Everything you need to know about breast cancer

Early detection of breast cancer can have a massive impact on treatment options and outcomes. Knowing what to look out for and doing regular breast self-exams are great first steps.

Breast cancer can develop when the cells in the breast begin to grow uncontrollably, forming a tumor that can often be felt as a lump or seen on an x-ray. Like many health conditions, breast cancer symptoms can vary widely from person to person and can sometimes be confused with other issues. If you feel like something isn’t right, it’s important to advocate for yourself with your providers and ask for a differential diagnosis when possible.

The symptoms you may experience depend on various factors, such as the type and stage of breast cancer, as well as your personal health.

Some common symptoms of breast cancer include:

Going to the doctor can be intimidating, but the sooner you have answers and information, the sooner you can take action. Getting diagnostic tests will help you and your healthcare provider get a clear insight about your health so you can make a gameplan, together. 

The process of diagnosing breast cancer typically starts with a breast exam. Your healthcare provider will check for lumps or other physical changes in the breast and underarm area. If any abnormalities are detected, the next steps may include imaging tests like mammograms or ultrasounds to visualize the breast tissue. Imaging tests are not invasive and should only cause minor discomfort. 

Mammograms are generally recommended annually for women over the age of 40, or earlier depending on personal or family risk factors. While some individuals find mammograms uncomfortable, most report that the procedure is relatively quick and tolerable.

If any suspicious areas are found on the imaging, a biopsy may be recommended. During a biopsy, a small sample of tissue is removed from the breast and examined under a microscope to determine if cancer cells are present. There are several types of biopsy procedures, ranging from fine-needle aspiration to surgical biopsy. Your care team will determine the best option for you.

Keeping track of specialists, labs, and test results can be overwhelming, but we’re here to help. PicnicHealth’s timeline feature gathers all of your medical records and organizes them into one chronological timeline that you can share with new providers, loved ones who want to be in the loop, and, if you want, breast cancer researchers working on the next treatment breakthrough.

A breast biopsy is a medical procedure where a small sample of breast tissue is removed and examined under a microscope to determine if cancer cells are present. The process can sound intimidating, but your healthcare team will work to keep you as comfortable as possible and answer any questions you might have. Getting a breast biopsy is a crucial step in diagnosing breast cancer and determining the most effective treatment plan for your specific needs.

Here's what you can expect during a breast biopsy:

‍Preparation: Before the biopsy, your healthcare provider may run some tests or review your mammograms and ultrasounds to identify the area(s) that needs to be biopsied. You may be asked to avoid certain medications that could increase your risk of bleeding during the procedure. Your doctor will discuss the different types of biopsies and recommend the best one for your needs.

‍Local anesthesia: On the day of the biopsy, you will receive local anesthesia to numb the area where the biopsy needle will be inserted. This ensures that you don't feel any pain during the procedure. It’s totally normal to be nervous, and if helpful, your doctor might give you a sedative to help you relax. 

‍Taking the sample: Once the area is numb, the doctor will use a needle or other specialized instrument to collect a small tissue sample from the breast. The procedure may be guided by ultrasound, mammography, or MRI to ensure that the sample is taken from the correct area. You may feel some pressure, but it should not be painful.

‍Recovery: After the biopsy, you'll be given instructions on how to care for the biopsy site and what activities to avoid in the short term. You may experience some tenderness or bruising for a few days. Your medical team will monitor you for a short time after the procedure to ensure that you're doing well.

‍Results and next steps: You should hear back about your biopsy within a few days. Your healthcare provider will go over the findings with you and discuss the appropriate next steps, including potential treatment options if cancer is detected.We know that a breast biopsy can be a nerve-wracking experience, but remember that you're not alone. Our team is here to support you at every stage of your care journey. With the information from the biopsy, you and your care team can work together to create a personalized plan that addresses your unique needs.

After your biopsy, your healthcare team should have a better understanding of what stage the breast cancer is at so they can recommend the best treatment plan for you. Like other cancers, breast cancer progresses through different stages. Each stage is determined by the extent of the disease and its spread within the body. Early detection and management of breast cancer can improve your chances of successful treatment and recovery.

Here's a breakdown of the stages of breast cancer:

‍Stage 0: Known as "carcinoma in situ," this is the earliest stage of breast cancer, where abnormal cells are only found in the ducts or lobules of the breast and have not spread anywhere.

