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Breast Cancer | Symptoms & Types | Shanghai
Understanding Breast Cancer -Symptoms
What Are the Symptoms of Breast Cancer?
In its early stages, breast cancer usually has no symptoms. As a tumor develops, you may note the following signs:
* A lump in the breast or underarm that persists after your menstrual cycle; often the first apparent symptom of breast cancer, breast lumps are painless, although some may cause a prickly sensation. Lumps are usually visible on a mammogram long before they can be seen or felt.
* Swelling in the armpit.
* Although lumps are usually painless, pain or tenderness in the breast can be a sign of breast cancer.
* A noticeable flattening or indentation on the breast, which may indicate a tumor that cannot be seen or felt.
* Any change in the size, contour, texture, or temperature of the breast; a reddish, pitted surface like the skin of an orange could be a sign of advanced breast cancer.
* A change in the nipple, such as an indrawn or dimpled look, itching or burning sensation, or ulceration; scaling of the nipple is symptomatic of Paget's disease, a localized cancer.
* Unusual discharge from the nipple that may be clear, bloody, or another color. It's usually caused by benign conditions but could be due to cancer in some cases.
* A marble-like area under the skin.
* An area that is distinctly different from any other area on either breast.
Call Your Doctor About Breast Cancer If:
One or both breasts develop an abnormal lump or persistent pain, or look or feel abnormal. The cause often is something other than cancer but should be identified.
You have swollen lymph glands in your armpits. Any such swelling could be associated with cancer.
Breast Cancer: Warning Signs
What Are the Warning Signs of Breast Cancer?
The warning signs of breast cancer include:
* Lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
* A mass or lump, which may feel as small as a pea.
* A change in the size, shape or contour of the breast.
* A blood-stained or clear fluid discharge from the nipple.
* A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly or inflamed).
* Redness of the skin on the breast or nipple.
* An area that is distinctly different from any other area on either breast.
* A marble-like hardened area under the skin.
These changes may be found when performing monthly breast self-exams. By performing breast self-exams, you can become familiar with the normal monthly changes in your breasts.
Breast self-examination should be performed at the same time each month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month.
Invasive Breast Cancer: Symptoms, Treatments, Prognosis
Breast cancer can happen to anyone. It is not bound by age, gender, or ethnic group. But among women, breast cancer is the most common form of cancer.
Women in the U.S. have a one in eight chance of developing invasive breast cancer. And the American Cancer Society estimates that more than 1 million women in the U.S. have breast cancer and don't know it.
There are effective treatments for invasive breast cancer. It's important to recognize the signs of invasive breast cancer and to work closely with your doctor. Here's information you can use to help you have the best outcome with invasive breast cancer.
How does the anatomy of the breast relate to breast cancer?
The female breast consists of:
* fat
* fibrous or connective tissue
* glands
* 15 to 20 lobes and smaller lobules
tiny ducts
After a pregnancy, milk is produced in tiny glands and then flows through miniscule tubes or ducts to the nipple.
The breast also contains lymph vessels and lymph nodes. The lymph nodes serve to keep the body well. They do that by trapping cancer cells, bacteria, and other harmful substances.
Some breast cancers begin in the glands. Most breast cancers, though, begin in the breast ducts or tubes that connect the lobules to the nipple. Other cancers start in the breast tissues.
What is invasive breast cancer?
Invasive breast cancer is cancer that spreads outside the membrane of the lobule or duct into the breast tissue. The cancer can then spread into the lymph nodes in the armpit or beyond to the brain, bones, liver, or lungs.
When breast cancer cells are found in other parts of the body, the cancer is called metastatic breast cancer.
There are several types of invasive breast cancer, including:
Invasiveductal carcinoma (IDC). With IDC, cancer cells start in a milk duct, break through the duct walls, and then invade fatty breast tissue. IDC can remain localized, which means it stays near the site where the tumor originated. Or the cancer cells may enter the bloodstream or lymphatic system and metastasize -- spread -- anywhere in the body. Invasive ductal carcinoma is the most common type of invasive breast cancer. It accounts for 80% of invasive cancers.
Ductal carcinoma in situ (DCIS). This cancer is ductal carcinoma in its earliest stage -- stage 0. In situ means the breast cancer hasn't spread beyond its point of origin. That means the cancer is confined to the milk ducts and has not invaded nearby breast tissue. If it is left untreated, though, it can become invasive cancer.
