Breast Cancer Symptoms
Breast cancer may or may not cause symptoms. Some women may discover the problem themselves, while others may have the abnormality first detected on a screening exam. Common breast cancer symptoms, when they occur, include the following:
• Non-painful lumps or masses
• Lumps or swelling under the arms
• Nipple skin changes or discharge
• Noticeable flattening or indentation of the breast
• Change in the nipple
• Unusual discharge from the nipple
• Changes in the feel, size, or shape of the breast tissue
Lump in Breast: Could it be Cancer?
Remember that the majority (about 80%) of breast lumps are not due to cancer. Cysts, benign tumors, or changes in consistency due to the menstrual cycle can all cause benign breast lumps. Still, it’s important to let your doctor know about any lumps or changes in your breast that you find.
Breast Cancer Stages
Breast cancer stages are classified according to cancer tumor size, location, and extent of spread. Staging helps doctors determine the prognosis and treatment for cancer. The TNM staging system classifies breast cancers according to the following criteria:
• Tumor (T): Primary tumor size and/or extent
• Nodes (N): Spread of cancer to lymph nodes in the regional area of the primary tumor
• Metastasis (M): Spread of cancer to distant sites away from the primary tumor
Mammograms and Breast Cancer Prevention
Early detection of breast cancer is the key to survival. Mammograms are X-rays of the breast that can detect tumors at a very early stage, before they would be felt or noticed otherwise. During a mammogram, your breasts are compressed between two firm surfaces to spread out the breast tissue. Then an X-ray captures black-and-white images of your breasts that are displayed on a computer screen and examined by a doctor who looks for signs of cancer. 3D mammograms, or breast tomosynthesis, is a breast imaging procedure that also uses X-rays to produce images of breast tissue in order to detect abnormalities.
Breast Cancer Prevention: Breast MRI and Ultrasound
• Breast MRI
MRI (magnetic resonance imaging) is a technology that uses magnets and radio waves to create detailed, 3D images of the breast tissue. Before the test you may be injected with a contrast solution (dye) through an intravenous line in the arm. The contrast solution will allow potential cancerous breast tissue to show more clearly. Radiologists are able to see areas that could be cancerous because the contrast tends to be more concentrated in areas of cancer growth.
During a breast MRI the breasts are exposed as the patient lies flat on a padded platform with cushioned openings for the breasts. A breast coil surrounds each opening and works with the MRI unit to create the images. MRI imaging is a painless diagnostic tool. The test takes between 30 and 45 minutes.
• Ultrasound
Sometimes a breast ultrasound is ordered in addition to a mammogram. An ultrasound can demonstrate fluid-filled cysts that are not cancerous. Ultrasounds may also be recommended for routine screening tests in some women at a higher risk of developing breast cancer. During a breast ultrasound a small amount of water-soluble gel is applied to the skin over the area to be examined. Then, a probe is gently applied against the skin. You may be asked to hold your breath, briefly several times. The breast ultrasound takes about 10 minutes to complete.
• Breast Self-Exam?
A breast self-exam is a way to check your breasts for changes such as lumps or thickenings. Early breast cancer detection can improve your chances of surviving the disease. Any unusual changes discovered during the breast self-exam should be reported to your doctor.
Lump in Breast: Could it be Cancer?
Remember that the majority (about 80%) of breast lumps are not due to cancer. Cysts, benign tumors, or changes in consistency due to the menstrual cycle can all cause benign breast lumps. Still, it’s important to let your doctor know about any lumps or changes in your breast that you find.
Breast Cancer Survival Rates
Breast cancer survival depends upon a number of factors. Cancers that are found early are often localized to the breast. Statistics on the survival rate of breast cancer are often given as fiveyear survival rates. The five year survival rate is the percentage of people who live at least five years after being diagnosed with breast cancer. According to the American Cancer Society, women with early stage (stage 1) breast cancer have a five year survival rate of 100%. Women with breast cancer that has spread to distant sites in the body (stage 4) have only a 22% chance of surviving 5 years; but this rate can improve as treatment advances are made.
Breast Cancer Treatments
Surgery
Breast-conserving surgery removes the cancer and some healthy tissue around it, but not the breast. Some lymph nodes under the arms may be removed for biopsy. If the cancer is near the chest wall, part of it may be removed. Breast-conserving surgery is also known as breast-sparing surgery, lumpectomy, partial mastectomy, quadrantectomy, and segmental mastectomy.
Mastectomy
Mastectomy is the removal of the entire breast and all the surrounding tissue and possibly nearby tissues. There are different mastectomy surgeries available, depending on how much additional tissue is removed.
Radiation Therapy
High-energy beams of localized radiation are used to kill targeted cancer cells. Radiation therapy can be used after breast cancer surgery, or it may be used in addition to chemotherapy for widespread cancer. This treatment does have side effects, which can include swelling of the area, tiredness, or a sunburn-like effect. There are two ways to administer radiation therapy.
• External Beam Radiation
A beam of radiation is focused onto the affected area by an external machine. The treatment is usually given five days a week for five to six weeks.
• Brachytherapy
This form of radiation involves radioactive seeds or pellets that are implanted into the breast next to the cancer.
Chemotherapy
Chemotherapy drugs are given to kill cancer cells that are located anywhere in the body. It can be administered by a slow IV infusion, by pill, or by a brief IV injection, depending upon the drug. Sometimes chemotherapy is given after surgery to help prevent the cancer from recurring (adjuvant therapy). Side effects of chemotherapy can include an increased risk of infection, nausea, fatigue, and hair loss.
• Adjuvant Chemotherapy
If all visible cancer has been removed, there is still the possibility that cancer cells have broken off or are left behind. Adjunct chemotherapy is given to assure that these small amounts of cells are killed. Since some women have a very low risk of recurrence even without chemotherapy, it is not given in all cases.
• Neoadjuvant Chemotherapy
Neoadjuvant chemotherapy is given before surgery. There is no correlation between neoadjuvant chemotherapy and long-term survival, but there are advantages to see if the cancer responds to the chemotherapy before surgical removal. This can also reduce the size of the cancer and allow for a less extensive surgery in some patients.
• Chemotherapy for Advanced Breast Cancer
Chemotherapy can be used if the cancer has metastasized to distant sites in the body. In this case, doctors will determine the most appropriate treatment.
• Chemotherapy Side Effects
Different drugs cause different side effects. Certain types of chemotherapy have specific side effects, but each patient’s experience is different. The following are common side effects of chemotherapy:
• Fatigue
• Pain (headaches, muscle pain, stomach pain, and pain from nerve damage)
• Mouth and throat sores
• Diarrhea
• Nausea and vomiting
• Constipation
• Blood disorders
• Changes in thinking and memory
• Sexual and reproductive issues
• Appetite loss
• Hair loss
• Permanent damage to the heart, lung, liver, kidneys, or reproductive system