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Treatments for Breast Cancer

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What Is Breast Cancer?

Breast cancer is one of the most common cancers in women in the United States. It’s the second most common cause of cancer death in women, and the main cause in women 45 to 55 years old. The death rate has decreased in the past 20 years, partly because better screening catches the disease earlier, so chances of recovery and cure are higher.

What Are the Symptoms of Breast Cancer?

Early breast cancer usually causes no pain and usually no other symptoms.

As a breast tumor grows, certain changes may occur. These include a lump or thickening (mass, swelling, skin irritation, or distortion) in or near the breast or under the arms or changes in breast size or shape. The color or feel of the skin of the breast, areola, or nipple (dimpled, puckered, or scaly) can change. Women can also have discharge, erosion, inversion, or tenderness of nipples.

How Is Breast Cancer Diagnosed?

Many women (or doctors during the physical exam) feel a lump or finds breast changes. An abnormal mammogram can suggest breast cancer. Some women at high risk of getting breast cancer may get magnetic resonance imaging (MRI) for screening.

A lump shouldn’t be ignored. Mammograms may not show breast cancers in nearly 20% of cases.

When cancer is suspected, the doctor will remove (biopsy) a small piece of abnormal area for study.

How Is Breast Cancer Treated?

The doctor must stage the cancer. Staging determines how far it has spread, to decide on treatment and prognosis. The stage of the cancer is based on tumor size, whether skin, chest wall, and local lymph nodes (glands) are involved, and whether cancer has spread to other organs (metastasis). The biology of the cancer is based on the look of the cancer under the microscope and the tumor’s protein and gene markers.

These things help doctors choose the treatment: surgery, radiotherapy, and medical therapies, such as antiestrogens, chemotherapy, or other biological or targeted therapies.

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Most women have surgery to remove the cancer, such as lumpectomy (removing only the lump). Operations to remove the breast, part or whole, include partial (segmental), modified radical, radical, or total (simple) mastectomies. Lymph nodes and muscles may be removed. Radiation therapy, chemotherapy, or hormone therapy can be used before or after surgery. Breasts can be rebuilt after surgery.

Radiotherapy uses high-energy x-rays to kill cancer cells. Radioactive substances in needles, devices known as "seeds," wires, or catheters can be put into or near the cancer.

Chemotherapy uses drugs to kill cancer cells or stop them from dividing. Drugs can be taken by mouth, injected into veins or muscles, or placed near cancer cells.

Hormone therapy (tamoxifen and aromatase inhibitors) stops hormones, especially estrogen, from helping cancer cells grow. Biological therapy works by using the body’s immune (infection-fighting) system to kill cancer cells.

DOs and DON’Ts in Managing Breast Cancer:
  • DO take medicines if suggested by your health care provider.
  • DO find local support groups to help you get through this challenging time.
  • DO visit your health care provider regularly to monitor your progress.
  • DO eat a diet with enough calories, or maybe supplemental drinks.
  • DO get enough fluids.
  • DON’T smoke.
  • DON’T drink alcohol in excess.
FOR MORE INFORMATION

Contact the following sources:

  • American Cancer Society
    Website: http://www.cancer.org
  • National Comprehensive Cancer Network
    Website: http://www.nccn.org
  • Susan G. Komen Breast Cancer Foundation
    Website: http://www.komen.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor

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What Is Breast Cancer?

Male breast cancer is rare. It accounts for about 1% of all breast cancers, with about 2000 cases diagnosed each year. It’s most common in men 60 to 70 years old and most often occurs as a type of breast cancer known as infiltrating ductal carcinoma. Greater risk of having breast cancer is related to radiation exposure, high estrogen levels, and family history of breast cancer. Abnormal breast cancer genes (BRCA1 or BCRA2) can increase risk, as can liver disease, being overweight, and drinking alcohol in excess.

Survival for men is similar to that for women with the same cancer stage at diagnosis. Staging means finding out how much cancer spread. Men are often diagnosed at a later stage and may be less likely to be cured.

What Are the Symptoms of Breast Cancer?

Men usually have a breast lump that can be felt, the most common sign. It usually presents as a painless mass or swelling, just below the nipple or in the breast or chest wall. Changes near the nipple include skin ulcers, skin puckering or dimpling, redness or scaling of the nipple or skin, inversion (turning inward) of the nipple, and bloody or opaque nipple discharge.

Most breast lumps in males are not cancerous and are a sign of gynecomastia (swelling of breasts with age and obesity).

How Is Breast Cancer Diagnosed?

Men (or health care providers) may feel a lump or see breast changes. Doctors may order mammography, ultrasonography, and biopsy. In a biopsy, cells are removed for study with a microscope. Tests may be done for hormone (estrogen, progesterone) receptors and a protein (HER2). In about 30% of cases, HER2 makes cancer cells grow.

Breast cancer in men is staged just as in women. For staging, doctors use x-rays, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and biopsy results.

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How Is Breast Cancer Treated?

Surgery, usually lumpectomy or modified radical mastectomy, is the most common first treatment. With mastectomy, the breast, lymph nodes (glands), and sometimes chest wall muscles are removed. Lumpectomy involves removing the cancer and area surrounding it.

Chemotherapy, radiation therapy, and hormone therapy are also given, alone or together. Chemotherapy uses drugs to kill cancer cells or stop them from dividing. Hormone therapy stops hormones, especially estrogen, from helping cancer cells grow. Prognosis depends mainly on tumor stage, as in women, but men respond better than women to hormone therapy.

Radiotherapy uses high-energy x-rays to kill cancer cells.

Other treatments include monoclonal antibodies and biological therapy (immunotherapy). Monoclonal antibodies attack and block the HER2 protein and kill cancer cells. Biological therapy gets the body’s immune (infection-fighting) system to kill cancer cells.

DOs and DON’Ts in Managing Breast Cancer:
  • DO take medicines if suggested by your health care provider.
  • DO find local support groups to help you handle your disease.
  • DO visit your health care provider regularly.
  • DO maintain a healthy body weight. Eat a diet with enough calories, or maybe use supplemental drinks.
  • DO get enough fluids.
  • DON’T smoke.
  • DON’T drink alcohol in excess.
FOR MORE INFORMATION

Contact the following sources:

  • American Cancer Society
    Website: http://www.cancer.org
  • National Comprehensive Cancer Network
    Website: http://www.nccn.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor