Breast Cancer

If you've been recently diagnosed with breast cancer, you and your family might be overwhelmed with questions and concerns. Your first decision is where to get treatment.

You want a place where you can get the most advanced treatment options available. A place where you are supported by a team of compassionate experts. A place where you are treated as a whole person.

MultiCare Regional Cancer Center is that place. We have the region’s best health care providers in the field of oncology. Our world-class treatment facility offers cutting-edge technology in a welcoming and positive healing environment.

Learn about our comprehensive treatment approach, our cancer care team or more about breast cancer in the tabs below.

Breast Cancer Facts

Breast cancer occurs when abnormal cells grow out of control in one or both breasts. They can invade nearby tissues and form a mass, called a malignant tumor. The cancer cells can spread (metastasize) to the lymph nodes and other parts of the body.

Breast cancer is many women’s worst fear. But experts have made great progress in treating cancer. If it is found early, breast cancer can often be cured, and it is not always necessary to remove the breast. There are two main categories of breast cancers:

• Noninvasive cancers, also called in situ, are found only in breast ducts and lobules
• Invasive cancers start in the duct or lobules then spread into surrounding breast tissue. It may become metastatic breast cancer if it spreads to other organs like the lungs, bones, liver and brain.

According to the American Cancer Society, about 230,480 new cases of invasive breast cancer and 57,650 new cases of noninvasive breast cancer (carcinoma in situ) will be diagnosed in women in 2011.

Symptoms

The first sign of breast cancer is often a painless lump. But early breast cancer is often found on a mammogram before a lump can be felt.

Other symptoms of breast cancer may not appear until the cancer is more advanced. These include:

• A thickening in the breast or armpit
• A change in the size or shape of the breast
• Changes in the skin of the breast, such as a dimple or skin that looks like an orange peel
• A change in the nipple, such as scaling of the skin or a nipple that turns in
• A green or bloody fluid that comes from the nipple
• A change in the color or feel of the skin around the nipple (areola)

About 1 percent of breast cancer occurs in men. Although most men diagnosed with breast cancer are older than 65, the disease can appear in younger men. For this reason, any breast lump in an adult male is considered abnormal.

Inflammatory breast cancer is a specific type of breast cancer that involves the skin of the breast. It occurs when breast cancer cells form "nests" and block the lymphatic drainage from the skin of the breast. Symptoms include redness, tenderness and warmth. Thickening of the skin of the breast (an orange-peel appearance), rapid breast enlargement, and ridging of the skin of the breast may also be present. Some women may also develop a lump in the breast.

Prevention

Causes and Risk Factors

Doctors do not know exactly what causes breast cancer. But some things are known to increase your risk:

• Being a woman
• Getting older
• Gene changes
• Your race and ethnicity. White women have a slightly higher risk for getting breast cancer than African-American women. Asian, Hispanic, and Native American women have even less risk.
• Having a history of radiation treatment to the chest

There are also risk factors that you may be able to change. These are risk factors related to your lifestyle, such as:

• Using hormone therapy after menopause
• Lack of physical activity
• Being overweight or obese
• Not breast-feeding
• Not having children, or not having children until after age 30
• Drinking alcohol beverages

But many women who have risk factors do not get breast cancer. And many women who get breast cancer do not have any known risk factors other than being female and getting older.

Early Screening & Prevention

The earlier breast cancer is found, the more easily and successfully it can be treated. The most common methods for detecting breast cancer include:

• Mammogram: A mammogram is an X-ray of the breast. It can often find tumors that are too small for you or your doctor to feel. Your doctor may suggest that you have a screening mammogram, especially if you have any risk factors for breast cancer.
• Breast Self Exam (BSE) - Involves checking your breasts to help detect breast problems or changes. Many breast problems are first discovered by women themselves, often by accident. These exams should be routinely performed monthly.
• Clinical Breast Exam (CBE): During a clinical breast exam, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes.
• Magnetic Resonance Imaging (MRI) of the Breast: MRI is a test that uses a magnetic field and pulses of radio wave energy to provide pictures of the inside of the breast. It may be used as a screening test for women at high risk. It may be more sensitive than a mammogram for finding breast cancer. But MRI also finds small irregularities that can lead to further testing but turn out to not be breast cancer.

Talk to your doctor about an MRI if you have risk factors for breast cancer. These can include a positive test for the BRCA1 or BRCA2 gene or having two or more close family members who have had breast cancer before age 50.

