Breast Cancer (Female)

    Inspirational Testimonial from Survivor Barbara Edwards

    "When I was diagnosed with breast cancer in June, 2006, I felt despaired and didn’t want to live.  That’s when I was introduced to the Cancer Society. Every Tuesday I would see Miss Alex, the counselor. Miss Alex has been there for me at all times; she would even visit me on weekends. I fondly remember when she brought me wigs when my hair fell out. The Cancer Society even gave me prosthetic breasts.

    "Two years ago the cancer spread to my bladder and this really took a toll on me financially.  Although I do my bit of sewing, at times it gets rough. The Cancer Society has been a tower of strength with financial support. I am not sure what I would do without the Cancer Society; they have been involved throughout my entire diagnosis. Cancer is devastating but if you have support, like what I got from the Cancer Society it makes it much easier to cope."

    Explanation

    Breast cancer occurs when a malignant tumour develops in the cells of the breast. While this is predominantly a female condition a small percentage of men do develop breast cancer.

    Who is at Risk?

    A risk factor is anything that increases the chance that you might develop a disease.

    Main risk categories are:

    • Age: > 50 years has an increased risk
    • Ethnic origin - most prevalent in Caucasian
    • Gender: 100 x more likely in women than men
    • Estrogen related factors
      • Early menarche (beginning your menstrual periods at an early age): < 12 years Late menopause: > 55 years
      • Extended use of Hormone Replacement Therapy: > 5 years
      • Birth of a first child after the age of 30 years
      • Never having children
    • Post menopausal obesity
    • Personal medical history
      • Previous breast cancer
      • Benign breast disease
      • Previous history of endometrial or ovarian cancer
    • Family History - mother, sister or daughter
    • Breast density
    • Genetic alterations
    • Radiation therapy Lifestyle Factors
      • Lack of physical activity
      • Tobacco
      • Alcohol
      • High-fat diet

    Being overweight (obesity) and excess use of alcohol may also increase the risk of breast cancer. Since only one in four women with breast cancer had these risk factors, early detection through mammography, clinical breast examination, and breast self-examination is important for all women.

    Signs and Symptoms

    There is often no pain or symptoms in early breast cancer.

    Changes in your breasts that are possible warning signs of cancer are:

    • A lump or thickening in or near the breast or in the underarm area
    • A change in the size or shape of the breast.
    • Nipple discharge or tenderness, scaly skin on or around the nipple or retraction (inversion) of the nipple into the breast.
    • Dimpling or puckering of the skin
    • A change in the way any part of the breast looks or feels including a change in skin colour or texture, swelling, redness or heat; or the development of pain

    Any unusual breast changes should be reported to your doctor. Any pain in the breast (not usually a symptom), particularly that does not accompany monthly hormonal changes, should be reported to the doctor.

    Prevention

    A screening test is given to persons who have no symptoms of a disease or condition. It is looking for pre-cancerous conditions or cancer in its earliest stages before you develop symptoms.

    Regular screening is recommended for breast cancer and can be one of the following:

    Breast Self-Exam (BSE):

    The best time to do BSE is 5 - 10 days after the end of your period. There are several different methods ?| find the method that works for you.

    The BSE should be done on a monthly basis by all females over the age of 20 years of age.

    By examining your breasts regularly, you and your doctor can be aware of changes in your breast that are not normal. Most lumps are not cancer, but all lumps should be checked out by a doctor.

    Clinical breast exam:

    this should be done by a physician. Women between the ages of 20 - 39 years should have one done every three years and women aged 40 and over should have one on an annual basis.

    For best results, the clinical breast examination (CBE) should be done close to the time of your mammogram.

    Screening mammogram:

    A mammogram is an X-ray of your breast. The best time to do a mammogram is 5 ?| 10 days after the end of your period. On the day of your mammogram do NOT use any deodorant, lotion etc. as this may interfere with the results.

    This should be done every two years from the age of 40 onwards.

    Regular mammograms save lives. Mammography is safe and effective. It?s the best way to find breast cancers early, when they're most treatable. That's why the Cayman Islands Cancer Society recommends that women age 40 and over get a mammogram every year.

    Routine screening is NOT recommended for men due to the low occurrence of breast cancer in men.

    Diagnosis

    Cancer diagnosis is from the following:

    • Diagnostic mammogram
    • Ultrasound
    • Biopsy

    Treatment Options

    Treatment depends on:

    • the size of the tumour and where it is located.
    • if the cancer has spread within your breast.
    • if cancer is present in your lymph nodes under your arms.
    • if cancer is present in other parts of your body.

    Treatment options include:

    Nearly all women with breast cancer will have some type of surgery. Lumpectomy removes only the breast lump and the surrounding area, or margin, of normal tissue. If Cancer cells are present at the margin (the edge of the excisional biopsy or lumpectomy specimen), a re-excision can be done to remove the remaining cancer. In almost all cases, 6 or 7 weeks of radiation therapy follows lumpectomy. Doctors call this combination (of lumpectomy and radiation) breast conserving therapy. It?s an option for most, but not all, women with breast cancer.

    Those who probably should NOT undergo lumpectomy, or breast conserving therapy:

    • Women who have already had radiation therapy to the affected breast or chest.
    • Women with two or more areas of cancer, in the same breast, too far apart to be removed in one incision.
    • Women whose initial excisional biopsy - or, when needed, their re-excision has not completely removed their cancers.
    • Women with certain connective tissue diseases that make body tissues especially sensitive to the side effects of radiation.
    • Pregnant women who would require radiation while still pregnant.

    Other

    What are the side effects of breast cancer?

    Lymphedema is the main side effect and is the swelling of the arm that can occur right after surgery or even years after surgery. It is caused by a change in the normal drainage pattern of the lymph nodes under the arm as a result of surgery or radiation therapy.

    For more info on breast cancer and the BRCA 1 &2 gene mutations, click here.