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BREAST CANCER, TREATMENT, AND PREVENTION: A COMPLETE GUIDE

BREAST CANCER

“The first sign of breast cancer often is a breast lump or an abnormal mammogram. Breast cancer stages range from early, curable breast cancer to metastatic breast cancer, with a variety of breast cancer treatments. Male breast cancer is not uncommon and must be taken seriously.

Cancer occurs when changes called mutations to take place in genes that regulate cell growth. The mutations let the cells divide and multiply in an uncontrolled way.

Breast cancer is cancer that develops in breast cells. Typically, the cancer forms in either the lobules or the ducts of the breast. Lobules are the glands that produce milk, and ducts are the pathways that bring the milk from the glands to the nipple. Cancer can also occur in the fatty tissue or the fibrous connective tissue within your breast.”

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“The uncontrolled cancer cells often invade other healthy breast tissue and can travel to the lymph nodes under the arms. The lymph nodes are a primary pathway that help the cancer cells move to other parts of the body.”

SYMPTOMS

In its early stages, it may not cause any symptoms. In many cases, a tumor may be too small to be felt, but an abnormality can still be seen on a mammogram. If a tumor can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancer.

Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:

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  • a breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
  • breast pain
  • red, pitted skin over your entire breast
  • swelling in all or part of your breast
  • a nipple discharge other than breast milk
  • bloody discharge from your nipple
  • peeling, scaling, or flaking of skin on your nipple or breast
  • a sudden, unexplained change in the shape or size of your breast
  • inverted nipple
  • changes to the appearance of the skin on your breasts
  • a lump or swelling under your arm
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“If you have any of these symptoms, it doesn’t necessarily mean you have breast cancer. For instance, pain in your breast or a breast lump can be caused by a benign cyst. Still, if you find a lump in your breast or have other symptoms, you should see your doctor for further examination and testing.”

CAUSES

“The precise causes of this are unclear, but we know the main risk factors. Still, most women considered at high risk for breast cancer do not get it, while many with no known risk factors do.

The main risks are being older and having breast cancer in your family. The risk goes up for women with certain types of benign breast lumps and for women who have had ovarian cancer. And if you’ve had breast cancer, you can get it again.”

History.

“ A woman who has had cancer in one breast, such as ductal carcinoma in situ (DCIS) or invasive breast cancer, is three to four times likelier to develop a new form of this disease, unrelated to the first one, in either the other breast or in another part of the same breast. This is different than a recurrence of the previous breast cancer.”

Age.

Your risk goes up as you age. About 77% of women diagnosed with breast cancer each year are over 50, and more than 40% are 65 and older.

In women ages 40 to 50, there is a 1 in 68 chance of developing it. From 50 to 60, that goes up to 1 in 42. From 60 to 70, it’s one in 28. And in women 70 and older, it’s 1 in 26.

Direct family history.

Having a mother, sister, or daughter (“first-degree” relative) with breast cancer puts a woman at higher risk. It’s even greater if this relative developed breast cancer before 50 and had cancer in both breasts.

Having one first-degree relative with breast cancer roughly doubles your risk, and having two first-degree relatives triples your risk. Having a male blood relative with breast cancer will also increase the risk.

Genetics.

 About 5% to 10% of breast cancer cases are inherited. Carriers of alterations in either of two genes, called BRCA1 or BRCA2, are at higher risk. Women with an inherited alteration in the BRCA1 gene have a 72% chance of developing breast cancer by the time they’re 80. There’s a 69% chance that a woman with an inherited alteration in the BRCA2 gene will get breast cancer by that age.

Dense breasts.

 Your breasts are a mix of fatty, fibrous, and glandular tissue. Dense breasts have more glandular and fibrous tissue and less fat. A woman with dense breasts is 1.5 to 2 times more likely to get it.

Breast lesions.

Having atypical hyperplasia (lobular or ductal) or lobular carcinoma in situ increases a woman’s breast cancer risk by four to five times.

Distant family history.

This refers to breast cancer in second- or third-degree relatives such as aunts, grandmothers, and cousins.

Previous abnormal breast biopsy.

Women with earlier biopsies showing any of the following have a slight increased risk: fibroadenomas with complex features, hyperplasia without atypia, sclerosing adenosis, and solitary papilloma.

TREATMENT

Some treatments are local, meaning they treat the tumor without affecting the rest of the body.

Most women with breast cancer will have some type of surgery to remove the tumor. Depending on the type of breast cancer and how advanced it is, you might need other types of treatment as well, either before or after surgery, or sometimes both.

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Drugs used to treat breast cancer are considered systemic therapies because they can reach cancer cells almost anywhere in the body. They can be given by mouth or put directly into the bloodstream. Depending on the type of breast cancer, different types of drug treatment might be used, including:

  • Chemotherapy
  • Hormone Therapy
  • Targeted therapy
  • Immunotherapy
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Typically, treatment plans are based on the type of breast cancer, its stage, and any special situations. Your treatment plan will depend on other factors as well, including your overall health and personal preferences.

