INITIAL DIAGNOSIS

When a woman is diagnosed with breast cancer, fear is the most natural reaction. The same is true for men. Learning the facts about breast cancer can be a lifesaving act for women and men Arming yourself with knowledge about breast cancer, its effects, and its treatments is an advisable way to prepare for the challenges and choices the illness often brings. This quick reference guide is designed to be a first stop on the road to self-education about breast cancer.

The Facts
Apart from skin cancer, breast cancer is the most prevalent cancer among American women. On average, every woman has a one in eight (12%) chance of developing breast cancer at some time in her life. According to the American Cancer Society, there will be an estimated 240,000 new cases of breast cancer diagnosed in the United States in 2007. About 180,000 of these will be invasive breast cancer.

Causes
While the exact causes of breast cancer are not clear, a number of risk factors have been identified by the medical community. They include:

Gender: simply being a woman represents a risk for contracting breast cancer
Age: your risk of developing breast cancer increases with age
Heredity: 5-10% of breast cancer cases are thought to be hereditary and are the result of gene mutations inherited from a parent
Race: White women** face a somewhat higher likelihood of developing breast cancer than do African American women, while Asian, Hispanic and Native-American women have an even lower risk

** Note: Reference to this statement about breast cancer and race can be found here:
http://www.cancer.gov/cancertopics/factsheet/estimating-breast-cancer-risk

There is no sure way to avoid contracting breast cancer. However, certain behavioral factors such as alcohol use, lack of exercise and being overweight can increase the risk of contracting the disease.

Types of Breast Cancer
There are four main types of breast cancer, determined by a combination of two factors: where the cancer originated in the breast and whether or not it has metastasized (i.e., spread beyond the breast to other parts of the body). Cancer which originates in the milk ducts of the breast is called ductal carcinoma, while cancer which originates in the lobules of the breast is called lobular carcinoma. Cancer that originates from either of these locations can either remain in the general area of origin (in situ) or can spread to other parts of the body (invasive). In summary, the four main types of breast cancer are: ductal carcinoma in situ, lobular carcinoma in situ, invasive ductal carcinoma, and invasive lobular carcinoma.

In general, the in situ forms of cancer are treated with higher success rates, given their localized condition. However, viable treatments are available for all four types of cancer listed here.

Key Terminology (Initial Diagnosis)

Adenocarcinoma: Cancer in gland forming tissue, such as breast tissue

Biopsy: Removing or taking a sample of tissue that has been invaded by cancer

Calcification: A small calcium deposit which can be seen on a mammogram

Cancer: Term for multiple diseases which are characterized by abnormal cell growth and which may destroy surrounding tissue. Cancer can metastasize, or spread to other parts of the body via the blood or lymph system.

Carcinoma: A cancerous growth that begins in the lining of an organ and tends to invade surrounding tissues and metastasize (spread) to other regions of the body.

Clinical Trials: Cancer research studies often include the testing of new drugs or treatments in order to compare them to current, standard treatments. Before a new treatment is used on people, it is studied in a laboratory environment. If lab studies suggest that a treatment works, it is tested with cancer patients. These human studies are called clinical trials.

DCIS (ductal carcinoma in situ): Cancer cells which have not spread outside the duct

Fibroadenoma: Benign, fibrous breast tissue

HRT: Hormone replacement therapy

IDC (invasive ductal carcinoma): Cancer cells which have metastasized, spreading outside of the duct to other parts of the breast

ILC (invasive lobular carcinoma): Cancer cells which have metastasized, spreading outside of the lobule to other parts of the breast

Lobule: Part of breast which can produce milk

LCIS (lobular carcinoma in situ): Cancer cells which have not spread outside the lobule

Malignant: Cancerous (cells)

Mastectomy: Removal of a breast as an element of a breast cancer treatment regimen

Metastasis: The spread of cancer from the site of origin to other parts of the body, or a secondary cancer growth

Prognosis: The expected outcome of having cancer

Staging: Tests used to figure out where the cancer is in the body, whether it has spread, and how it compares to other cancers. (e.g., Stage I is the least serious stage of breast cancer, while Stage IV is the most serious.)

TREATMENT AND POST-TREATMENT SUPPORT

Typical Treatments and their Side Effects
Typical cancer treatments can be divided into local therapies and systemic therapies. Local therapies, such as surgery and radiation therapy, involve treating tumors at their site of origin while minimizing effects on the rest of the body. Meanwhile, systemic therapies are drugs which can be given orally or placed directly into the bloodstream to reach cancer cells anywhere in the body. Examples of systemic therapies include chemotherapy, hormone therapy, and targeted therapy.

