Cancer that begins in the breast when breast cells grow out of control is called breast cancer. The cancer cells form a tumor which is felt as a lump. It is common in women but men can also get breast cancer. When cancer cells are spread to other organs, it is called metastatic breast cancer.

What are the signs & symptoms?

Some symptoms include changes in the nipples or the skin of the breasts, swollen or stiff lymph nodes.

What are the diagnostic tests for breast cancer?

Mammogram: It is a breast x-ray that helps find early breast cancer symptoms.

Breast ultrasound: The doctor moves a small wand around on the skin. It produces sound waves and picks up the echoes as they bounce off tissues. The echoes are represented in an image on a computer screen. Ultrasound identifies the fluid-filled cyst or lump (unlikely to be cancer) or if it’s a cancerous tumor.

MRI: The radio waves and strong magnets help make precise images of the affected area. MRI identifies the size of cancer and other tumors in the breast.

Nipple discharge test: If the fluid is oozing out from the nipple, the doctor will send it to a lab to check the presence of the cancer cells.

Breast biopsy: The doctor removes the pieces of the cancerous part of the breast with a long, hollow needle.

CT scan: It uses x-rays to create detailed images of the body. A CT scan detects the spread of cancer outside the breast.

Bone scan: It detects cancer spread to the bones.

PET scan: It detects the cancer spread. The doctor puts a small amount of a low-level radioactive substance into the blood. The substance attaches to the cancer cells. A special camera shows any areas of radioactivity.

How advanced is my cancer? 

The stages are based on the cancer growth or cancer spread.

Cancer has five stages, 0, 1, 2, 3, or 4. A lower number means the extent of cancer spread is minimum. A higher number means cancer has spread maximum.

The breast cancer cells are tested for progesterone and estrogen receptors. Hormone receptor-positive breast cancer occurs when proteins are present in cancer cells. The doctor identifies the levels of the HER2 protein in the cells. High levels are high, HER2-positive cancer. These cancers are easier to treat. If both the tests are negative for any of these proteins, it’s known as triple-negative breast cancer.

It is beneficial to test the cells for specific genes, which can help decide the effectiveness of chemo and chances of recurrence.

Ask your doctor about these tests and what the results might mean.

What are the suitable treatments for me?

Several kinds of treatment are available for breast cancer, including surgery, radiation, hormone therapy, immunotherapy, targeted therapy, and chemotherapy.

SURGERY

Surgery helps to cure or control cancer and make symptoms better. It is a common choice to cure breast cancer if not spread outside the breast. The standard type of breast cancer surgeries are lumpectomy, mastectomy, and removing lymph nodes from the underarm.

The common side effects of breast cancer surgery are shoulder stiffness, fatigue (tiredness), lymphedema, change in breast shape, and numbness.

Ask the doctor about the kind of surgery needed and what to expect.

RADIATION THERAPY

Radiation uses high-energy rays to kill cancer cells left in the breast, chest, or armpit after surgery. There are two ways to treat breast cancer with radiation. The first is by aiming the rays at the breast from a machine outside the body. The second is by putting radioactive pellets, or tiny seeds, into the breast.

The common side effects are fatigue (tiredness), skin discoloration, nausea, and vomiting (emesis).

Most side effects may improve after radiation ends. Some side effects may last longer. Ask your doctor about what to expect.

HORMONE THERAPY

It reduces or blocks the levels of estrogen, female hormones. It shrinks breast tumors or curbs cancer growth. Hormone therapy does not cure breast cancer.

The common side effects are headache, vomiting, diarrhea (dysentery), and appetite loss (anorexia). Ask your doctor about what to expect from the hormone treatment.

CHEMOTHERAPY

You can take chemo medicines intravenously or orally. These medicines move into the blood and spread through the body. Chemo is given in cycles or rounds. Each cycle of treatment has a rest time. Chemo is beneficial only if cancer has spread outside the breast tissue.

The common side effects are fatigue, body pain, and hair loss. These side effects go away after chemo treatment ends. There are ways to treat chemo side effects. If you have side effects, ask your doctor for help.

TARGETED THERAPY

Targeted therapy drugs are helpful for breast cancer that makes a high amount of HER2 protein. These drugs majorly affect cancer cells and rarely normal cells.

The most common side effects are fatigue, diarrhea (dysentery), heart damage, and liver problem. If you have side effects, talk to your doctor so they can help.

IMMUNOTHERAPY

Immunotherapy boosts your immune system to attack the cancer cells. You can administer the drugs intravenously, as a shot, or as pills.

The most common side effects are fatigue, cough, nausea, skin rash, and appetite loss (anorexia).

What are the other treatment options? 

The other treatment options may or may not be standard medical treatments. These treatments include vitamins, herbs, and diets. Talk to your doctor about other treatment options.

What to expect after treatment?

You may have fear of cancer recurrence. Visit your doctor every three months after the treatment ends. Do not skip follow-up visits. Your doctors will ask you about new symptoms. A physical examination and diagnostic tests may help to check recurrence.

For the first year, the follow-up visits may be every three months. After the first year, follow-up visits might be every six months, and then at once a year after five years.

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