Infiltrating (invasive) lobular carcinoma (ILC). This cancer accounts for about 10% to 15% of invasive breast cancers. ILC starts in the lobules or milk glands. It then spreads in a way similar to IDC. With ILC, most women feel a mass or thickening instead of a breast lump.
What are the signs of invasive breast cancer?
Breast cancer may have no signs or symptoms at all, especially during the early stages. As the cancer progresses, you may notice one or more of the following warning signs:
* a lump or thickening that persists through the menstrual cycle in or near the breast or in the underarm
* a mass or lump, which may feel as small as a pea
* a change in the size, shape, or contour of the breast
* a blood-stained or clear fluid discharge from the nipple
* a change in the feel or appearance of the skin on the breast or nipple -- dimpled, puckered, scaly, or inflamed
* redness of the skin on the breast or nipple
* a change in shape or position of the nipple
* an area that is distinctly different from any other area on either breast
* a marble-like hardened area under the skin
You may find these changes when you do a monthly breast self-exam. By doing a regular self-exam of your breast, you can become familiar with the normal monthly changes that your breasts undergo.
What increases the risk of invasive breast cancer?
Breast cancer can happen at any age. But the risk of developing breast cancer increases with age. According to the American Cancer Society, one out of eight invasive breast cancer diagnoses are given to women under age 45. And two out of every three women with invasive breast cancer are 55 or older when they are first diagnosed.
What is tumor grading?
After surgery to remove the breast tumor, a pathologist will check the breast tissue. The pathologist will then assign a grade to the tumor. The grade depends on how closely the cancer cells resemble normal tissue cells when viewed under a microscope. Low-grade cancer cells are similar to normal breast cells. Higher grade breast cancer cells look more abnormal. They indicate the breast cancer is more aggressive.
The pathologist will also do a test called the estrogen progesterone receptor test. This test will show whether female hormones -- estrogen or progesterone -- influence the cancer cells. If the test is positive, it means hormones cause the cancer cells to grow. In that case, hormonal therapy may be effective in treating the cancer.
Other tests, such as a bone scan or CT scan, may be warranted. It depends on the grade of the tumor. These tests will determine if the cancer has spread from the breast into other areas of the body.
How is invasive breast cancer treated?
There are many treatments for invasive breast cancer. They include:
* surgery
* chemotherapy
* radiation therapy
* hormone therapy
* biological therapy
Your doctor may use one breast cancer treatment or a combination of them. The goal will be to give you the best prognosis.
The type of breast cancer treatment your doctor recommends will be determined by different factors. Those factors include:
* size of the breast cancer tumor
* location of the breast cancer tumor
* results of lab tests done on the cancer cells
* stage of the breast cancer
* your age and general health
* your menopause status
* your personal feelings about the treatment options
Invasive breast cancer treatments may be local or systemic. Local treatments, including surgery and radiation therapy, are used to remove the breast cancer tumor and destroy or control the remaining cancer cells. Systemic treatments include:
* chemotherapy
* hormone therapy
* biologic therapy
These treatments aim to destroy or control cancer cells that have spread to other parts of the body.
Some women with invasive breast cancer choose to be part of a clinical trial. In a breast cancer clinical trial, you may receive either the best standard treatment or a treatment that holds promise of being superior. The new treatment may be a novel drug or surgery or an alternative medicine.
Women with invasive breast cancer have more promise for a good outcome than ever before. Talk to your doctor to determine the best course of treatment for your situation.
Side Effects From Breast Cancer Chemotherapy & Radiation
Chemotherapy and radiation therapy can destroy constantly dividing breast cancer cells. But these treatments can also affect healthy cells. Medications and other self-help methods can ease many of these side effects:
* Loss of appetite
* Nausea and vomiting
* Weakness and fatigue
* Mouth soreness
* Hair loss
* Weight gain
* Premature menopause
* Lowered resistance to infections
Loss of Appetite
Loss of appetite is a common side effect of breast cancer treatment. Try these tips to ensure you are eating a healthy diet during treatment:
* Eat several small meals during the day, instead of three large meals.
* Try an "instant breakfast" mix or other nutritional shakes.
* Eat the largest meal when you are most hungry, which varies from person to person.
* Drink beverages either a half hour before or after meals so they do not interfere with your appetite.
* Consider moderate exercise to increase your appetite.
