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Saturday, October 29, 2011

Symptoms of Breast Cancer

What You Need to Know About Breast Cancer Symptoms
Symptoms of Early Stage Breast Cancer, Advanced Disease, and Recurrence

Symptoms: the physical signs of a disease

Why You Need To Know About Breast Cancer Symptoms
Breast cancer begins in a cell, which divides and multiplies at an uncontrolled rate. A small clump of cancer cells are too tiny to be felt, so the earliest stages of breast cancer usually have no symptoms. A mammogram can detect cancer before you can feel a lump, which is why your annual screening mammogram is so important. Some benign breast conditions can seem like cancer, so it’s good to know the difference, and get a health professional to check out worrisome lumps.

Understanding Symptoms
The classic symptom for breast cancer is a lump found in the breast or armpit. An aggressive type of this disease, inflammatory breast cancer (IBC), grows in sheets or nests of tumor cells that invade the skin and can resemble a rash. Doing your monthly breast self-exam (BSE) is a great way to be familiar with your breasts’ texture, cyclical changes, size, and skin condition. Early detection is the best way to protect your health and improve your odds of survival. Don’t hesitate to see your doctor or nurse for a clinical breast exam (CBE) if you have a question about a change in your breasts.

Symptoms You Can See or Feel

swelling or lump (mass) in the breast
swelling in the armpit (lymph nodes)
nipple discharge (clear or bloody)
pain in the nipple
inverted or retracted nipple
scaly or pitted skin on nipple
persistent tenderness of the breast
unusual breast pain or discomfort

Symptoms Seen On Breast Imaging

Microcalcifications in tight clusters
Dense mass with spiky (spiculated) outline

Some Symptoms of Advanced (Metastatic) Breast Cancer
Stage 4, or metastatic breast cancer is the most advanced stage of this disease. Metastatic breast cancer is defined as having spread beyond the breast and underarm lymph nodes into other parts of the body.

bone pain (bone metastases)
shortness of breath (lung metastases)
drop in appetite (liver metastases)
unintentional weight loss (liver metastases)
headaches, neurological pain or weakness (could be brain metastases)

Inflammatory Breast Cancer (IBC) – Aggressive and Unusual Symptoms
One type of breast cancer that does not appear in lumps is called inflammatory breast cancer (IBC). This aggressive cancer grows in sheets instead of lumps, and it invades nearby skin, resembling a rash. It will not respond to topical creams or antibiotics, and should be treated very promptly. Symptoms:

a sudden increase in mature breast size (as much as a cup size in a few days)
itching in the skin of the breast that is continuous and not relieved by pills or creams
a change in the breast skin color, resulting in pink, red, or dark-colored areas
breast is excessively warm to the touch, or harder or firmer than usual
unusual pain, which occurs out of the regular cycle
sometimes a change in skin texture, similar to the skin of an orange
breast skin ulcers (later stage IBC)

Symptoms of Breast Cancer Recurrence
Recurrence of breast cancer is classified as local, regional, and distant. A distant recurrence is the same as advanced (metastatic) breast cancer. A local recurrence is breast cancer that has returned after treatment, in or close to the original tumor location. It can often be effectively treated. Regional recurrence may be in the chest wall muscles, or in lymph nodes located beneath your sternum, just above your collarbones, and around your neck.

Local Recurrence Symptoms:

a small lump or rash in the excision scar, on or under the skin

Regional Recurrence Symptoms:

swollen lymph node in the same armpit where cancer was previously removed
swollen lymph nodes above collarbones or sides of neck

A New Tumor Is Not a Recurrence
If a new tumor appears and has a different pathology than the original breast cancer, it is not considered a recurrence. It is called a new primary, and can occur in a different area of the breast that was originally affected, or in the opposite breast. A new cancer is diagnosed and treated independently from the original tumor.

What is Breast Cancer?
Diagnosis of Breast Cancer
Treatments for Breast Cancer
Preventing Breast Cancer

Source:
National Institutes of Health. Medline Plus. Breast Cancer. Symptoms. Updated: 4/3/2007

All About Breast Cancer Prevention

All About Breast Cancer Prevention and Lowering Your Risk of Breast Cancer
Risk Factors, Reducing Risk, Protect Your Breast Health

Prevention: actions which reduce the chance of getting a disease

Why You Need To Know About Breast Cancer Prevention

In 2007, an estimated 240,000 women will be diagnosed with breast cancer in America. Of those diagnosed, 40,000 will die from this disease. Although some of the contributors to the development of breast cancer are known, there is no guaranteed way to prevent it. But by educating yourself and taking control of some lifestyle factors, you can lower your risk of developing breast cancer.

Understanding Your Risk of Breast Cancer
Your risk is calculated by looking at several factors, some of which you are born with, and some of which you can choose. Knowing your health background will help you and your doctor make good choices about lifestyle and health care, which can lower your risk of breast cancer. You can try online risk assessment tools, but don’t use these as a substitute for talking with your doctor.

Breast Cancer Risk Factors in Detail:

Factors You Can’t Control


Gender
Genes
Race
Age
Menopausal status
Drugs and treatments
Menses onset
Family Health History

Lifestyle Factors You Can Control

Pregnancy
Breastfeeding
Hormone Replacement Therapy use
Alcohol
Smoking
Diet
Exercise
Weight

Lower Your Risk of Breast Cancer
Whether you are at low or high risk, you have many options to lower your risk. When it’s found at an early stage, breast cancer can effectively be treated, and there are several ways to help prevent recurrence. Take responsibility for your breast health.

Protect Your Breast Health

Do regular breast self exams (BSE)
Know Your Cyclical Changes

Learn About Breast Lumps
- Cysts
- Fibroadenomas
- Pseudolumps
- Breast Hematomas
- Tumors
Learn About Benign Breast Conditions
- Fibrocystic changes
- Atypical hyperplasia
- Breast Inflammation (Mastitis)
- Duct Ectasia
- Benign Nipple Discharge
- Adenosis (enlarged lobules)
- Intraductal Papillomas (benign tumors)

Have a Clinical Breast Exam

Schedule Your Annual Mammogram
- Taking Two Mammogram Views
- Look at Mammogram Images
- Understand Your Mammogram Report

Having a Breast Ultrasound

Having Ductal Lavage

Breast Cancer Risk Myths

Ten Common Myths About Causes of Breast Cancer
Will Grapefruit Really Increase My Risk of Developing Breast Cancer?
Ten Common Questions About Breast Cancer

Ongoing Research – the Future of Breast Cancer Prevention
Will breast cancer ever be preventable? Researchers hope so, and the National Cancer Institute says that clinical trials for high-risk women have been done. Since estrogen fuels 80% of all breast cancers, the trials have focused on drugs that affect estrogen levels. Selective estrogen receptor modulators (SERMs) such as Tamoxifen and Raloxifene have been tested, and appear to help prevent the development of breast cancer, but all the results are not in yet. Aromatase inhibitors, such as Aromasin, help prevent estrogen production, and are still in trial studies. Genetic tests for BRCA1 and BRCA2 are now available to help women determine the degree of risk they may face. In very high-risk patients, preventive mastectomy may be considered, as well as oophorectomy (removal of ovaries to lower estrogen levels). If you have a family history of breast cancer, talk to your doctor about the options that would lower your risk.

What is Breast Cancer?
Symptoms of Breast Cancer
Diagnosis of Breast Cancer
Treatments for Breast Cancer

Source:
National Cancer Institute. Fact Sheet. Breast Cancer Prevention Studies. Updated: 06/01/2005.

Overview of Breast Cancer Treatment Options

Overview of Breast Cancer Treatment Options
The Five Types of Breast Cancer Treatments

After your breast cancer has been diagnosed and staged, your healthcare team will recommend treatment. Your treatment plan will be based on the type of breast cancer you have; the size, grade, and biological characteristics of the tumor; your hormonal status; and your general health.

