Think About What Is Important To You
After you have talked with a breast cancer surgeon and learned the facts, you may also want to talk with your spouse or partner, family, friends, or other women who have had breast cancer surgery.
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Three women describe how they decided which type of breast cancer surgery was right for them.
Then, think about what is important to you. Thinking about these questions and talking them over with others might help:
What Is Estrogen Receptorpositive Breast Cancer And Progesterone Receptorpositive Breast Cancer
Cells from your breast cancer can be tested for receptors on two hormones that can fuel cancer growth: estrogen and progesterone. Receptors are special proteins on cells that attach to certain substances, such as estrogen and progesterone, much like a key entering a lock. Breast cancer can contain receptors for one of these hormones, both, or neither.
- Breast cancer with receptors for estrogen is called estrogen receptor positive, or ER positive.
- Breast cancer with no receptors for estrogen is called estrogen receptor negative, or ER negative.
- Breast cancer with receptors for progesterone is called progesterone receptor positive, or PR positive.
- Breast cancer with no receptors for progesterone is called progesterone receptor negative, or PR negative.
If your cancer is ER positive, PR positive, or positive for both estrogen and progesterone receptors, your treatment may include a hormone therapy a drug or drugs that keep these hormones from plugging into their receptors. The idea is to cut off the cancers access to the fuel that would otherwise power its growth, much like putting a child safety cap on an electrical outlet.
What Type Of Breast Cancer Do I Have
Breast cancers arent all the same. Doctors classify them in a number of different ways. The most basic place to start is where the cancer cells originate. Their origin is a key factor in whether or not your cancer may spread and helps dictate the kind of treatment youll get.
Most breast cancers 70% to 80% start in the milk ducts. Theyre known as infiltrating or invasive ductal carcinomas, meaning that theyve broken through the milk ducts wall and have proliferated into the breasts fatty tissue. Once there, its possible for the cancer cells to further spread to other parts of the body.
Another 10% of breast cancers start in the milk-producing glands, or lobules, and are called invasive lobular carcinomas. Theyre also capable of spreading.
Other rarer breast cancers may involve the nipple, the breasts connective tissue or the linings of blood vessels or lymph vessels.
Some breast cancers are non-invasive. They havent spread. Theyre contained within the milk ducts and are called ductal carcinoma in situ . Generally, the prognosis for patients with DCIS is very good, Dr. Abraham says.
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Mammography: Screening For Breast Cancer
Mammography is one of the best ways to detect breast cancer early. Mammography is designed to be sensitive enough to detect the possibility of cancer at an early stage, sometimes years before it can be felt. Because mammography is so sensitive, it may indicate cancer when none is presenta false-positive result. About 85 to 90% of abnormalities detected during screening are not cancer. Typically, when the result is positive, more specific follow-up procedures, usually a breast biopsy, are scheduled to confirm the result. Mammography may miss up to 15% of breast cancers. It is less accurate in women with dense breast tissue.
Breast tomosynthesis may be used with mammography to produce a clear, highly focused 3-dimensional picture of the breast. This technique makes it somewhat easier to detect cancer, especially in women with dense breast tissue. However, this type of mammography exposes women to almost twice as much radiation as traditional mammography.
Recommendations for routine screening with mammography vary. Experts disagree about
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When it should start
When a lump or another abnormality is detected in the breast during a physical examination or by a screening procedure Screening Breast cancer occurs when cells in the breast become abnormal and divide uncontrollably. Breast cancer usually starts in the glands that produce milk or the tubes that carry… read more , other procedures are necessary.
Oncogene Expression May Negatively Affect Breast Cancer Outcome
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A relatively new addition to the discussion of breast cancer survival statistics and prognosis is oncogene expression.
An oncogene is a tiny fragment of genetic material which is carried in a chromosome and can cause normal cells to become malignant.
The oncogene HER-2, in particular, has been linked to more aggressive breast cancers.
Around one-third of all breast tumours produce the HER-2 oncogene, and these patients tend to have higher rates of recurrence and lower overall breast cancer survival rates.
According to a 2013 Canadian scientific study, the overall 5-year survival rate of HER-2 positive breast cancer is 88.6%. Furthermore, the relapse-free survival rate for 5 years is 79.4%.
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Tests To Determine Specific Types Of Treatment
You’ll also need tests that show whether the cancer will respond to specific types of treatment. The results of these tests can give your doctors a more complete picture of the type of cancer you have and how best to treat it. The types of test you could be offered are discussed below.
In some cases, breast cancer cells can be stimulated to grow by hormones that occur naturally in your body, such as oestrogen and progesterone.
If this is the case, the cancer may be treated by stopping the effects of the hormones, or by lowering the level of these hormones in your body. This is known as “hormone therapy”.
During a hormone receptor test, a sample of cancer cells will be taken from your breast and tested to see if they respond to either oestrogen or progesterone. If the hormone is able to attach to the cancer cells , they’re known as “hormone receptor positive”.
While hormones can encourage the growth of some types of breast cancer, other types are stimulated by a protein called human epidermal growth factor receptor 2 .
