Symptoms of Breast Cancer and Diagnosing Breast Cancer
Possible Symptoms of Breast Cancer (How can you tell that you have symptoms that should be investigated?)
1. There could be changes to a breast or nipple.
2. There may be tenderness, pain, burning, and the breast may feel irritated. (These are not considered signs of early breast cancer.)
3. You may feel a lump(s).
4. There may be a change in your breast size.
5. Thickening in the breast, near the breast, under the arms or in any lymph node areas from the neck to the chest.
6. Veins in the breast may have changed.
7. The nipple could be dimpled, retracted or inverted inward.
8. A nipple could be red, become scale-like, pitted, ulcerated or even could have ridges.
9. The nipple could have a spontaneous fluid discharge that could be clear or even bloody.
Diagnosing Benign Tumors or Even Breast Cancer
A Self Breast Exam (BSE) is when a patient does monthly checking of their breasts, lymph nodes (arm, collar bone, under your arms and chest wall). It's important to know your own body.
A Clinical Breast Exam is performed by a physican. He (or she) is checking your breasts and lymph nodes for palpable lumps.
A Digital Mammogram is important. These mammograms are read by a CAD (Computer Aided Digital Machine). You receive a score for your mammogram. There are 5 BIRAD scores.
Category O-They score indicates that they may need additional information.
Category 1-This is a negative score. Breasts are symmetrical and there are no abnormalities.
Cateogry 2-There are no cancerous or benign findings. There is no cancer but the radiologist may find a cyst, fibroadenoma or other benign tumor in the breast.
Category 3-This indicates probably benign findings, and you may need a short interval follow-up. This score means you probably have a benign tumor. The radiologist may recommend a follow-up mammogram in six months.
Category 4-This means there is a suspicious abnormality and a biopsy should be done. This is when a lesion isn't quite cancer but a biopsy should be done to be on the safe side.
Category 5-This score is highly suggestive of a maligant cancer and action needs to be taken. You will need a biopsy.
There are Different Types of Mammograms:
A Baseline Mammogram-This is a mammogram that is used to identify changes in a women's breast and is used as a measuring guide.
Diagnostic Mammogram-This usually follows an irregular screening mammogram. If they find a lump, you have nipple discharge or other skin abnormality, you would have this type of mammogram.
Screening Mammogram-This is a mammogram for women ages 40 or above who are at high risk due to their genes. It is important for future comparisons. A women ages 40-49 should have one every one or two years, depending on previous findings. Women who are age 50 or older should have one every year.
Important: Mammograms pick up slow growing breast cancer, early stage breast cancer, and DCIS. Mammograms are usually given once a year or every two years. Agressive breast cancers can occur anytime during the year, so see your physian right away with symptoms.
What About Recurrences of Cancer?
Several years ago I wrote a pocket folder of Symptoms & Signs of Breast Cancer & It's Recurences in The Body. I gave it out at Charter Media Women Rock. I have to give credit to an oncologist, Dr. Kwong who proofed my research on the topic. Many breast cancer patients wonder if they are going to get a breast cancer recurrence or if they will die from breast cancer. There are many types of breast cancer, some more agressive others more treatable.
According to The American Cancer society and The National Cancer Institute these facts remain true:
1. The chance of a women having invasive breast cancer sometime during her life time is 1 in 8 (all women averaged together). For women under 40 the chances of getting invasive breast cancer is 1 in 229.
2. The chance of dying from breast cancer is about 1 in 35.
3. Breast cancer deaths are falling, possibly due to early detection, improved treatment, and not using hormone replacement therapy.
4. The chance of getting breast cancer increases when a women is older. Most cases occur in women over 60 years old.
5. Skin cancer is the most common cancer of women in the
United States; breast cancer is the second common type of cancer.
6. Breast cancer does cause cancer deaths in the
United States, as does lung cancer.
Recurrent and Metastatic Breast Cancer:
Breast cancer can reappear on the same side as an initial breast cancer even after a mastectomy. The risk is slightly higher with partial breast removal and radiation therapy according to some sources. A breast cancer on one side slightly increases your chance of developing a cancer in the other breast.
General Symptoms of Advanced Cancer:
Feeling tired or not well, loss of appetite, loss of weight
Signs: a nodule, a sore or ulceration
Lymph Node Spread:
Most commonly found in the armpit (axilla) and the neck (supraclavicular).
Cancer travels through the lymph fluid to the bloodstream.
Lymph Node Locations of Spread:
Under the arm (axilla), by the neck region (supraclavicular), inside the chest (internal mammary glands)
Lymph Node Metastasis:
Enlarged (swollen), hard lump (s) may be fixed (connected irregular nodes) that increase over seveal weeks (see your doctor). May become painful or lead to swelling in the arm or hand (lymphedema) that develops before or after surgery.
Secondary/Metastatic Breast Cancer/Distant Recurrences:
Common areas of recurrence:
breast, chest wall skin, regional lymph nodes,
Bone, lung and liver are the most common metastatic areas in that order.
Tests: bone scan, x-ray, CAT scan, MRI, blood tests, biopsies
Factors That Increase Chances of Recurrences:
Local: At the same time of diagnosis these factors are associated with greater risk: larger size tumors, multiple tumors, high-grade tumors, lack of hormone receptors, a positive He2/neu gene over expression, triple negative breast cancer..
Regional: completion of less than the recommended surgery, radiation therpay, cheomtherapy or hormonal theray may increase up to double the risk of recurrence.
Lymph Node/Neck: The more lymph nodes involved at diagnosis, the greater the risk of recurrence. Also if there is metastasis around the node.
Lung Metastasis: Over 30% of the time at first recurrences.
Symptoms: shortness of breath, chronic cough, fatigue, weight loss, or chest pains
Tests: Chest x-rays, CT, biopsy
Liver Metastasis: Occurs in 10% of the time at first recurrences.
Symptoms: loss of appetite (anorexia), nausea, weight loss, fever, tiredness, weakness, loss of energy, not feeling well, constipation, upper right abdomen pain, feeling full with abdominal swelling, loose smelly stools
Advanced Liver Metastasis: Swelling in the abdomen, jaundice (bile build up with yellow green skin and eyes) or spider veins on the skin
Tests: Elevated alkaline phosphate or other liver enzymes, CT scan
Bone Metastasis: Occurs in 75% of the metastases or recurrences.
Symptoms: Bone pain (over the counter meds don't work) or bony aches
Signs: Brittle bones that fracture eaily, lameness from bone pain
Advanced Bone Metastasis may be associated with: can't sleep because of pain day and night, extra calcium in the blood, a sick feeling, constipation, thrist, fatigue, weakness or irritability. Bone Metastasis may involve the spine, pelvis, thigh, upper arm, rib or skull.
Tests: bone scan, Pet, MRI, blood tests (blood calcium and alkaline phosphate levels)
Brain and Spinal Cord Metastasis: Occurs less frequently, less than 5%.
Brain Metastasis Symptoms: Unbearable headaches, vision/hearing loss, numbness, trouble walking, talking, thinking becuase of confusion, disorientation, perception problems
Advanced Signs: One arm or leg doesn't work (paralysis), one side of the body is weak, seizures, excessive drowsiness.
Tests: CT or MRI
Spinal Cord Metastasis:
Symptoms: Stiffness or increased back pain
Signs: Weakness in arms or legs, trouble with bowels or bladder, impotence or sexual dysfunction.
Advanced Spinal Cord Signs: Paralysis or numbness of legs & arms, inability to empty bladder
Tests: MRI or CT scan