All Posts in Category: Breast Cancer

Breast reconstruction

Breast reconstruction is a type of surgery for women who have had all or part of a breast removed. The surgery rebuilds the breast mound to match the size and shape of the other breast. The nipple and the darker area around the nipple (areola) can also be added.

Most women who have had a breast removed (mastectomy) are able to have breast reconstruction. Women who have had only the part of the breast around the cancer removed (lumpectomy or breast-conserving surgery) might not need reconstruction, but sometimes they do. Breast reconstruction is done by a plastic surgeon.

Here are some facts to help you better understand the process and the words used when talking about breast reconstruction. Some of the words you might hear doctors use are also explained in the glossary at the end

Important Things to Know

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Get the Care You Deserve

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How Can I Protect Myself From Breast Cancer?

Follow these three steps for early breast cancer detection:

Annual screening mammography starting at age 40 or 50. Breast cancer experts don’t agree when women need to begin getting mammograms. Ask your doctor.
Women in high-risk categories should have screening mammograms every year and typically start at an earlier age. MRI or ultrasound screening can also be given in addition to mammograms. Discuss the best approach with your doctor.
Have your breasts examined by a health care provider at least once every three years after age 20, and every year after age 40. Clinical breast exams can complement mammograms.

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How Is Breast Cancer Treated?

If the tests find breast cancer, you and your doctor will develop a treatment plan to eradicate the breast cancer, to reduce the chance of cancer returning in the breast, as well as to reduce the chance of the cancer traveling to a location outside of the breast. Treatment generally follows within a few weeks after the diagnosis.

The type of treatment recommended will depend on the size and location of the tumor in the breast, the results of lab tests done on the cancer cells, and the stage or extent of the disease. Your doctor usually considers your age and general health as well as your feelings about the treatment options.

    Breast cancer treatments are local or systemic.

Local treatments are used to remove, destroy, or control the cancer cells in a specific area, such as the breast. Surgery and radiation treatment are local treatments.
Systemic treatments are used to destroy or control cancer cells all over the body. Chemotherapy; hormone therapy such as tamoxifen (Soltamox, Nolvadex); aromatase inhibitors such as anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara); and biologic drugs such as trastuzumab (Herceptin), pertuzumab (Perjeta), Ado-trastuzumab emtansine (Kadcyla), palbociclib (Ibrance), and lapatinib (Tykerb) are systemic treatments. A patient may have just one form of treatment or a combination, depending on her needs.

  • What Happens After Treatment?

Following local breast cancer treatment, your doctors will determine the likelihood that the cancer will recur outside the breast. This team usually includes a medical oncologist, a specialist trained in using medicines to treat breast cancer. The medical oncologist, who works with the surgeon, may advise the use of hormone therapy or possibly chemotherapy. These treatments are used in addition to, but not in place of, local breast cancer treatment with surgery and/or radiation therapy.

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How Is Breast Cancer Diagnosed?

During your regular physical exam, your doctor will take a careful personal and family history and perform a breast exam and possibly order a mammogram or an ultrasound of the breasts. In certain women who are at increased risk for breast cancer, an MRI may be ordered.

Based on the results of these tests, your doctor may or may not request a biopsy to get a sample of the breast mass cells or tissue.

After the sample is removed, it is sent to a lab for testing. A pathologist — a doctor who specializes in diagnosing abnormal tissue changes — views the sample under a microscope and looks for abnormal cell shapes or growth patterns. When cancer is present, the pathologist can tell what kind of cancer it is (ductal or lobular carcinoma) and whether it has spread beyond the ducts or lobules (invasive).

 

Lab tests such as hormone receptor tests (estrogen and progesterone) can show whether these hormones help the cancer to grow. If the test results show that these hormones help the cancer grow (a positive test), the cancer is likely to respond to hormonal treatment. This therapy deprives the cancer of the estrogen hormone.

Breast cancer diagnosis and treatment are best accomplished by a team of experts working together with the patient. Each patient needs to evaluate the advantages and limitations of each type of treatment, and work with her team of doctors to develop the best approach.

 

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What Are the Types of Breast Cancer?

The most common types of breast cancer are:

Invasive (or infiltrating) ductal carcinoma. This cancer starts in the milk ducts of the breast. Then it breaks through the wall of the duct and invades the fatty tissue of the breast. This is the most common form of breast cancer, accounting for 80% of invasive cases.
Ductal carcinoma in situ (DCIS) is ductal carcinoma in its earliest stage (stage 0). “In situ” refers to the fact that the cancer hasn’t spread beyond its point of origin. In this case, the disease is confined to the milk ducts and has not invaded nearby breast tissue. If untreated, ductal carcinoma in situ may become invasive cancer. It is often curable.
Infiltrating (invasive) lobular carcinoma. This cancer begins in the lobules of the breast where breast milk is produced, but has spread to surrounding tissues or other parts of the body. It accounts for about 10% of invasive breast cancers.
Lobular carcinoma in situ (LCIS) is cancer that is only in the lobules of the breast. It isn’t a true cancer, but serves as a marker for the increased risk of developing breast cancer later. Thus, it is important for women with lobular carcinoma in situ to have regular clinical breast exams and mammograms.
In addition, there are several other less common types of breast cancer.

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Facts About Breast Cancer

Cells in the body normally divide (reproduce) only when new cells are needed. Sometimes, cells in a part of the body grow and divide out of control, which creates a mass of tissue called a tumor. If the cells that are growing out of control are more normal cells, the tumor is called benign (not cancerous). If, however, the cells that are growing out of control are abnormal, don’t function like the body’s normal cells, and begin to invade other tissue, the tumor is called malignant (cancerous).

Cancers are typically named after the part of the body from which they originate. Breast cancer originates in the breast tissue. Like other cancers, breast cancer can invade and grow into the tissue surrounding the breast. It can also travel to other parts of the body and form new tumors, a process called metastasis.

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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. This is often the first apparent symptom of breast cancer. Lumps associated with breast cancer are usually 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.
  • Pain or tenderness in the breast. Although lumps are usually painless, pain or tenderness 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 a nipple retraction, dimpling, itching, a burning sensation, or ulceration. A scaly rash of the nipple is symptomatic of Paget’s disease, which may be associated with an underlying breast 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.
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Breast Cancer

Overview

The breast is made up of glands called lobules that can make milk and thin tubes called ducts that carry the milk from the lobules to the nipple. Breast tissue also contains fat and connective tissue, lymph nodes, and blood vessels.

The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Breast cancer can also begin in the cells of the lobules and in other tissues in the breast. Invasive breast cancer is breast cancer that has spread from where it began in the ducts or lobules to surrounding tissue.

In the U.S., breast cancer is the second most common cancer in women after skin cancer. It can occur in both men and women, but it is very rare in men. Each year there are about 2,300 new cases of breast cancer in men and about 230,000 new cases in women.

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