There are five standard treatment options: surgery and radiation (typically used for local control of cancer within the breast and lymph nodes) and chemo, biologic, and hormonal therapies (usually reserved for control of potential disease in the rest of the body).

1) Surgery
The goals of breast cancer surgery are to remove the cancerous tissue, and to analyze it for type, grade, size, hormonal status, and possible metastasis. Prevention of breast cancer recurrence is your surgeon’s top priority. You will have some choices about which kind of surgery to have, depending on the tumor size and location. If you have a mastectomy, reconstruction may also be an option.

Diagnostic surgery is done to determine if cancer is actually present, and if it has spread. Procedures include:

breast biopsy
lymph node removal (sentinel node biopsy or axillary node dissection)

Standard therapeutic surgeries, those used to remove cancer, are:

lumpectomy
quadrantectomy
mastectomy (partial, modified radical)

2) Radiation
DNA is the coding that serves as the programming for all of the body's processes and characteristics. Cancer cells grow in an unorganized and uncontrolled way as a result of glitches in DNA. Radiation therapy works by causing severe damage to that abnormal DNA, disrupting growth signals and preventing cell division. Healthy cells that surround the cancer can survive the radiation, with some side effects. Radiation technology is improving, becoming more targeted and effective.

There are two main types of radiation therapy:

external beam
brachytherapy (internal beam)

3) Chemotherapy
Cancer is uncontrolled cell growth, and chemotherapy targets rapidly diving cells throughout your body. Chemotherapy is considered systemic therapy because, like systemic (metastatic) cancer, it goes everywhere in your body's systems. Chemotherapy is used to kill cancer cells and prevent recurrence. Chemo may be used in all stages of breast cancer. Though commonly used for those in stage two, three, or four, many stage one patients who can benefit from this therapy can be identified.

Schedules and types of chemotherapy:

Adjuvant or neoadjuvant
Stem cell and bone marrow transplant

Most common drugs used:

Adriamycin
Cytoxan
Methotrexate
5-Fluorouracil
Cytoxan
Taxol

Life during chemo can involve:

side effects (nausea, vomiting, fatigue, hair loss, etc.)
white and red blood cell booster shots
frequent blood tests (complete blood count)
blood transfusions
tumor marker tests

4) Targeted (Biologic) Therapies
These therapies are designed to disrupt those processes that contribute to the continued growth of cancer cells. Such therapies include:

Tykerb
Herceptin
Avastin
Iressa

5) Hormonal Therapy
Breast cancers are frequently dependent on estrogen for their growth. Anti-estrogen hormone therapy starves tumor cells of the estrogen they need to grow, resulting in cancer cell death. This type of therapy may be delivered before surgery, or concurrently with radiation. You may need to take hormonal therapy for five years after you're finished with primary treatment to prevent recurrence.

Hormone therapies can include:

estrogen receptor blockers (Tamoxifen, Raloxifene)
aromatase inhibitors (Aromasin, Arimidex, Femara)
oopherectomy (surgical removal of the ovaries)
chemical ovarian suppression (Faslodex)

What is Breast Cancer?
Symptoms of Breast Cancer
Diagnosis of Breast Cancer
Preventing Breast Cancer
.

Diagnosis of Breast Cancer. Imaging, Pathology, Hormone Status, Staging

Diagnosis of Breast Cancer
Imaging, Pathology, Hormone Status, Staging

Diagnosis: Identification of a disease, based on signs and symptoms

Breast cancer isn't always detected with the naked eye. Its early signs are often hidden within your breast tissues. Changes to your breasts that you do see may not be the result of breast cancer at all. Lumps and bumps may come and go, as your hormones ebb and flow, and as you age. Breast skin may change texture due to sunburn, radiation treatments, or infections that cause rashes. So how would you know for sure whether or not a lump, skin rash, or skin dimpling is benign or cancerous? You will need help from your medical professionals to get a clear diagnosis.

Hands-on Screening
Clinical Breast Exam (CBE)

Women who are between 20 and 30 years old should have a clinical breast exam during their annual physical. If irregularities are found, a mammogram and ultrasound can help clarify the nature of the problem.

Getting the Right Picture: Imaging Studies

Mammograms
A mammogram is the gold standard for breast cancer screening and early detection. The American Cancer Society recommends that women 40 years old and up have an annual mammogram, though some other medical associations push that recommendation to age 50. Mammograms can help detect 85 to 90 percent of all breast cancers, even before you can feel a lump.

Having a Mammogram: Time your appointment for best results, bring your medical records, and know what to expect
Mammogram Views for Routine and Diagnostic Screening: Each of your breasts will be compressed and imaged twice
Mammogram Images, Descriptions and Details: See images of mammograms and what your radiologist will be checking for
Understanding Your Mammogram Report: Learn what may be on your imaging results report and what the medical terms mean to you
Findings on a Mammogram
- Cysts
- Calcifications
- Fibroadenomas
- Hematomas
- Tumors
- Implants
BIRADS – Breast Imaging Reporting and Data System: Your report will be rated by this system, and that rating will be included in your diagnosis

Breast Magnetic Resonance Imaging (MRI)
A breast MRI reveals different details of your breast health than a mammogram, so it can be used as a complementary test. MRIs don’t use compression, like mammograms, but are much more expensive and not as widely available. Learn more about how mammograms and MRIs are different.

Elastography - Staying in Touch With Breast Cancer Detection and Diagnosis
Elastography is a new, though still investigational, technology for imaging breast tissue. It may be better than mammography, ultrasound, and MRI at distinguishing between benign and cancerous growths. Elastograms can find a cancerous lump without a biopsy.

Getting Inside the Problem: Pathology Tests
If a breast lump is suspicious, a sample of tissue or fluid must be taken and tested by a pathologist.

Fluid Tests:

Ductal Lavage: Screening for pre-cancerous and cancerous breast cells
Ductal lavage has been referred to as the "Pap smear for the breast." A tiny tube is inserted into the breast to draw fluid from the breast ducts, which is then examined under a microscope or screened for cancer cells. This is also an investigational screening technique.

Aspiration: During an aspiration, your doctor will use a fine needle to suction a sample of fluid from a lump, such as a cyst, to be screened.

Tissue Tests:

Breast Biopsy: A surgeon can remove a very small tissue sample from your breast. The tissue will be tested and examined under a microscope for cancer. There are three types of breast biopsy:

Fine-needle aspiration (FNA)
Core needle biopsy (CNB)
Stereotactic biopsy
Open biopsy, or surgical biopsy

Discovering What Fuels the Cancer

Hormone Status
Breast cancers are divided into two main types: estrogen receptor positive, and estrogen receptor negative. If you test positive for breast cancer, estrogen and progesterone biomarker test results appearing on your pathology report will help your physician determine which type of the disease you have. This information affects your treatment as well as your follow-up care.

HER2 Status
HER2 (human epidermal growth factor receptor 2) protein can fuel the uncontrolled growth of a breast cancer tumor. Herceptin is used to treat this kind of breast cancer, in combination with other chemotherapy drugs. Lapatanib is also available for those who are HER2 positive. Knowing your HER2 status affects your diagnosis and treatment.

Getting the Overall Diagnosis
Breast Cancer Staging
Once all the test results are in, your doctor will summarize the diagnosis for you. Your cancer will be ranked in stages, once by your oncologist, and again by your radiologist. Knowing the stage of your breast cancer is critical to deciding on a course of treatment.

TNM System: Tumor Size, Node Status, Metastasis
Stages: Four Stages of Breast Cancer
Comparing Data: A Table of Stages and TNM Ranking

What is Breast Cancer?
Symptoms of Breast Cancer
Treatments for Breast Cancer
Preventing Breast Cancer
.

