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THE SIGNS OF BREAST CANCER
Identifying the signs and symptoms of breast cancer is a crucial step in saving your life, because the five-year survival rate of those affected is 97 % when the cancer is detected in the early stages.
Breast cancer is most effectively detected in the early stages by a mammogram, before signs are present. The most common sign of breast cancer is a lump, but spontaneous clear or bloody discharge from your nipple, a retraction or indentation of your nipple, a change in the size or shape of your breast, a flattening or redness or pitting of the skin around the breast are also indications of this type of cancer. If a woman ignores these signs, she may eventually experience pain if the tumor compresses a nerve or spreads to the bone.
Upon discovering a lump, many women avoid seeing a doctor because they fear a diagnosis of breast cancer, but it should be known that about 80% of lumps are non-cancerous; they can also be caused by trauma to the breast, a cyst, infection, or fibrocystic changes. If you do feel a lump and you have not gone through menopause, you may want to wait through one menstrual period before having it checked out, but afterwards, be sure to report this lump to your doctor.This important recommendation applies to all women, but especially those who have previously had breast cancer.
SCREENING FOR BREAST CANCER
Listed below are the most common methods of screening for breast cancer, administered by a doctor or nurse.
• Mammogram Annually beginning at age 40, earlier if you have a strong family history or genetic predisposition for the disease. A mammogram is a series of X-rays designed to detect tumors before they can be felt.
• Clinical Breast Exam Once every three years, administered by your doctor or nurse, until age 40. After that, it is recommended that women have a yearly clinical exam, where your breasts will be examined for lumps and changes.
• Breast Self Exam (BSE) Beginning in their 20s, women should be told about the benefits and limitations of BSE. Women should be aware of how their breasts normally feel and report any new breast change to a health professional as soon as they are found.
There are several tests being used in order to detect and diagnose breast cancer. Some of these include Magnetic Resonance Imaging (or MRI), ultrasound and digital mammography. Since early detection is key, all women should know about as many options as possible, and should practice the screening options listed above.
HOW DOES IT FEEL TO HAVE A MAMMOGRAM?
As a woman interviewed by CBS Cares put it, "Having a mammogram isn't any more uncomfortable than the rest of the rituals women undergo willingly on a daily basis. Like shoving your feet into too-small heels, or squeezing into your skinny jeans when it was apparent they didn't fit five pounds ago. And you wear those jeans all day - at least the mammogram's over in half an hour!" Another woman said, "It's like a big pinch. If you've been pinched before you know the little ones are even worse. But slight discomfort is nothing compared to the reward of knowing you're healthy or knowing you've caught something sooner rather than later."
Good points. What specifically happens when you have a mammogram? First, your breasts are compressed between plastic plates while X-rays are taken. The entire process takes about thirty minutes; the actual compression takes only a few minutes. You may find the procedure somewhat uncomfortable, but scheduling a mammogram after your menstrual period and avoiding caffeine for two days prior to the exam should alleviate too much discomfort. It should be emphasized that any minor discomfort is heavily outweighed by the opportunity to detect breast cancer at an early stage when it is far more treatable.
Although mammograms aren't perfect - about 10-15% of breast cancers don't show up on X-rays - they are still highly effective. Sixteen percent of all breast cancer-related deaths would be avoided if all women got regular mammograms; women who have yearly mammograms have a 20-50% reduced chance of dying of breast cancer compared to those who don't. The American Cancer Society points to alarming evidence that many women are still not getting these life-saving tests done for a variety of reasons, among them being that women are afraid of the procedure or its results, or are embarrassed, or that their doctors simply aren't conveying the importance. Minority women are especially among those not getting tested, although this is due mostly to socio-economic reasons. Most importantly, women with no health insurance should not let that keep them from getting regular mammograms, as many state health departments, as well as Planned Parenthood clinics offer low-cost or free screenings. To find out about free or low-cost screenings in your area, visit the American Cancer Society website, www.cancer.org, or call toll-free at 1-800-ACS 2345.
