Wednesday, October 28, 2015

FRIENDS!!!BREAST CANCER-PARTC--Why need an Early Detection Plan --1 in 8 women will be diagnosed with breast cancer in her lifetime. When breast cancer is detected early (localized stage), the 5-year survival rate is 100%.


Imaging tests used to evaluate breast disease

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests may be done for a number of reasons, including to help find out whether a suspicious area might be cancerous, to learn how far cancer may have spread, and to help determine if treatment is working.

What is a mammogram?

The most effective way a woman can detect early breast cancer is through routine mammography. A mammogram can detect a tumor about two years before it can be felt by a woman. 
     A screening mammogram is an x-ray of the breast used to find breast changes in women who have no signs of breast cancer. Women ages 50 to 70 years should get a mammogram every 2 years. Women younger than 50 should talk to a doctor about when to start and how often to have a mammogram.
For a mammogram, the breast is pressed between 2 plates to flatten and spread the tissue. This may be uncomfortable for a moment, but it is necessary to produce a good, readable mammogram. The compression only lasts a few seconds.

If  breast symptoms (like a lump or nipple discharge) or an abnormal result on a screening mammogram -will have a diagnostic mammogram. This will include more images of the area of concern.

If diagnostic mammogram shows that the abnormal area is more suspicious for cancer, a biopsy will be is needed to tell if it is cancer.

Even if the mammograms show no tumor, if  can feel a lump, a biopsy is usually needed to make sure it isn't cancer. One exception would be if an ultrasound exam finds that the lump is a simple cyst (a fluid-filled sac), which is very unlikely to be cancerous.

If cancer is found, a diagnostic mammogram is often done to get more thorough views of both breasts. This is to check for any other abnormal areas that could be cancer as well.

Mammograms and Other Breast Imaging Tests has more detailed information about mammograms.

Breast ultrasound

Ultrasound, also known as sonography, uses sound waves to outline a part of the body. For this test, a small, microphone-like instrument called a transducer is placed on the skin (which is often first lubricated with ultrasound gel). It emits sound waves and picks up the echoes as they bounce off body tissues. The echoes are converted by a computer into a black and white image that is displayed on a computer screen. This test is painless and does not expose you to radiation.

Ultrasound has become a valuable tool to use along with mammography because it is widely available and less expensive than other options, such as MRI. Usually, breast ultrasound is used to target a specific area of concern found on the mammogram. Ultrasound helps distinguish between cysts (fluid-filled sacs) and solid masses and sometimes can help tell the difference between benign and cancerous tumors. In someone with a breast tumor, it can also be used to look for enlarged lymph nodes under the arm.

The use of ultrasound instead of mammograms for breast cancer screening is not recommended. However, clinical trials are now looking at the benefits and risks of adding breast ultrasound to screening mammograms in women with dense breasts and a higher risk of breast cancer.


Mammograms and Other Breast Imaging Tests has more detailed information about breast ultrasound.

Magnetic resonance imaging (MRI) of the breast

MRI scans use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of body tissue and by certain diseases. A computer translates the pattern into a very detailed image. For breast MRI to look for cancer, a contrast liquid called gadolinium is injected into a vein before or during the scan to show details better.


MRI scans can take a long time − often up to an hour. For a breast MRI, you have to lie inside a narrow tube, face down on a platform specially designed for the procedure. The platform has openings for each breast that allow them to be imaged without compression. The platform contains the sensors needed to capture the MRI image. It is important to remain very still throughout the exam.

MRI can be used along with mammograms for screening women who have a high risk of developing breast cancer, or it can be used to better examine suspicious areas found by a mammogram. MRI is also sometimes used for women who have been diagnosed with breast cancer to better determine the actual size of the cancer and to look for any other cancers in the breast. It is not yet clear how helpful this is in planning surgery in someone known to have breast cancer. In someone known to have breast cancer, it is sometimes used to look at the opposite breast, to be sure that it does not contain any tumors.

If an abnormal area in the breast is found, it can often be biopsied using an MRI for guidance. This is discussed in more detail in the "Biopsy" section.

Mammograms and Other Breast Imaging Tests has more detailed information about breast MRI.

Other tests

These tests may be done for the purposes of research, but they have not yet been found to be helpful in diagnosing breast cancer in most women.


