need radiation therapy. Radiation treatments are usually given 5 days a week for 5 to 8 weeks.
If you have a mastectomy, you may still need radiation therapy.
No matter which surgery you choose, you might need:
What will my breast look like?
To get a better idea of what to expect, ask your surgeon if you can see before and after pictures of other women who have had different types of surgery.
What Are The Effects Of Treatment
Removing lymph nodes from the area around the affected breast and the armpit can cause lymphedema. This is where the arm or chest on the affected side becomes swollen because lymph fluid builds up there. It is important to treat lymphedema as soon as possible because symptoms can get worse over time and then become more difficult to treat.
Depending on how extensive surgery was, the wound may be painful and heal slowly, and there will almost always be visible scarring. Surgery may also make the skin less sensitive and make it more difficult to move the shoulder. One common side effect of cancer treatment is debilitating physical and mental exhaustion.
Losing one or both breasts is a tough blow for a lot of women. The breast is a symbol of femininity, sexual attractiveness and maternity. Losing a breast may stoke fears of no longer being attractive or able to enjoy sexuality, or women may even worry that their partner will leave them. So it can be worth getting a second opinion and looking over more information before deciding whether or not to have surgery. After a breast is removed, it may be possible to reconstruct it through surgery. There is usually no need to rush into a decision.
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Are Gep Tests Available For Other Cancer Types
GEP tests are not widely available and are still used mainly within research. They are still in the early stages of development for most types of cancer. It takes time for scientists to develop these tests, to make sure that they work and that they are accurate and cost effective.
The tests have to be different for each type of cancer. For example,;the gene activity in the cells of a breast cancer is different to the cells of a bowel cancer. Even within one type of cancer it might be necessary to develop different tests for different stages of that cancer.
Researchers have been looking into GEP tests for different cancers including;breast cancer,;bowel cancer,;food pipe cancer;and;stomach cancer.
National Institute for Health and Care Excellence December 2018
Impact of gene expression profiling tests on breast cancer outcomes. Evidence Reports/Technology Assessments, No. 160L. Marchionni and othersRockville : Agency for Healthcare Research and Quality 2008
The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroupsChristina Curtis and other
Coping With Worries About Recurrence
Nearly everyone who has been treated for cancer worries about it coming back.;
At first, every ache or pain can frighten you. But, as time passes, you may come to accept minor symptoms for what they are in most cases warning signs of a cold or flu or the result of over-exerting yourself.
Some events may be particularly stressful the days or weeks leading up to your check-ups, the discovery that a friend or relative has been diagnosed with cancer or the news that someone you met while having treatment is ill again or has died.
We all cope with such anxieties in our own way and there are no easy answers. But keeping quiet about them and not wanting to bother anyone is probably not the best approach.
Just as talking about your diagnosis and treatment may have helped you through the early days, talking about your fears relating to recurrence may help you later on.
Breast Cancer Nows Forum lets you share your worries with other people in a similar situation to you.
You can also read our tips on coping with anxiety and find suggestions in BECCA, our free app that helps you move forward after breast cancer.
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What Is The Treatment
Once you notice that you have recurrent breast cancer symptoms, itâs time to start thinking about recurrent breast cancer treatment. The type of treatment youâll receive will depend upon what type of treatment you initially had.
You may have had a lumpectomy to remove abnormal breast tissue from your chest. If you have a local recurrence after a lumpectomy, youâll have a mastectomy. This procedure surgically removes the entire breast and sometimes some of the surrounding tissue as well.
Some doctors will perform a mastectomy right away. If you have recurrence near this area youâll have the tumor surgically removed. Often times, this surgery is followed by a course of radiation.
Regardless of whether youâve had a lumpectomy or a mastectomy, you will probably have either radiation, hormone therapy, or chemotherapy after your second surgery. In some circumstances, your doctor will use a combination of these things to treat you with.
When breast cancer is found in your other breast, it may be a new tumor that is in no way related to your first bout with breast cancer. In this case, breast cancer treatment is conducted as though youâve developed a whole new case of cancer. You will get either a lumpectomy or a mastectomy, followed by more treatment if your doctor feels that itâs necessary.
