Screening For Breast Cancer
- Retired professional woman’s hockey league player and active firefighter Erica Howe was just 32 years old when she was diagnosed with stage two breast cancer called invasive ductal carcinoma—after finding a lump in her breast while brushing crumbs off her shirt. Now she’s using her diagnosis to spread awareness for the disease and help others by raising money for cancer research.
- Stage two invasive ductal carcinoma [cancer] “happens when abnormal cells growing in the lining of the milk ducts change and invade breast tissue beyond the walls of the duct,” and “breast ducts are the passageways where milk from the milk glands (lobules) flows to the nipple,” Johns Hopkins Medicine explains.
- The U.S. Preventive Services Task Force recommends women at average breast cancer risk begin screening at age 40. Women with the BRCA gene mutation, who have a family history of cancer, or have dense breasts are at higher risk and should talk with doctors about screening earlier.
- SurvivorNet experts recommend performing a monthly breast self-exam to look for anything unusual with your breasts as well.
- Breast self-exams (BSE) are a simple yet important self-check method that involves observing and feeling the breasts for any changes or abnormalities. While they are not a replacement for professional clinical exams or mammograms, BSE can serve as an essential first step in monitoring breast health and detecting any potential concerns
Erica Howe, of Ontario, Canada, initially wasn’t worried about the lump she discovered because she thought she was too young for cancer, but she ultimately chose to get checked, thanks to her wife, friends, and teammates advice. Now she’s sharing her story to spread awareness for the disease and money for cancer research.
Read MoreAfter getting checked, she learned she had stage two invasive ductal carcinoma, which Johns Hopkins Medicine explains is cancer (carcinoma) “that happens when abnormal cells growing in the lining of the milk ducts change and invade breast tissue beyond the walls of the duct,” noting that, “breast ducts are the passageways where milk from the milk glands (lobules) flows to the nippleView this post on Instagram
“Once that happens, the cancer cells can spread. They can break into the lymph nodes or bloodstream, where they can travel to other organs and areas in the body, resulting in metastatic breast cancer,” Johns Hopkins adds.
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Just weeks after her diagnosis, she underwent a procedure to remove the lump, but her doctors later informed her the cancer had spread to her lymph nodes and she’s need chemotherapy to fight the disease.
She told the NY Times that her diagnosis came at a time she and her wife were “trying to get pregnant” and she was planning to play some more hockey, making her cancer fight more challenging because she felt as her life “came to a full stop.”
Howe, who chose to keep her diagnosis a secret for about a month, is now undergoing chemotherapy twice a week and has a treatment “end date” she’s looking forward to.
Now, as it’s been three months since her cancer journey began, Howe does admit the “mental” aspect of not being able to work or do what she loves hasn’t been easy, as she has a weakened immune system.
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She continued, “Every week is a battle (and) I go through the cycle of the symptoms, but I have all these people there to support me.
“And I think that’s part of why I want to make a difference for others because I can only imagine what it would be like if I didn’t have all that.”
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Howe took to Instagram in October to share some photos from her cancer journey and praise her loved ones for support, writing, “I used to let breast cancer awareness month pass me by. Buy a T-shirt or donate to the fight for a cure but never think deeply about the impact of breast cancer and how many people it has affected.
“That was until August 26th when my world was flipped upside down. That was the day I got a call from my doctor and I was diagnosed with breast cancer.”
She continued, “Not sure if this post is to help me connect, or to help others feel less alone in the battle, but there are a few things I know for sure: I am thankful for my wife (who is so goddamn brave), my family and my support friends who have been by side every step of the way. I am thankful for my team of doctors and nurses who made me feel safe when I was scared. And I am thankful for all those who have donated, supported and fought to find a cure.
“Please don’t send any ‘I’m sorry you have cancer messages,’ love and support is all I need. I consider myself one of the luckiest people on earth and while I’ve been dealt a shit hand here, an army of people have shown up for me in ways I couldn’t ever imagine.”
Howe concluded, “Breast cancer at 32 has been one hell of a ride so far, not the battle I wanted, but it’s the battle I got and I am learning more about myself than I ever imagined. Cancer is about to meet its match. Fundraiser for cancer research coming soon….”
She has since created an online fundraiser to raise awareness and money for cancer research, according to the NY Times, and she’s since raised more than $21,000 for the Canadian Cancer Society.
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Understanding Breast Cancer Types
The first order of business for doctors is determining their patients’ breast cancer types and subtypes so they can effectively start treating the disease with the least amount of side effects.
According to Cleveland Clinic, the most common types of breast cancer include:
- Invasive (infiltrating) ductal carcinoma (IDC), which starts in your milk ducts and spreads to nearby breast tissue. It’s the most common type of breast cancer in the United States.
- Lobular breast cancer, which is the second most common breast cancer in the U.S., starts in the lobules, the milk-producing glands in your breast and spreads to nearby breast tissue.