Nipple discharge exam--
If  having nipple discharge, some of the fluid may be collected and looked at under a microscope to see if any cancer cells are in it. Most nipple discharges or secretions are not cancer. In general, if the secretion appears milky or clear green, cancer is very unlikely. If the discharge is red or red-brown, suggesting that it contains blood, it might possibly be caused by cancer, although an injury, infection, or benign tumors are more likely causes.

Even when no cancer cells are found in a nipple discharge, doctors cannot be sure breast cancer is not present. If you have a suspicious mass, it will be necessary to biopsy the mass, even if the nipple discharge does not contain cancer cells.

Ductal lavage and nipple aspiration

Ductal lavage is an experimental test developed for women who have no symptoms of breast cancer but are at very high risk for the disease. It is not a test to screen for or diagnose breast cancer, but it may help give a more accurate picture of a woman's risk of developing it.

Ductal lavage can be done in a doctor's office or an outpatient facility. An anesthetic cream is applied to numb the nipple area. Gentle suction is then used to help draw tiny amounts of fluid from the milk ducts up to the nipple surface, which helps locate the ducts' natural openings. A tiny tube (called a catheter) is then inserted into a duct opening. Saline (salt water) is slowly infused into the catheter to gently rinse the duct and collect cells. The ductal fluid is drawn through the catheter and sent to a lab, where the cells are looked at under a microscope.


Ductal lavage is not done if a women isn't at high risk for breast cancer. It is not clear if it will ever be useful. The test has not been shown to detect cancer early. It is more likely to be helpful as a test of cancer risk rather than as a screening test for cancer. More studies are needed to better define the usefulness of this test.

Biopsy

A biopsy is done when mammograms, other imaging tests, or the physical exam finds a breast change (or abnormality) that is possibly cancer. A biopsy is the only way to tell if cancer is really present.
During a biopsy, a sample of the suspicious area is removed to be looked at under a microscope, by a specialized doctor with many years of training called a pathologist. The pathologist sends  doctor a report that gives a diagnosis for each sample taken. Information in this report will be used to help manage  care.

There are several types of biopsies, such as fine needle aspiration biopsy, core (large needle) biopsy, and surgical biopsy. Each has its pros and cons. The choice of which to use depends on specific situation.
Fine needle aspiration biopsy

In a fine needle aspiration (FNA) biopsy, the doctor uses a very thin, hollow needle attached to a syringe to withdraw (aspirate) a small amount of tissue from a suspicious area, which is then looked at under a microscope. The needle used for an FNA biopsy is thinner than the one used for blood tests.

If the area to be biopsied can be felt, the needle can be guided into the area of the breast change while the doctor is feeling (palpating) it.

Core needle biopsy

A core biopsy uses a larger needle to sample breast changes felt by the doctor or pinpointed by ultrasound or mammogram.


Vacuum-assisted core biopsies

Another way to do a core biopsy is known as vacuum-assisted. For this procedure, the skin is numbed and a small incision (about ¼ inch) is made. A hollow probe is inserted through the incision into the abnormal area of breast tissue. The probe is guided into place using mammography, ultrasound, or MRI. A cylinder of tissue is then suctioned in through a hole in the side of the probe, and a rotating knife within the probe cuts the tissue sample from the rest of the breast. Several samples can be taken from the same incision. Vacuum-assisted biopsies are done as an outpatient procedure. No stitches are needed, and there is minimal scarring. This method usually removes more tissue than a regular core biopsy.

Surgical (open) biopsy

Usually, breast cancer can be diagnosed using needle biopsy. Rarely, surgery is needed to remove all or part of the lump for microscopic examination. This is referred to as a surgical biopsy or an open biopsy. Most often, the surgeon removes the entire mass or abnormal area as well as a surrounding margin of normal-appearing breast tissue. This is called an excisional biopsy. If the mass is too large to be removed easily, only part of it may be removed. This is called an incisional biopsy.
Lymph node biopsy

If the lymph nodes under the arm are enlarged (either when felt or on an imaging test like mammography or ultrasound), they may be checked for cancer spread. Most often, a needle biopsy is done at the time of the needle biopsy of the breast tumor.

How is breast cancer classified?