Talk With Your Doctor
Breast cancer is scary, but it can be successfully treated.
Talk with a breast cancer surgeon about your choices. Find out:
- what happens during surgery
- the types of problems that sometimes occur
- any treatment you might need after surgery
Be sure to ask a lot of questions and learn as much as you can. You may also wish to talk with family members, friends, or others who have had surgery.
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Can I Lower My Risk Of Getting A Second Cancer
There’s no sure way to prevent all cancers, but there are steps you can take to lower your risk and stay as healthy as possible. Getting the recommended early detection tests, as mentioned above, is one way to do this.
Its also important to stay away from tobacco products. Smoking increases the risk of many cancers, including some of the second cancers seen after breast cancer.
To help maintain good health, breast cancer survivors should also:
Chemo Brain And Stress
Many people experience mental changes after chemotherapy treatment. This is sometimes called chemo brain. You may have problems such as poor memory, trouble finding words, difficulty focusing. This can affect parts of your life, including caring for your family and managing your job.
Some things that help with chemo brain include keeping a calendar, writing everything down, and exercising your brain with puzzles and reading. Try to focus on 1 task at a time instead of more than 1 task. You can also work with an occupational therapist for cognitive behavioral rehabilitation. This is a treatment to help you if you have cognitive issues. Occupational therapists work in the Department of Rehabilitation Medicine, Occupational and Physical Therapy. For more information about cognitive behavioral rehabilitation, talk with your healthcare provider for a referral.
Try to avoid having goals for yourself that are too high. This can add to your stress level and frustration. Most people say it takes 6 to 12 months after they finish chemotherapy before they truly feel like themselves again. Read the resource Managing Cognitive Changes: Information for Cancer Survivors for more information about managing chemo brain.
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Understanding The Risk Of Late Recurrence Of Breast Cancer
Even as a young child, Crystal Moore, MD, PhD, FCAP, knew she wanted to be a physician. For her, medicine is not just a profession but also a calling. She received her MD/PhD at the Medical College of Virginia. Her PhD was awarded by the Department of Biochemistry and Molecular Biophysics. She completed her residency training in Anatomic and Clinical Pathology at Duke University and is a board-certified fellow of the College of American Pathologists. Follow Dr. Moore at www.DrCrystalMoore.com and on Twitter .
An astonishing 15 years after her initial diagnosis and treatment, my mothers breast cancer unexpectedly recurred. Eventually, it claimed her life. As a daughter, I felt blindsided. But as a physician, I grew determined to help all people with breast cancer understand the risk of late recurrence.
From surgery and reconstruction to radiation therapy, chemotherapy, adjuvant hormone therapy, and follow-up doctor visits, the road back to health after a breast cancer diagnosis can be long and difficult to navigate. Patients anxiously await the day when theyll hear that seemingly magical word: remission.
Once there has been a diagnosis of breast cancer, the risk of a recurrence is never zero.
Check On Whether You Need Medications
After you complete your cancer treatment, if you have a high chance of your cancer returning, your doctor may prescribe you certain drugs to reduce your risk.
Tamoxifen and raloxifene are two such drugs. These drugs are approved for use in the U.S. and doctors usually prescribe them to lower the chances of estrogen-related breast cancer. Both drugs block estrogen hormone in breast cells. Studies show that they reduce your chances of getting breast cancer again by about 40%.
Tamoxifen. You take this once a day by mouth as a pill or liquid. It may make it less likely for you to get cancer in parts of your breast that werenât affected earlier. You may have side effects like hot flashes, vaginal discharge, irregular periods, loss of sexual interest, memory loss, fatigue, and joint pain.
Raloxifene. Itâs a pill you take once a day. Itâs usually given to women who are post-menopausal — those who stopped having their periods. It may also help you avoid or treat osteoporosis, when your bone density thins, putting you at risk of fractures.
While rare, these drugs can also cause blood clots in your leg veins or lungs. This can be a serious side effect that may need immediate medical attention. Contact your doctor as soon as possible if you think you have a blood clot.
Side effects can include vaginal discharge, muscle and joint pain, hot flashes, and night sweats. These drugs may also speed up osteoporosis and may raise your cholesterol.
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