Nausea and Vomiting
Some - but not all - cancer patients experience nausea. You can take medicines called antiemetics before chemotherapy to reduce nausea. Keep track of when you have nausea. Nausea can occur right after treatment or several days later.
* Eat small meals frequently and avoid fatty, greasy foods and citrus.
* Try foods at room temperature instead of very hot or cold.
* When nauseous, try bland foods like crackers, gelatin, ice chips, rice, plain mashed potatoes, or applesauce.
Contact your doctor if you have severe nausea or frequent vomiting. If you vomit, wait an hour before eating or drinking anything. Then, begin with ice chips and gradually add foods. Chamomile or ginger root tea, or ginger ale can sometimes help settle your stomach.
Weakness and Fatigue
Weakness and fatigue can have many causes, including the treatment itself, worry or depression, not eating, pain, inactivity, and low blood counts.
* Make sure you get enough rest. Sleep at least eight hours a night, and try to lie down during the day to rest. Avoid caffeine if it interferes with sleep.
* Exercise. Short walks can actually increase appetite and energy. Exercise can help you rest better, even if you are feeling fatigued.
* Be choosy about activities. Get help from family and friends with errands and other chores.
* If you feel pain, let your oncologist know. There is no need to suffer in silence.
* Eat a diet high in iron.
* If fatigue is caused by low red blood cell counts (anemia), you may be given a growth factor called erythropoietin (Procrit), which stimulates bone marrow to make red blood cells. It can be given by injection, which can be continued at home. Patients receiving this are carefully monitored for rashes and blood pressure.
Mouth Soreness
Sometimes, a sore mouth or throat can be related to breast cancer treatment. Check with your doctor or dentist to rule out other causes of mouth pain.
* Ask your doctor about medicines to reduce mouth soreness.
* Choose soft foods that will not irritate your mouth, such as scrambled eggs, macaroni and cheese, pureed cooked vegetables and bananas.
* Cut foods into small pieces.
* Avoid citrus, spicy, or salty foods and rough foods.
Hair Loss
Whether women lose their hair depends on the type of chemotherapy they take for breast cancer and the dose. Your oncologist will likely tell you if you can expect hair loss.
While some women notice only thinning of their hair, others lose their hair completely. Some lose hair suddenly, while others notice a more gradual loss a few weeks after starting treatment. Sometimes, eyelashes and eyebrows also fall out.
Losing hair can be very difficult emotionally. Some women prepare by getting a short hair cut before chemotherapy begins. A variety of hair wraps and wigs are available to wear during chemotherapy.
Some women notice that their hair texture changes when it grows back in, but many experience no change in their hair. The good news about hair loss is that it begins growing back once treatment is stopped. It can take several months to completely regrow hair.
Weight Gain
Some women with breast cancer gain weight because of several factors:
* Lack of activity
* Emphasis on eating
* Medicines
* Depression
If you notice you are gaining weight, let your doctor know. Do not go on a diet on your own since your body needs a lot of nutrients during breast cancer treatment.
Lowered Resistance to Infections
Chemotherapy and radiation therapy for breast cancer can disrupt the production of white blood cells, which are essential for fighting infection. Try to stay out of large crowds, and away from sick adults and children, for seven to 10 days after receiving chemotherapy. That's when your white counts are usually lowest.
Contact your doctor right away if you become sick. Sometimes doctors recommend taking antibiotics as a precaution. Others suggest women receive a flu shot before beginning chemotherapy.
If your white blood cell counts are too low, you may be given a growth factor called G-CSF (granulocyte colony stimulating factor -- Neupogen or Granocyte) or GM-CSF (granulocyte macrophage colony stimulating factor -- Leucomax).
Recognizing a Breast Cancer Emergency
If you have breast cancer, call your nurse or doctor if you have:
* A temperature greater than 100º F. If you have any fever and chills, notify your doctor immediately. If you are unable to contact your doctor, go to the emergency room.
* If you notice in your mouth new sores, patches, swollen tongue, or bleeding gums.
* If you experience a dry, burning, scratchy, or "swollen" throat.
* A cough that is new or persistent and produces mucus.
* Changes in bladder function, including increased frequency or urgency to go; burning during urination; or blood in your urine
* Changes in gastrointestinal function, including heart burn; nausea, vomiting, constipation, or diarrhea that lasts longer than two or three days; or blood in stools.
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