‍Stage 1: At this stage, the tumor is small (less than 2 centimeters) and may or may not have spread to nearby lymph nodes but has not spread to other parts of the body.

‍Stage 2: At this stage, the cancer is larger (2 to 5 centimeters) or has spread to a few nearby lymph nodes but not to distant organs. This stage can be divided into 2A and 2B, depending on the tumor size and lymph node status.

‍Stage 3: This stage is further divided into 3A, 3B, and 3C. The tumor may be larger, and the cancer may have spread to more lymph nodes, the chest wall, or the skin of the breast. However, it hasn't spread to distant organs.

‍Stage 4: This is the most advanced stage of breast cancer, where the disease has spread beyond the breast and nearby lymph nodes to other parts of the body, such as the lungs, liver, bones, or brain.

Once the stage has been determined, you can work closely with your healthcare team to create a tailored treatment plan for your needs.

Living with breast cancer can be challenging – both physically and emotionally. As you begin treatment, it’s important to have a support network you can lean on for help with errands or even keeping you company when you go for treatments. 

Your treatment options will be a collaborative effort with your healthcare team and will depend on your specific breast cancer stage, any other health conditions you may have, and the medications you are currently taking.

Here’s a breakdown of the treatment options your care team might recommend.

‍Medications
‍Several medications are available to treat breast cancer, including hormonal therapies, targeted therapies, and chemotherapy. Hormonal therapies like tamoxifen and aromatase inhibitors work by blocking the effects of estrogen on cancer cells. Targeted therapies focus on specific characteristics of cancer cells to stop their growth, while chemotherapy uses drugs to kill or slow the growth of cancer cells. Each medication works differently and is prescribed based on your unique situation.

‍Procedures
‍There are also several procedures for treating breast cancer, including surgery, radiation therapy, and immunotherapy. Here’s what you can expect with each procedure.

Surgery: This is usually the first line of treatment for breast cancer. Typically the tumor and surrounding tissue are removed, and in some cases, the entire breast. There are two main types of surgery for breast cancer: lumpectomy (breast-conserving surgery) and mastectomy. In a lumpectomy, only the tumor and some surrounding tissue are removed, preserving most of the breast. In a mastectomy, the entire breast is removed. The choice of surgery depends on a few different factors, like the size and location of the tumor, the stage of the cancer, and your personal preference. Some patients want as little surgical intervention as possible, while others want more for peace of mind. After surgery, if you’d like, you can have breast reconstruction to restore its appearance. 

Radiation therapy: This treatment uses high-energy rays or particles to target and kill cancer cells, often after surgery, to destroy any remaining cancer cells. Radiation therapy can be delivered externally (external beam radiation) or internally (brachytherapy). External beam radiation is the most common type and involves directing a beam of radiation to the affected area from outside the body. Brachytherapy involves placing a radioactive source directly into or near the tumor. The type of radiation therapy you do will depend on the location and size of the tumor, the stage of the cancer, and your overall health. While radiation therapy is generally well-tolerated, it can cause side effects such as fatigue, skin changes, and soreness in the treated area. Your healthcare team will work with you to manage any side effects and ensure your comfort during treatment.

Chemotherapy: Chemotherapy uses drugs to kill or slow the growth of cancer cells. It can be used before surgery to shrink tumors (neoadjuvant therapy) or after surgery to kill any remaining cancer cells and reduce the risk of recurrence (adjuvant therapy). Chemotherapy is typically delivered intravenously or as a pill. Since chemotherapy travels throughout your body, it is an effective option for treating breast cancer that has spread. Chemotherapy can cause side effects, including fatigue, nausea, and hair loss. It also compromises your immune system, so it’s crucial to avoid contact with anyone who is sick. Your healthcare team will work with you to manage any side effects and provide support throughout your treatment.

Many patients find taking a holistic approach to treatment, including medication and lifestyle changes, helps them stay on track. Learning what medications work (or don’t work) for you is also important. Resources like PicnicHealth can help you track your progress as well as keep all of your healthcare providers informed on the medications you’re currently taking and any side effects you experience. 

Each of the treatment options mentioned above comes with its pros and cons, as well as possible side effects. It's crucial to maintain open communication with your healthcare team to find the best treatment plan tailored to your needs. With a combination of treatment, support, and self-care, you can continue to lead a fulfilling life while treating breast cancer.