These types of cancer can be diagnosed using a HER2 test, and treated with medication to block the effects of HER2. This is known as “biological” or “targeted” therapy.
What Is Breast Cancer
Breast cancer is the most common cancer in women in Australia and the second most common cancer to cause death in women, after lung cancer.
Breast cancer is the abnormal growth of the cells lining the breast lobules or ducts. These cells grow uncontrollably and have the potential to spread to other parts of the body. Both men and women can develop breast cancer, although it is uncommon in men. Transwomen, non-binary people can also get breast cancer.
Transgender and gender-diverse people can also get breast cancer. A transgender woman taking medication to lower male hormones and boost female hormones may have an increased risk of developing breast cancer.
It is estimated that 19,866 women and 164 men in Australia will be diagnosed with breast cancer in 2021.
In Australia, the overall five year survival rate for breast cancer in females is 91%. If the cancer is limited to the breast, 96% of patients will be alive five years after diagnosis this figure excludes those who die from other diseases. If the cancer has spread to the regional lymph nodes, five year relative survival drops to 80%.
Treatment depends on the extent of the cancer.
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Ways To Avoid Gaining Weight Between Thanksgiving And New Years Day
Dont ruin all the good work you have been doing all year with your weight, during the holidays! The holidays and fattening food go hand-in-hand. Thanksgiving and the leftovers can last a week or two Before you know it, it is Christmas followed by. New Year. Studies show that about 75% of a persons annual weight gain happens between Thanksgiving and the end of the year. How can you avoid gaining weight during the holidays?
The first way to avoid gaining weight during the holidays is to make sure you have a healthy meal before arriving at a party or other event that includes food. Feel free to go crazy on Thanksgiving. A single day wont ruin your waistline. For other holiday events, fill yourself up with healthy food first. Eat fruits and veggies before you go for your event. Your stomach will be full of healthy food, and youll be less likely to eat junk food.
The second way is to focus on things other than food. When attending a party, spend your time and attention on the other attendees. Mingle and socialize. Find a healthy snack and a bottle of water. Talk and listen to others, get your mind busy at the events you attend so that food and alcohol wont do all your talking for you. If they do, you will eat and drink and gain weight!
Less Common Forms Of Breast Cancer
Some other types of breast cancer you may hear about include:
- Colloid breast cancer, or mucinous breast cancer, a form of invasive ductal carcinoma that makes mucus and is typically less aggressive.
- Medullary breast cancer, rare and resembling the color of brain tissue under the microscope. It is usually triple negative, more common in women with a BRCA mutation and less likely to involve the lymph nodes.
- Tubular breast cancer, a type of invasive ductal carcinoma made up of tube-like structures. It tends to be small and slow-growing.
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Will I Need Chemotherapy
Typically chemotherapy is a consideration for patients with high-risk breast cancers. Some factors that may indicate the need for chemotherapy are:
- Lymph node involvement.
- Tumors that are higher-grade, ER/PR-negative, HER2-negative or triple-negative .
- Tumors that are HER2-positive.
- Breast cancers in younger patients, especially those below the age of 40.
If you need chemotherapy, it will be given as an outpatient treatment every two to three weeks, delivered either directly into a vein or through a port.
Should I Have Breast Reconstruction And When
This is another question that has a multi-layered answer. It involves both medical and personal considerations. Some women opt not to have reconstruction. Others believe it benefits their appearance and psychological recovery.
This is another question that has a multi-layered answer. It involves both medical and personal considerations. Some women opt not to have reconstruction. Others believe it benefits their appearance and psychological recovery.
If youre having one or both breasts removed and are considering reconstruction, the stage of your cancer may dictate the timing of the reconstructive surgery. For patients with early-stage breast cancer, Dr. Abraham says immediate reconstruction is reasonable. With a Stage III cancer, you should discuss with your oncologist and surgeon whether immediate reconstruction is advisable.
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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.
What Is The Prognosis For Invasive Ductal Carcinoma
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Based on individual markers and prognostic factors, including the staging of your tumor, your physician will work to give you a prognosis. At Johns Hopkins Medicine, our team of breast cancer specialists is dedicated to developing cutting-edge techniques for surgery, breast reconstruction, chemotherapy, biologic targeted therapy, radiation therapy and other hormonal therapies. Our research allows us to make great strides forward for patients with breast cancer.
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What Are The Symptoms Of Inflammatory Breast Cancer
Symptoms of inflammatory breast cancer include swelling and redness that affect a third or more of the breast. The skin of the breast may also appear pink, reddish purple, or bruised. In addition, the skin may have ridges or appear pitted, like the skin of an orange . These symptoms are caused by the buildup of fluid in the skin of the breast. This fluid buildup occurs because cancer cells have blocked lymph vessels in the skin, preventing the normal flow of lymph through the tissue. Sometimes the breast may contain a solid tumor that can be felt during a physical exam, but more often a tumor cannot be felt.
Other symptoms of inflammatory breast cancer include a rapid increase in breast size sensations of heaviness, burning, or tenderness in the breast or a nipple that is inverted . Swollen lymph nodes may also be present under the arm, near the collarbone, or both.
