Understanding Breast Cancer
- Ann Gilbert, 49, was diagnosed with triple negative breast cancer after a myriad of odd symptoms. She initially thought she felt unwell from menopause and long Covid. But once her daughter noticed a lump in her breast and urged her to see a doctor, she finally got the answers she needed.
- Breast cancer is a common cancer that has been the subject of much research, so there are many treatment options out there. Mammograms, a standard screening procedure for breast cancer, and self breast exams can save lives.
- Signs and symptoms of breast cancer can include a breast lump or thickening that feels different from the surrounding tissue; a change in the size, shape or appearance of a breast; changes to the skin over the breast such as dimpling; developing a newly inverted nipple; peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin; and redness or pitting of the skin over your breast like the skin of an orange.
- Risk factors for breast cancer include: being a woman, age, family history, having had a prior biopsy on an abnormal area, radiation exposure, lifetime estrogen exposure, not having a child before age 30 or never having children, obesity, drinking alcohol and lack of exercise.
The month of October serves as a special time for breast cancer survivors and cancer advocates alike to come together and honor both the men and women who’ve battled the disease and raise awareness for the impact of breast cancer. It’s also a time for crucial education surrounding the disease that affects about 1 in 8 women during their lifetime.
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“The biggest thing is shock because you hear the word ‘cancer’ and you automatically go into a tailspin,” she said. “You automatically think a cancer diagnosis means the inevitable end of your life, or that you’re going to become extremely unwell, and it’s frightening. It is that dread and that feeling of, ‘Oh my gosh, I’m 48, how the heck can this be happening to me?'”
Naturally, telling her family about the diagnosis proved to be particularly heartbreaking. She says telling her brother was “quite a trauma,” but telling her daughter was “possibly one of the most difficult things I’ve ever done.”
“I’m quite a resilient person, I’d like to think,” she said. “We’re a typical Liverpudlian family, we cherish each other very much, and I didn’t want them to be really devastated. So, the kind of conversations we had were, you know, ‘I’ve been diagnosed with breast cancer, but it’s treatable.'”
For treatment, she’s currently undergoing chemotherapy which will be followed by surgery and radiotherapy. She’s determined to stay positive by focusing on the future, but she’s also hoping to educate others with her story.
“You should know your own body,” she said. “If you’re in the shower, check your armpits, have a good feel. If anything doesn’t feel right, or you’re even slightly concerned, just get some professional advice on it.”
Learning about Breast Cancer
Breast cancer is a common cancer that has been the subject of much research. Many women develop this disease every year, but men can develop this cancer too though it is more rare, in part, due to the simple fact that they have less breast tissue.
There are many treatment options for people with this disease, but treatment depends greatly on the specifics of each case. Identifying these specifics means looking into whether the cancerous cells have certain receptors. These receptors the estrogen receptor, the progesterone receptor and the HER2 receptor can help identify the unique features of the cancer and help personalize treatment.
"These receptors, I like to imagine them like little hands on the outside of the cell, they can grab hold of what we call ligands, and these ligands are essentially the hormones that may be circulating in the bloodstream that can then be pulled into this cancer cell and used as a fertilizer, as growth support for the cells," Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, previously told SurvivorNet.
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One example of a type of ligand that can stimulate a cancer cell is the hormone estrogen, hence why an estrogen receptor positive breast cancer will grow when stimulated by estrogen. For these cases, your doctor may offer treatment that specifically targets the estrogen receptor. But for HER2 positive breast cancers, therapies that uniquely target the HER2 receptor may be the most beneficial.
Symptoms of Breast Cancer
Screening for breast cancer is typically done via mammogram, which looks for lumps in the breast tissue and signs of cancer. The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. It's also important to be on top of self breast exams.
Signs and symptoms of breast cancer may include:
- A breast lump or thickening that feels different from the surrounding tissue
- Change in the size, shape or appearance of a breast
- Changes to the skin over the breast, such as dimpling
- A newly inverted nipple
- Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
- Redness or pitting of the skin over your breast, like the skin of an orange
It’s important to keep an eye out for these symptoms while remembering that having one or many of them does not necessarily mean you have breast cancer. Regardless, you should always speak with a doctor promptly if anything ever feels off or you’re experiencing one or more of the signs listed above. You never know when speaking up about your health can lead to a very important diagnosis.
Understanding Your Risk
The risk of developing breast cancer varies greatly from person to person, so it's important to discuss your specific risk level with your doctor. That being said, there are some important risk factors to keep in mind.
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In a previous interview with SurvivorNet, Dr. Comen laid out several risk factors for breast cancer including:
- Being a woman: Women are at a higher risk for breast cancer, though men can get the disease too.
- Age: "Breast cancer becomes increasingly more common as women age," Dr. Comen said.
- Family history: "Some people think that breast cancer is only inherited through genes on the mom's side,' Dr. Comen said. "But it can also be related to genetic mutations that could be found on the father's side."
- Having had a prior biopsy on an abnormal area: "There are different markers, that if a woman has had a biopsy, it's important that she talk to her doctor about whether those markers are lending themselves to an increased risk of breast cancer," Dr. Comen said. If you've had a biopsy that indicated atypical hyperplasia, for example, you are at an increased risk of breast cancer. Atypical hyperplasia isn't cancer, but it is a precancerous condition that describes an accumulation of abnormal cells in the milk ducts and lobules of the breast.
- Radiation exposure: Cancer survivors who've had radiation to their chest are at an increased risk of breast cancer.
- Lifetime estrogen exposure: "About 2/3 of breast cancer are driven by the hormone estrogen," Dr. Comen said. "So, that means if a woman has had her period at an early age and started to go through puberty at an early age, at seven, eight, nine, and potentially a later age of menopause, means that her lifetime of having had menstrual periods and being exposed to higher levels of estrogen is higher, and therefore her risk of breast cancer is slightly higher."
- Not having a child before age 30 or never having children
- Obesity
- Drinking alcohol
- Lack of exercise: "While there's more research to be done in this area, it looks like if a woman is not exercising, she may also increase her risk for breast cancer," Dr. Comen said.
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