Based on your treatment options, you might have different types of doctors on your treatment team. These doctors could include:

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A breast surgeon or surgical oncologist: a doctor who uses surgery to treat breast cancer

A radiation oncologist: a doctor who uses radiation to treat cancer

A medical oncologist: a doctor who uses chemotherapy and other medicines to treat cancer

A plastic surgeon: a doctor who specializes in reconstructing or repairing parts of the body

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You might have many other specialists on your treatment team as well, including physician assistants (Pas), nurse practitioners (NPs), nurses, psychologists, nutritionists, social workers, and other health professionals.

It’s important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. It’s also very important to ask questions if there’s anything you’re not sure about.

If time permits, it is often a good idea to seek a second opinion. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.

PREVENTING

1. Keep Weight in Check

“It’s easy to tune out because it gets said so often, but maintaining a healthy weight is an important goal for everyone. Being overweight can increase the risk of many different cancers, including breast cancer, especially after menopause.”

2. Be Physically Active

“Exercise is as close to a silver bullet for good health as there is, and women who are physically active for at least 30 minutes a day have a lower risk of breast cancer. Regular exercise is also one of the best ways to help keep weight in check.”

3. Eat Your Fruits & Vegetables – and Avoid Too Much Alcohol

“A healthy diet can help lower the risk of breast cancer.  Try to eat a lot of fruits and vegetables and keep alcohol at moderate levels or lower (a drink a day or under). 

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While moderate drinking can be good for the heart in older adults, even low levels of intake can increase the risk of breast cancer.  If you don’t drink, don’t feel you need to start. If you drink moderately, there’s likely no reason to stop. But, if you drink more, you should cut down or quit.”

4. Don’t Smoke

“Smokers and non-smokers alike know how unhealthy smoking is.  On top of lowering the quality of life and increasing the risk of heart disease, stroke, and at least 15 cancers – including breast cancer – it also causes smelly breath, bad teeth, and wrinkles. Now that’s motivation to stay smoke-free or work to get smoke-free.”

5. Breastfeed, If Possible

“Breastfeeding for a total of one year or more (combined for all children) lowers the risk of breast cancer. It also has great health benefits for the child.”

6. Avoid Birth Control Pills, Particularly After Age 35 or If You Smoke

“Birth control pills have both risks and benefits. The younger a woman is, the lower the risks are. While women are taking birth control pills, they have a slightly increased risk of breast cancer.

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This risk goes away quickly, though, after stopping the pill. The risk of stroke and heart attack is also increased while on the pill – particularly if a woman smokes. However, long-term use can also have important benefits, like lowering the risk of ovarian cancer, colon cancer, and uterine cancer – not to mention unwanted pregnancy – so there’s also a lot in its favor. If you’re very concerned about breast cancer, avoiding birth control pills is one option to lower risk.”

7. Avoid Post-Menopausal Hormones

“Post-menopausal hormones shouldn’t be taken long term to prevent chronic diseases, like osteoporosis and heart disease.

Studies show they have a mixed effect on health, increasing the risk of some diseases and lowering the risk of others, and both estrogen-only hormones and estrogen-plus-progestin hormones increase the risk of this disease. If women do take post-menopausal hormones, it should be for the shortest time possible. The best person to talk to about the risks and benefits of post-menopausal hormones is your doctor.”

8. Tamoxifen and Raloxifene for Women at High Risk

“Although not commonly thought of as a “healthy behavior,” taking the prescription drugs tamoxifen and raloxifene can significantly lower the risk of breast cancer in women at high risk of the disease.

Approved by the FDA for prevention, these powerful drugs can have side effects, so they aren’t right for everyone. If you think you’re at high risk, talk to your doctor to see if tamoxifen or raloxifene may be right for you.”

FOODS TO EAT

“It can start in different places, grow in different ways, and require different kinds of treatment. Just as particular types of cancer respond better to certain treatments, some cancers respond well to specific foods.”

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The following foods can play a role in a healthful diet in general, and they may also help prevent the development or progression of this

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  • a variety of fruits and vegetables, including salad
  • foods that are rich in fiber, such as whole grains, beans, and legumes
  • low-fat milk and dairy products
  • soybean-based products
  • foods rich in vitamin D and other vitamins
  • foods, particularly spices, with anti-inflammatory properties
  • mainly plant-based food— that contain antioxidants
  • Dietary patterns that prioritize these foods include:
  • A southern diet that is high in cooked greens, legumes, and sweet potatoes
  • A Mediterranean diet, which emphasizes fresh fruits and vegetables and healthful oils
  • Any “prudent” diet that contains plenty of fruit, vegetables, whole grains, and fish

FRUITS AND VEGETABLES

Along with their other benefits, fruits and vegetables are rich in flavonoids and carotenoids, which appear to have various medical benefits.

Studies have suggested that the following foods may help preventing:

  • dark, green, leafy vegetables, such as kale and broccoli
  • fruits, especially berries and peaches
  • beans, pulses, fish, eggs, and some meat

“Researchers have associated beta carotene, which occurs naturally in vegetables such as carrots, with a lower risk of breast cancer. Scientists speculate that this may be because it interferes with the growth process of cancer cells.”

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