It is important to note that these symptoms may also be signs of other diseases or conditions, such as an infection, injury, or another type of breast cancer that is locally advanced. For this reason, women with inflammatory breast cancer often have a delayed diagnosis of their disease.
About Breast Surgery Choices
- If I have breast-sparing surgery, am I willing and able to have radiation therapy 5 days a week for 5 to 8 weeks?
- If I have a mastectomy, do I also want breast reconstruction surgery?
- If I have breast reconstruction surgery, do I want it at the same time as my mastectomy?
- What treatment does my insurance cover? What do I have to pay for?
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Breast Cancer Survival Rates For All Types Of Breast Cancers
Breast cancer survival rates and prognosis are determined by so many different factors that it is always difficult to make generalizations.
NOTE: this page has been recently updated with the most up-to-date statistics. Prognosis has improved so much because breast cancer treatments have become more effective since this page was first created. Remember that survival is better than listed here. Most importantly, ask your oncologist and specialist team, who keep current with the latest statistics and best treatments.
Certain Benign Changes In The Breast
Some changes in the breast seem to increase risk of breast cancer. They include
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Changes in the breast that required a biopsy to rule out cancer
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Conditions that change the structure, increase the number of cells, or cause lumps or other abnormalities in breast tissue, such as complex fibroadenoma Fibroadenomas of the Breast Fibroadenomas of the breast are small, smooth, solid, rounded noncancerous lumps composed of fibrous and glandular tissue. Fibroadenomas… read more , hyperplasia , atypical hyperplasia in the milk ducts or milk-producing glands, sclerosing adenosis , or papilloma
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Dense breast tissue, seen on a mammogram
Having dense breast tissue also makes it harder for doctors to identify breast cancer.
For women with such changes, the risk of breast cancer is increased only slightly unless abnormal tissue structure is detected during a biopsy or they have a family history of breast cancer.
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Understanding Density: Whats In A Breast
To understand breast density, you need to know whats in a breast. Your breast tissue is comprised of a collection of fat cells or adipose tissue that extends from your collarbone to under your arm and across the middle of your ribcage. In a healthy female breast, there will be around 12-20 sections called lobes which are connected by milk ducts that carry milk to the nipple. This complex network is part of what is called the glandular tissue. Its within this glandular tissue that most breast cancers develop.
When there is more glandular tissue than fatty and supportive tissue tissue, your breast is considered dense. But its not something you can tell from a breast self-exam. Dr. Hayley Sheldon, a body and breast radiologist at CDI in Minneapolis explains, The only way to know your breast density is with a mammogram.
How Are Screening And Diagnostic Mammograms Different
The same machines are used for both types of mammograms. However, diagnostic mammography takes longer to perform than screening mammography and the total dose of radiation is higher because more x-ray images are needed to obtain views of the breast from several angles. The technologist may magnify a suspicious area to produce a detailed picture that can help the doctor make an accurate diagnosis.
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What Are The Benefits And Potential Harms Of Screening Mammograms
Early detection of breast cancer with screening mammography means that treatment can be started earlier in the course of the disease, possibly before it has spread. Results from randomized clinical trials and other studies show that screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74, especially for those over age 50 . However, studies to date have not shown a benefit from regular screening mammography in women under age 40 or from baseline screening mammograms taken before age 40.
The benefits of screening mammography need to be balanced against its harms, which include:
False-positive results. False-positive results occur when radiologists see an abnormality on a mammogram but no cancer is actually present. All abnormal mammograms should be followed up with additional testing to determine whether cancer is present.
False-positive mammogram results can lead to anxiety and other forms of psychological distress in affected women. The additional testing required to rule out cancer can also be costly and time consuming and can cause physical discomfort.
Because doctors cannot easily distinguish cancers and cases of DCIS that need to be treated from those that do not, they are all treated.
In addition, finding breast cancer early may not help prolong the life of a woman who is suffering from other, more life-threatening health conditions.
Side Effects And Safety Of Medical Cannabis
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Information on cannabis side effects is limited because research on medical cannabis in people with cancer is limited. Side effects are also likely to vary depending on the dose you take and the amounts and combinations of THC and CBD in each product.
Reported side effects of marijuana, which has THC, include:
- increased heart rate
CBD is usually well-tolerated, but reported side effects include:
- drowsiness and fatigue
- diarrhea
- reduced appetite
Its not well understood how cannabis products may interact with other medicines, including cancer therapies. Thats why its important to talk to your doctor about using medical cannabis both before and during treatment. Working together, you can come up with the best way to relieve your symptoms.
The medicines and therapies you use can interact with each other. They may meet up and cause no effect, a beneficial effect, or a harmful effect, said Marisa Weiss, M.D., founder and chief medical officer of Breastcancer.org and director of breast radiation oncology at Lankenau Medical Center. For example, a helpful effect is when cannabis reduces nausea from chemotherapy. But a harmful effect can happen if cannabis interferes with the benefit of chemotherapy or increases the risk of lung damage during radiation and chemotherapy if cannabis is smoked or vaped.
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