Diagnosis

Diagnostic Tests

If your doctor thinks that you have breast cancer, you may have other tests, including:

• Mammogram: If you have not already had one.
• Ultrasound: You may have an ultrasound of the breast if a lump is found during a clinical breast exam or on a mammogram. Breast ultrasound is often used to distinguish between solid lumps and fluid-filled (cystic) lumps.
• MRI of the breast: Which is sometimes used to get more information about a breast lump or to evaluate problems in women who have breast implants. MRI of the breast may be most useful for very high-risk women, such as those who test positive for the BRCA1 or BRCA2 gene or have two or more close family members who have had breast cancer before age 50. MRI may also be used to evaluate the opposite breast in women diagnosed with breast cancer.
• Breast Biopsy. If a lump is found in your breast, your doctor will need to remove a small sample of the lump (biopsy) and look at it under a microscope to see whether any cancer cells are present. A needle biopsy is done by inserting a needle into the breast and removing some of the tissue.
• Lymph Node Biopsy: Decide whether breast cancer cells have spread to the axillary lymph nodes under the arm.
• Tumor Markers Test: Which are usually done on tissue from a lumpectomy or a mastectomy.
• Complete Blood Count (CBC): Provides important information about the kinds and numbers of cells in your blood, including red blood cells, white blood cells and platelets.
• Chemistry Screen: Measures the levels of several substances (such as those involved in liver functions) in your blood.
• Chest X-ray: Provides a picture of organs and structures within your chest, including your heart and lungs, your blood vessels and the thin sheet of muscle just below your lungs (diaphragm).

If your doctor thinks that breast cancer may have spread to other organs in your body (metastasized), he or she may order additional testing, including a:

• CT scan to provide detailed pictures of the organs and structures in your chest, abdomen and pelvis.
• Bone scan to detect cancer that has spread (metastasized) to the bones.
• CT scan or MRI of the brain to provide detailed pictures of your brain and to check for cancer that may have spread to your brain.

Staging

Once breast cancer has been diagnosed, doctors perform tests to determine the stage of the cancer. Staging is the process of determining the size of the tumor and whether it has spread within the breast or to other parts of the body. Doctors use a cancer’s stage as a key factor in making treatment recommendations and estimating the patient’s chance for recovery.

Treatments

A nurse navigator for your cancer journey

From your initial cancer diagnosis through treatment and rehabilitation, you may have your own personal advocate: a nurse navigator. Not only are nurse navigators available to answer any questions you may have, they provide you with support and guidance. Working closely with your doctors, they are there for you every step of the way.

Surgery

Surgery may be one element of the treatment process. The goal of surgery is to remove the tumor. If your doctors feel they are able to perform breast-conserving surgery without compromising your health, a lumpectomy may be an option.

Radiation Therapy

Your doctor may recommend one or two forms of radiation therapy – external or internal – to eliminate any cancerous cells in your body. External therapy is administered using high-energy x-ray beams that focus on the breast in the area of the tumor. Over time, treatment destroys or weakens the cancer cells so they cannot reproduce.

Chemotherapy

Chemotherapy drugs are designed to interfere with the rapidly dividing cancer cells in your body. Your doctors may suggest chemotherapy as form of breast cancer treatment before or after surgery.

Chemotherapy is usually administered intravenously (through the vein) or orally in the form of pills. Your doctor may recommend additional medications to help alleviate chemotherapy-related side effects.

Targeted Drug Therapy

If your tumor is hormone-responsive, your doctors may consider hormone therapy as part of your breast cancer treatment plan. The goal of hormone therapy treatment is to prevent estrogen from stimulating the growth of any cancer cells that may have moved away from the tumor to other parts of the body or at the tumor site itself.

Supportive and Integrative Therapies

In addition to the therapies described above, we offer integrative therapies such as nutritional therapy, physical therapy, yoga, massage and emotional counseling. Many of these therapies are remarkably effective in addressing the side effects of chemotherapy, surgery and radiation by easing tension, reducing pain and improving quality of life.

We also offer personalized services through Healthy Reflections Boutique including: wigs, scarves, doctor-prescribed skin care products and make-up, custom-fitted bras, breast forms and lymphedema products.

Support

Healthy Reflections Boutique offers a wide variety of women's health care items to enhance your physical and mental well-being.