After  a biopsy, the samples of breast tissue are looked at in the lab to determine whether breast cancer is present and if so, what type it is. Certain lab tests may be done that can help determine how quickly a cancer is likely to grow and (to some extent) what treatments are likely to be effective. Sometimes these tests aren’t done until the entire tumor is removed by either breast-conserving surgery or mastectomy.

If a benign condition is diagnosed, will need no further treatment. Still, it is important to find out from  doctor if the benign condition puts  at higher risk for breast cancer in the future and what type of follow-up ymight need.

If the diagnosis is cancer, there should be time for  to learn about the disease and to discuss treatment options with cancer care team, friends, and family. It is usually not necessary to rush into treatment. Get a second opinion before deciding what treatment is best.

Breast cancer type

The tissue removed during the biopsy (or during surgery) is first looked at under a microscope to see if cancer is present and whether it is a carcinoma or some other type of cancer (like a sarcoma). If there is enough tissue, the pathologist may be able to determine if the cancer is in situ (not invasive) or invasive. The biopsy is also used to determine the cancer's type, such as invasive ductal carcinoma or invasive lobular carcinoma. See "What is breast cancer?" for more about each type.

With an FNA biopsy, not as many cells are removed and they often become separated from the rest of the breast tissue, so it is often only possible to say that cancer cells are present without being able to say if the cancer is in situ or invasive.

The most common types of breast cancer, invasive ductal and invasive lobular cancer, generally are treated in the same way.

Breast cancer grade

A pathologist also assigns a grade to the cancer, which is based on how closely the biopsy sample looks to normal breast tissue and how rapidly the cancer cells are dividing. The grade can help predict a woman's prognosis. In general, a lower grade number indicates a slower-growing cancer that is less likely to spread, while a higher number indicates a faster-growing cancer that is more likely to spread. The tumor grade is one factor in deciding if further treatment is needed after surgery.

For invasive cancers, the histologic tumor grade is sometimes called the Bloom-Richardson grade, Nottingham grade, Scarff-Bloom-Richardson grade, or Elston-Ellis grade. Sometimes the grade is expressed with words instead of numbers:

Grade 1 is the same as well differentiated
Grade 2 is the same as moderately differentiated.
Grade 3 is the same as poorly differentiated

Grade 3 cancers tend to grow and spread more quickly.


What can I do to reduce my risk of breast cancer?

     The strongest risk factors for breast cancer are things that a woman can’t control, such as age, personal or family history of breast cancer, and age at menopause. Links with diet and obesity have been suggested, and the American Cancer Society advises that maintaining an ideal body weight may reduce breast cancer risk.

Women at high risk due to a family history of the disease should discuss their concerns with their primary care provider. Early detection of breast cancer through clinical breast exams and screening mammograms provides the best means of reducing the risk of breast cancer.

October is Breast Cancer Awareness Month, which is an annual campaign to increase awareness of the disease. While most people are aware of breast cancer, many forget to take the steps to have a plan to detect the disease in its early stages and encourage others to do the same. A lot of progress but still have a long way to go and need  help!


How You Can Help?

There are many ways  can support those affected by breast cancer.
Support will help  provide mammograms, education and support services to women in need
Volunteer to help educate women about breast cancer..
Volunteers Make a Difference!
Spread the word about the importance of early detection and the services.
Join a charity that will work  to create a custom campaign and help make a difference in the fight against breast cancer.
Host a Fundraiser to help provide mammograms for women in need.
Show support. Donation helps provide mammograms for women in need.



                                                   Why you need an
                                                  Early Detection Plan 
1 in 8 women will be diagnosed with breast cancer in her lifetime.
The best way to fight breast cancer is to have a plan that helps detect the disease in its early stages. Create Early Detection Plan to receive reminders to do breast self-exams, and schedule  clinical breast exams and mammograms based on age and health history.

When breast cancer is detected early (localized stage), the 5-year survival rate is 100%


Looking for breast cancer spread

Once breast cancer is diagnosed, one or more of the following tests may be done. These tests aren’t often done for early breast cancer. Which tests (if any) are done depends on how likely it is the cancer has spread, based on the size of the tumor, the presence of lymph node spread, and any symptoms you are having.

Chest x-ray

This test may be done to see whether the breast cancer has spread to your lungs.

Bone scan

A bone scan can help show if a cancer has spread (metastasized) to your bones. It can be more useful than standard x-rays because it can show all of the bones of the body at the same time and can find small areas of cancer spread not seen on plain x-rays.