Breast Cancer. Types of Breast Cancer, Definition, Common Symptoms

What is Breast Cancer?
Definition, Types of Breast Cancer, Common Symptoms

Breast cancer is a malignant (cancerous) growth that begins in the tissues of the breast. Cancer is a disease in which abnormal cells grow in an uncontrolled way. Breast cancer is the most common cancer in women, but it can also appear in men. In the U.S., it affects one in eight women.

The most common types of breast cancer are:
ductal carcinoma (85 - 90% of all cases)
lobular carcinoma (8% of all cases)

Invasive (Infiltrating) Breast Cancer
Invasive, or infiltrating, breast cancer has the potential to spread out of the original tumor site and invade other parts of your breast and body. There are several types and subtypes of invasive breast cancer.

Less common are:
inflammatory breast cancer (occurs in the skin)
Paget's disease of the nipple

Breast Cancer Symptoms and Explanations

A lump or a thickening in the breast or in the armpit:
Some lumps or swelling in the breast tissue may be due to hormonal changes. But if a lump or thickening persists, whether it is in the breast or in the armpit area, it may be a cause for concern. Swelling in the armpit, where the lymph nodes are located, may indicate that the body is fighting an invasion. A lump in the breast tissue may indicate a cyst, or it may indicate a problem in the duct or the lobes. See your doctor or nurse practitioner for a screening. Here is an overview of lumps.

A change in size or shape of the mature breast:
If a mature breast changes size or shape, and especially if only one breast is changing, it may signal that milk ducts or the lobes deeper within the breast are swelling. This could be due to fibrocystic or regular monthly hormonal cycles. If the changes are not in step with regular periodical changes, consult a health professional and get an exam. Having a baseline mammogram can help you and your doctor keep track of changes with accuracy.

Fluid (not milk) leaking from the nipple:
Between ages 41 - 58, there may be a small bit of non-bloody leakage from the nipples of both breasts. This leakage is usually due to hormonal changes and is not worrisome. However, if the fluid is leaking from only one nipple, is a new discharge, or is bloody, there are several tests that can be done to discover what is causing it. Ask your doctor for a professional opinion on your next steps.

Change in size or shape of the nipple:
Changes in body weight, or natural changes that come with age may affect the size or shape of the nipples. However, if a nipple retracts (pulls in) and does not easily return to its normal shape, see your doctor or a nurse practitioner for a manual exam. If there is a problem with the milk ducts which are just below the surface of the nipple and areola, then having a diagnostic mammogram or ultrasound can help diagnose the trouble.

Changes of color, shape or texture of the nipple or the areola:
If you observe dimples, puckers, or a rash on the skin of the nipple or the areola, (darker skin that surrounds the nipple) and these symptoms persist, or do not respond well to treatment creams, check with your doctor to determine what action to take. One unusual type of breast cancer is called Paget's disease, and starts out in the form of a rash. When caught and dealt with at an early stage, this is a very curable condition.

Unusual pain in the breast or in the armpit:
Know your cyclical pains, and note if breast pain occurs in tune with the monthly period, and in both breasts. While uncomfortable, if it is normal to you, it may not be worrisome. But if you have pain which occurs off-cycle or in only one breast or armpit, get it checked out. Keeping a good record of your cycles will help you understand hormonal changes in your breasts, and also helps your doctor and nurse determine what may be happening in your body.

Everything is Connected:
Our bodies go through cycles and changes, some of which are due to age, weight gain or loss, hormones, medications, pregnancy, stress, or changes in diet. Some of us are very aware of living in our bodies, while others of us live more in our minds or in our emotions. In order to have and keep our health, it's good to be aware of our body and its rhythms.

Just as getting a toothache can seem to make your entire head hurt, or pulling a muscle in your leg causes you to limp and throws you off balance, finding a change in your breast affects your overall health and may signal a need to get a checkup or a diagnostic screening.

Knowing your body's normal changes helps you deal wisely with your health. Regular communication with your health care team can allay fears and help you raise your defenses against disease.

Symptoms of Breast Cancer
Diagnosis of Breast Cancer
Treatments for Breast Cancer
Preventing Breast Cancer

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