What is breast cancer?
Breast cancer is a malignant tumor in the breast. As with other forms of cancer the tissue grows too quickly. Thereby forming a small lump in the breast or underarm. This nodule is growing and can spread to other parts of the body.
What are the signs and symptoms of breast cancer?
These changes in the chest may indicate breast cancer:
- a lump in the breast or underarm;
- swelling of the breast or underarm;
- withdrawals or folds in the skin of the breast;
- blotchy, red rash on the chest;
- changes in the nipple: scaling, thickening, separation of blood or other fluids, withdrawal of the nipple;
- pain in the chest.
When one or more of these symptoms you should go to your GP.
Breast cancer is fortunately often curable.
Breast cancer is the most common type of cancer in women. Breast cancer also occurs in men. One in every hundred breast cancer patients are men.
Who is at greater risk of breast cancer?
Exactly how breast cancer occurs is not yet clear. However, there are circumstances that give more breast cancer risk.
Who has more risk of breast cancer?
- Women who are in the transition and to use hormone preparations. Even if you only a short time swallows hormones, breast cancer risk is increased considerably. Once you stop taking the hormones, you have again the same breast cancer risk as women who have never swallowed hormones.
- Women and men who already have had breast cancer.
- Men and women whose mother or sister has had breast cancer.
- Women and men who have already had a benign tumor.
- Women who already were young menarche or late menopause.
- Women who have few or no children.
- Women who had their first child at a later age.
- Women who take the "pill". While using the pill, there is little risk of breast cancer.
- Women taking DES during pregnancy have swallowed.
- Women who during and after the transition suffer from overweight.
- Women who long drink more than one glass of alcohol per day.
Breast cancer diagnosis
Go with a change in or on your chest to your doctor. Your doctor will examine your breasts carefully. Also examining whether there are lymph nodes in your armpit or in your neck.
If necessary, the doctor recommends further research. Maybe she will refer you directly to a surgeon or a Breast Clinic. At a Breast Clinic operates a group of specialists (such as a surgeon, radiologist, pathologist, oncologist) with specialist nurses. At a Breast Clinic done research in one day. Often you get the results of that investigation the same day.
In the hospital, the following examinations are possible:
- mammography;
- echo;
- MRI scan ;
- biopsy.
What are the treatments for breast cancer?
The treatment of breast cancer usually begins with an operation. That can be a breast-conserving surgery (lumpectomy) or a mastectomy (mastectomy). The doctor will discuss with you what is the best treatment for you.
After surgery, you will likely have an additional treatment:
- Irradiation. With radiation you may prevent residual cancer tissue still spreads. Irradiation takes about six weeks. You need four or five times a week to the hospital.
- Chemotherapy. Chemotherapy comes with a drip in hospital. You go there every three weeks in the hospital, a total of four to six times.
- Hormone therapy. Usually the doctor gives the hormone therapy tamoxifen. However, it can also provide aromatase inhibitors, such as anastrozole.
- Treatment with monoclonal antibodies. This is a fairly new treatment. Monoclonal antibodies are artificial, "customized" made proteins. These antibodies attack the cancer cells directly. They recognize cancer cells, attach themselves to it and make them broken. You get the antibodies probably via infusion or injection into your body. The doctor usually gives this treatment along with chemotherapy and sometimes hormone therapy.
Mastectomy and breast conserving surgery
The treatment for breast cancer usually begins with an operation. There are two possibilities:
- Breast-conserving surgery (lumpectomy). You keep your chest.
- Mastectomy (mastectomy). You touch your chest lost.
What perhaps is important in your choice: after breast-conserving surgery you are getting radiation therapy after mastectomy is often not necessary.
Mastectomy
In a mastectomy, the surgeon gets the entire breast away. This is done to take away more than the tumor. The underlying chest muscles are spared. Radiation therapy is usually not necessary. You are therefore ready faster treatment than breast-conserving surgery.
Should it transpire that the tumor has not been eliminated yet spacious enough, you will still receive a radiation treatment.
The probability of cure is the same as breast-conserving surgery (if possible).
After a mastectomy can allow you to do a reconstruction of the breast. You can ask for advice from your surgeon to the plastic surgeon.
Breast-conserving surgery
When breast-conserving surgery, the surgeon takes away the tumor from the breast. The pathologist then examines whether it has spread into the lymph nodes.
After breast-conserving surgery, you always get radiation (radiotherapy). There sometimes stay behind because cancer cells in the breast tissue. The irradiation makes these cells than broken.
Is breast-conserving surgery with you possible? Then this treatment has the same chance of cure as a mastectomy. After the treatment, the breast may have a different shape and color than the non-treated breast.
After an surgery for breast cancer
After a breast cancer surgery creates a lot of moisture in the wound. To overcome this moisture to dissipate the surgeon has one or two drains (thin tubes) left behind in the wound. The drains come through the wound to the outside. The doctor removes the drains after one to five days away. This does not hurt.
The first few weeks after surgery can make the wound pain and pulling. The skin around the wound may be slightly discolored and swollen. These phenomena are less when the wound heals.
After the operation is your arm and shoulder on the side of the operated breast stiff. In the hospital, you will learn exercises to make your arm and shoulder again mobile. These exercises have to keep doing it, even when you're home. Try to exercise four times a day, but do not force yourself. Probably you can use your arm and shoulder after a few months again.
When a part of the treated women, the arm on the side of the operated breast and armpit thicker than normal (lymphedema).
This creates extra lymph fluid if you do too much heavy work with your arm. Even if you get an infection in your arm or hand, there is more moisture. Give therefore your arm rest. Wear gloves when housework and when working in the garden.
The chances of lymphedema is 5 to 10%. Is the armpit irradiated after the operation, then the risk 20 to 30%. Irradiated axillary alone, you have 5% risk for lymphedema.
Risks of surgery for breast cancer
Surgery for breast cancer has the same risks as any other surgery. The wound can bleed some, or there may be an infection. Other risks include thrombosis (a blood clot in a blood vessel) and pneumonia.
Additionally, you may have to deal with some specific complications:
His lymph nodes removed? Then, it can sense in the skin along the wound edges and on the inside and / or rear side of the upper arm are gone. It seems as if a part of your arm 'asleep'. This is because a part of the sensory nerves has been cut in the wound area. Usually, the feeling comes after a period of time, back again.
After some time, moisture may accumulate in the wound. This is called seroma formation. Your doctor can typically remove the wound fluid with a syringe. It almost does not hurt.
Surgery for breast cancer is physically seen any major surgery. Also for women in old age the surgery is safe.