Additionally, during National Breast Cancer Awareness month each October, women should make a special point of utilizing helpful resources in their area that will help protect them against breast cancer.
WHAT IF I'M DIAGNOSED WITH BREAST CANCER?
A diagnosis of breast cancer is a very difficult experience to go through, because you are faced with a life-threatening illness and must make complex decisions about treatment. Since no one "right" treatment exists for everyone, it is important to know your options. Make sure that you are in the hands of a doctor who is very experienced in the treatment of breast cancer. Don't be afraid to ask your doctor questions or ask for a second opinion. Learn as much as you can from books, websites and information available from such organizations as the American Cancer Society and the Susan G. Komen Breast Cancer Foundation. Talk to other women who are sharing similar experiences, read as much as you can and take charge of your health. Make sure that your relationship with your doctor is a true partnership and that s/he is taking the time to answer your questions.
There are treatments for every one of the five stages of breast cancer. According to the Mayo Clinic's website, most women will have surgery and additional therapy such as radiation, chemotherapy or hormone therapy.
BREAST CANCER SURGERY - WHAT ARE THE OPTIONS?
Lumpectomy This operation removes only the lump plus a surrounding area of normal tissue, saving as much of your breast as possible. The surgeon will probably do a lymph node dissection to check for the spread of cancer. In most cases, women will undergo radiation therapy following their operation, usually every weekday for six to seven weeks. Many women choose the lumpectomy plus radiation instead of a mastectomy because they are more satisfied with their appearance after a lumpectomy, and the survival rates for both operations are similar. However, a lumpectomy may not be an option if a tumor is very large or deep within your breast; it may also not be possible if you've had radiation therapy, are pregnant or have had two or more areas of cancer in the same breast.
Mastectomy A mastectomy involves removing breast cancer as well as the surrounding breast tissue. There are different types of mastectomies, which include the following: partial mastectomy, which is considered to be a breast-sparing operation, as it only removes the tumor as well as some breast tissue around the tumor, the lining of the chest muscles and some lymph nodes under your arm; simple mastectomy, where all the breast tissue is removed, including lobules, ducts, fatty tissue and the nipple and areola area; and the modified radical mastectomy, which is a procedure where the surgeon removes your entire breast and some underarm lymph nodes, but leaves the chest muscles intact. Depending on the results of all of these mastectomies, you may need further treatment.
AFTER THE SURGERY
A big part of dealing with breast cancer is what happens after the surgery. There may be changes in your physical appearance, especially if you undergo a mastectomy. Many women choose to have breast implants to restore not only their shape, but also their self-esteem. Many women will have chemotherapy, which involves receiving drugs in a combination that will kill cancer cells that have spread outside the breast. There are medications like Tamoxifen, which reduce the effect of estrogen in your body. Side effects associated with chemotherapy may include hair loss and nausea, though nausea is often helped by other drugs.
Want to know about treatment options? The most common treatment option is chemotherapy, which is highly effective. It does pose some risks and doesn't work for everyone. But, the sooner breast cancer is detected, the more likely it is to respond to treatment with chemotherapy drugs. It is important to note that a number of new approaches to treating breast cancer are being studied in clinical trials, emphasizing methods that could prolong women's lives, with minimal side effects.
WHAT TO DO IF YOU OR SOMEONE YOU KNOW IS DIAGNOSED WITH BREAST CANCER
All of this information about breast cancer, and certainly a diagnosis, can be overwhelming. But remember, you are not alone! Find a strong support system of other survivors, friends, family or doctors whom you can turn to in times of need. Links to important websites are provided below and they can help you to find support groups, which include other women with breast cancer.
Remember that everyone wants you to get better, so don't be afraid to ask for help. Focus on getting better and improving the quality of your life one day at a time. Certainly having breast cancer will change your life, as well as the lives of your family and those close to you. But, with advances and medical breakthroughs on the horizon, there is always good reason to hope for the best. Read stories of inspiration from survivors and continue to do things that you enjoy; after all, improving the quality of your life never hurts, with or without a disease like breast cancer.
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