Links to Support Resources

All About You:
http://all-about-you.org/

Cancer Hope Network:
http://www.cancerhopenetwork.org/

Cancer Consultants - Cancer Topics
http://www.texasoncology.com/cancer-blood-disorders.aspx

Ernie’s Boutique:
http://www.baylorhealth.com/Locations/Ernies.htm

I Can Cope:
http://www.cancer.org/docroot/ESN/content/ESN_3_1X_I_Can_Cope.asp?sitearea=SHR

Living Beyond Breast Cancer:
http://www.lbbc.org/

Look Good . . . Feel Better
http://www.cancer.org/docroot/ESN/content/ESN_3_1X_Look_Good_Feel_Better.asp?sitearea=SHR

Other Helpful Links:
https://cissecure.nci.nih.gov/factsheet/FactsheetSearchResult.aspx?PubLnk=8.1&CancerType=2

Reach to Recovery:
http://www.cancer.org/docroot/ESN/content/ESN_3_1x_Reach_to_Recovery_5.asp?sitearea=SHR

Sisters Networking:
http://www.sistersnetworkinc.org/default.asp

Susan G. Komen for the Cure:
http://ww5.komen.org/home/

“TLC” Tender Loving Care:
http://www.cancer.org/docroot/SHR/content/SHR_2.1_x_tlc_tender_loving_care.asp?sitearea=SHR

Managing Chemotherapy
Chemotherapy is a commonly-prescribed systemic therapy for treating cancer. While chemotherapy is a powerful technique, it is usually accompanied by a number of side effects. Here is a list of common chemotherapy side effects and some strategies for managing them:

Weakened Immune System:

Avoid crowds, especially those with children.
Wash your hands as frequently as possible.
Prevent breaks in the skin.

Nausea and Vomiting:

Eat smaller meals more frequently.
Avoid sweets and fatty, fried foods.
Eat foods only when they are at room temperature.
Avoid strong odors.
Take anti-emetic drugs.

Diarrhea:

Drink plenty of fluids.
Avoid dairy products.
Try foods that are low in fiber such as bananas, rice, and mashed potatoes.

Constipation:

Drink plenty of fluids.
Eat high fiber foods.

Sore Mouth:

Drink plenty of fluids.
Suck on ice chips.
Chew sugarless gum or eat hard candy.
Moisten dry foods before chewing.

Fatigue:

Plan fewer activities.
Try to rest whenever you can.

Hair Loss:

Try cooling your scalp during chemotherapy, as this may reduce hair loss.
Ask your cancer nurse about wigs and hairpieces, if you are interested in wearing one.

Breast Reconstruction
Women who have had a mastectomy (removal of one or both breasts) as part of their breast cancer treatment often choose to undergo breast reconstruction surgery. As its name implies, the goal of this surgery is to give the affected breast(s) an appearance of relative normalcy despite the recent removal of part of or the entire breast. Breast reconstruction is typically carried out by a plastic surgeon.

Here are some facts and tips about the breast reconstruction process:

It can be helpful to consult with your plastic surgeon before your mastectomy procedure, as this aids the surgical team in planning the treatment that is right for you.
You may be presented with the choice to remove either your entire breast or just a portion of your breast.
Your body image and self-esteem may improve after reconstruction surgery, but it may not.
The reconstruction process may require one or more sessions.
Immediate breast reconstruction is done at the time of your mastectomy, while delayed reconstruction is done at a later time.
Breast reconstruction can restore the shape of your breast, but it cannot restore your normal breast sensation.

Key Terminology (Treatment and Post-Treatment)

Adjuvant therapy: A type of therapy whereby drugs are used in conjunction with surgery and/or radiation to destroy microscopic disease and improve the overall chances of living without disease.

Alopecia: Hair loss (often accompanying chemotherapy)

Chemotherapy: The treatment of cancerous diseases with drugs that interfere with cancer cell growth and reproduction

Lumpectomy: Surgical removal of a lump, along with the small circle of tissue surrounding it

Lymphedema: Swelling of armpit, arm or chest wall due to excess fluid in the tissues after surgery

Quality of Life: How you live on a day-to-day basis (self-care, relationships, social activities, ability to work, emotional life, etc.)

Radiation Therapy: Treatment with high-energy X-ray radiation. Radiation kills cancerous cells (and also healthy cells).

Reconstruction: Rebuilding a breast after a mastectomy

Systemic Treatment: Treatment of the whole body (usually through some type of drug therapy)