- Ductal carcinoma in situ (DCIS), which starts in your milk ducts like IDC. The difference between the two is DCIS doesn’t spread beyond your milk ducts.
Less common breast cancer types include:
- Triple-negative breast cancer (TNBC): This invasive cancer is aggressive and spreads more quickly than other breast cancers.
- Inflammatory breast cancer (IBC) is rare, fast-growing and looks like a rash on your breast.
Breast Cancer Subtypes
Estrogen and progesterone help cancerous cells grow, so healthcare providers must immediately find out if the cancer is fueled by either — or both, or neither. Here is an overview of subtypes:
- ER-positive (ER+) breast cancers have estrogen receptors.
- PR-positive (PR+) breast cancers have progesterone receptors.
- HR-positive (HR+) breast cancers have estrogen and progesterone receptors.
- HR-negative (HR-) breast cancers don’t have estrogen or progesterone receptors.
- HER2-positive (HER2+) breast cancers, which have higher than normal levels of the HER2 protein. This protein helps cancer cells to grow. About 15% to 20% of all breast cancers are HER2-positive.
The Food and Drug Administration (FDA) has recently approved a drug called Truqap (generic name: capivasertib) for certain women with hormone receptor positive (HR+), human epidermal growth factor receptor negative (HER2-) breast cancer. The approval is another major step for targeted, hopefully more effective therapies in the breast cancer field.
“It’s a really, really important drug [creating] new opportunities for patients with breast cancer,” says Dr. Carlos Doti, Vice President, Head of Medical Affairs, US Oncology Business Unit for the pharmaceutical giant AstraZeneca. “One of the important parts of this is that we are expanding the number of patients that can be treated with targeted therapies in the second-line setting.”
Hormone receptor positive cancer means that the cancer needs the hormones estrogen and/or progesterone to grow. HER2 negative means that the breast cancer cells do not have high levels of the HER2 protein.
Determining the exact type of breast cancer a patient has can help doctors determine what is fueling the disease — and can help them narrow down the best way to treat it.
All About Breast Self-Exams
Breast self-exams (BSE) are a simple yet important self-check method that involves observing and feeling the breasts for any changes or abnormalities.
While they are not a replacement for professional clinical exams or mammograms, BSE can serve as an essential first step in monitoring breast health and detecting any potential concerns, SurvivorNet’s experts explain.
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These type of exams play a crucial role in early detection and diagnosis of potential breast conditions, including breast cancer. By performing regular self-examinations, you become familiar with the normal look and feel of your breasts, making it easier to identify any unusual changes. Early detection of breast cancer can vastly improve treatment outcomes and the chances of successful recovery.
While BSE alone isn’t a guarantee for early breast cancer diagnosis, it serves as a supplementary tool to other screening methods, such as clinical breast exams and mammography.
Here are some key reasons why breast self-exams are important:
- Familiarization with your breasts: Regular BSE helps you understand how your breasts normally look and feel. This knowledge makes it easier to identify changes or abnormalities as they occur.
- Early detection: In some cases, a breast self-exam might lead to the discovery of a lump or other change that could indicate breast cancer or another noncancerous condition. The earlier a problem is identified, the better the chances for successful treatment.
- Empowerment: Taking control of your breast health by performing regular self-exams can empower you and foster a sense of awareness, responsibility, and confidence regarding your well-being.
- Routine health monitoring: Incorporating BSE into your monthly self-care routine helps establish a consistent health-monitoring practice, making it more likely that you will notice any unexpected changes.
It’s important to remember that BSE should never replace professional clinical exams or mammograms. Instead, view these self-exams as a complementary practice to maintain optimum breast health and ensure early detection in case an issue arises. Don’t hesitate to consult your doctor if you notice any changes or abnormalities during your self-examination.
When to Screen for Breast Cancer
The medical community has a broad consensus that women have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
Women with a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Breast density is determined through mammograms. However, women with dense breasts are at a higher risk for developing breast cancer because dense breast tissue can mask potential cancer during screening. 3D mammograms, breast ultrasound, breast MRI, and molecular breast imaging are options for women with dense breasts for a more precise screening. It is important to ask your doctor about your breast density and cancer risk.
What To Ask Your Doctor
If you have been diagnosed with breast cancer, you may have questions about how to keep your strength through treatment. Here are a few questions to help you begin the conversation with your doctor:
- What treatment will I be receiving?
- What side effects are associated with this treatment?
- Are there steps I can take in my daily life to help minimize these side effects?
- What physical activity routine do you recommend for me during treatment?
- Do you have recommendations for someone who doesn’t particularly enjoy exercise?
- Can you recommend a dietician who can help me with healthy eating tips and maintaining a healthy weight?
- I’ve been having trouble sleeping, do you have any treatment recommendations?
Contributing: SurvivorNet Staff
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