October is Breast Cancer Awareness Month: So, let’s talk

 
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Aside from skin cancer, Breast Cancer is the most common cancer for women in the United States. About 1 in 8 American women will develop breast cancer in their lifetime. Breast Cancer is the 2nd leading cause of cancer death in women (only lung cancer kills more women). The chance that a woman will die from her breast cancer is about 2.6%.

Thanks to Beyonce’s dad, there is increased awareness about male breast cancer. Of all breast cancers, less than 1% occur in men.

So yes! Most breast cancer is curable and overall death rates from breast cancer have dropped by 40% since 1989.

What are the early signs of breast cancer?

Early detection is key. When breast cancer has not spread outside the breast the 5 year survival rate is 99%. Mammograms do not detect every breast cancer. That is why we tell our patients to be aware of changes in your breasts. Monthly self breast exams are important and we recommend a yearly breast exam by your healthcare provider.

What are the signs and symptoms of breast cancer?

Most common sign of breast cancer is a lump or mass in the breast. Usually a painless, hard, irregular edged lump but can also be painful, soft and smooth.

Other signs and symptoms to watch for:

Swelling or thickening or a lump in the breast or underarm area

Breast or nipple pain

Skin dimpling or asymmetry of the breast

Nipple inversion or retraction (turning inward)

Nipple or breast skin that is red, dry, scaly or thickened

Nipple discharge (not breast milk)

Swollen lymph node underarm or around collar bone

Any new lump, mass, or skin change should be checked out by your healthcare provider. At any age!

What are the causes of breast cancer? Who’s at risk?

Causes:

We don’t know the exact causes of cancer. It is often unclear why one woman gets breast cancer and another one doesn’t. Cancer develops when there is damage to the cell’s DNA. This damage could be caused by genetic or environmental changes or a combination of both.

Risk Factors:

  • Gender: breast cancer is more likely in women than men

  • Age: risk slowly increases with age, most women are diagnosed over age 55

  • Genetics: a close relative with breast cancer or certain genetic mutations increases risk

  • History of breast cancer or breast lumps: women with a history of breast cancer are more likely to have it again. Some types of noncancerous breast lumps increase risk. 

  • Dense breast tissue- women with dense breast tissue (identified on mammogram) have increased risk and dense breast tissue makes it harder to detect cancer

  • Reproduction history-having period before 12 or menopause after 55 increase risk, having first child at an older age or never having children increases risk

  • Radiation exposure- radiation from a different cancer increases risk

  • Body weight-obesity increases risk, especially after menopause

  • Alcohol- more alcohol a woman drinks increases risk

  • Hormone treatments- oral contraceptives have slightly increased risk and taking HRT (hormone replacement therapy) is related to increased risk of breast cancer

How is screened for and how is it diagnosed? What the common treatment recommendations?

Breast Cancer Screening and Diagnosis:

  • Breast Exam- checking breast and armpit for lumps or other changes.

  • Mammogram- XRAY of the breast. Commonly used for screening.

  • Breast Ultrasound- Using sound waves to detect if a breast lump is solid (more likely cancer) or fluid filled (less likely cancer).

  • Breast MRI-Uses a magnet and radio waves (not radiation) to create images of the inside of breasts.

  • Breast biopsy-Uses imaging and a specialized needle to get a piece of the breast lump tissue to determine if the tissue is cancerous.

What are the common treatments?

Treatment is based on the stage of breast cancer, general health of the patient, and patient preferences. The treatment plan for a breast cancer patient will be based on a conversation the patient has with their medical oncologist, surgical oncologist, radiation oncologist and cancer care team.

  • Breast cancer surgery- this can be removing the lump (lumpectomy) or removing the entire breast (mastectomy) and it is determined based on the stage of the cancer and patient preferences.

  • Radiation treatment- High powered X-rays and protons that kill cancer cells.

  • Chemotherapy- Chemical treatments used to kill cancer cells.

  • Hormone therapy- Many breast cancers are driven by hormones (estrogen and progesterone) and blocking the hormones can treat the cancer or prevent recurrence.

  • Targeted therapies- These treatments treat certain targets on the cancer cell. In breast cancer, this can be the HER2 protein. If HER2 protein is over expressed on the cancer cell, it helps the cancer cells grow. There are several drugs that target HER2 receptor to kill the cancer cells.

  • Immunotherapy- The newest type of treatment for cancer is immunotherapy. Immune therapy stimulates the immune system to fight the cancer. At this time, immunotherapy has been shown to be helpful in “triple negative” breast cancer (Breast cancer that is ER/PR/HER2 negative).

Support and Resources

Bring part of the support system is what drives the ship for us. We may not be the ones who will figure out a cure for cancer but we can be the ones to support everyone going through cancer. We are really good at that! The entire foundation of Field Guides to Cancer Care is based on providing the best support and resources for cancer patients.

So when a brave woman spoke at a recent Scripps and MD Anderson Cancer Care Symposium about being both a breast cancer survivor and an oncology nurse we listened - intently. She shared some wisdom about being on “both sides of the fence”. She shared what support meant to her. 

Here are some takeaways from her talk:

  • Prepare for anticipated outcomes. The Cancer Care Team can often identify side effects from meds, possible reactions, and ways to prevent or treat these issues. Ask your Team about this.

  • Image transition. Hair loss, body image changes. Knowing the timing of these changes and having resources for these transitions is so important. 

  • A chemotherapy guide was essential to her. It outlined everything she needed to know to care for herself during chemo. Our tip: we especially love our Field Guides. Both the guide for chemotherapy symptoms and nutrition. Look for our guides at: www.fieldguidestocancercare.com

  • Assess true needs by paying attention. People can indirectly tell you what their needs are. Offer food gift cards, maybe clean their house, or start a meal trains. Offer help and offer positive thoughts or prayers.

  • Celebrate milestones. This is highly personal but recognizing and reflecting on milestones along the way can be helpful. 

Love her quote: “This was a journey that I didn’t ask for. It is what it is. Can’t change this fact and might as well make the best of it.”