Computed tomography (CT) scan

The CT scan is an x-ray test that produces detailed cross-sectional images of your body. Instead of taking one picture, like a regular x-ray, a CT scanner takes many pictures as it rotates around you while you lie on a table. A computer then combines these pictures into images of slices of the part of your body being studied. In women with breast cancer, this test is most often used to look at the chest and/or abdomen to see if the cancer has spread to other organs such as the lungs or liver.

Magnetic resonance imaging (MRI) scan

MRI scans use radio waves and strong magnets instead of x-rays to take pictures of the body. See “Can breast cancer be found early?” for more about getting an MRI of the breast.

MRI scans are also used to look for cancer that has spread to various parts of the body, just like CT scans. MRI scans are particularly helpful in looking at the brain and spinal cord.

Ultrasound

The use of this test to look at the breast was discussed in the section “How is breast cancer diagnosed?” But ultrasound can also be used to look for cancer that has spread to some other parts of the body.

Abdominal ultrasound can be used to look for tumors in your liver or other abdominal organs. When you have an abdominal ultrasound exam, you simply lie on a table and a technician moves the transducer on the skin over the part of your body being examined. Usually, the skin is first lubricated with gel.

Positron emission tomography (PET) scan

For a PET scan, glucose (a form of sugar) that contains a radioactive atom is injected into the bloodstream. Because cancer cells grow rapidly, they absorb large amounts of the radioactive sugar. After about an hour, a special camera is used to create a picture of areas of radioactivity in the body.

How is breast cancer staged?

The stage describes the extent of the cancer in the body. It is based on whether the cancer is invasive or non-invasive, the size of the tumor, how many lymph nodes are involved, and if it has spread to other parts of the body. The cancer’s stage is one of the most important factors in determining prognosis and treatment options.

Staging is the process of finding out how widespread a cancer is when it is diagnosed. Depending on the results of your physical exam and biopsy, your doctor may want you to have certain imaging tests such as a chest x-ray, mammograms of both breasts, bone scans, computed tomography (CT) scans, magnetic resonance imaging (MRI), and/or positron emission tomography (PET) scans. Blood tests may also be done to evaluate your overall health and sometimes can indicate if the cancer has spread to certain organs.

The American Joint Committee on Cancer (AJCC) TNM system

A staging system is a standardized way for the cancer care team to summarize information about how far a cancer has spread. The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system.

The stage of a breast cancer can be based either on the results of physical exam, biopsy, and imaging tests (called the clinical stage), or on the results of these tests plus the results of surgery (called the pathologic stage). The staging described here is the pathologic stage, which includes the findings after surgery, when the pathologist has looked at the breast mass and nearby lymph nodes. Pathologic staging is likely to be more accurate than clinical staging, as it allows the doctor to get a firsthand impression of the extent of the cancer.

The TNM staging system classifies cancers based on their T, N, and M stages:

The letter T followed by a number from 0 to 4 describes the tumor's size and spread to the skin or to the chest wall under the breast. Higher T numbers mean a larger tumor and/or wider spread to tissues near the breast.
The letter N followed by a number from 0 to 3 indicates whether the cancer has spread to lymph nodes near the breast and, if so, how many lymph nodes are affected.
The letter M followed by a 0 or 1 indicates whether the cancer has spread to distant organs -- for example, the lungs or bones.

Breast cancer survival rates, by stage

Survival rates are often used by doctors as a standard way of discussing a person's prognosis (outlook). Some patients with breast cancer may want to know the survival statistics for people in similar situations, while others may not find the numbers helpful, or may even not want to know them. If you decide that you do not want to read them, skip to the next section.

The 5-year observed survival rate refers to the percentage of patients who live at least 5 years after being diagnosed with cancer. Many of these patients live much longer than 5 years after diagnosis.
Stage
5-year Relative          Survival Rate

0                                     100%

           

I                                     100%



II                                  93%    


III                                  72%



IV                                   22%

How is breast cancer treated?

These views are based on their interpretation of studies published in medical journals, as well as their own professional experience.This treatment information is not official policy of the Society and is not intended as medical advice to replace the expertise and judgment of  cancer care team.

Doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask him or her questions about  treatment options.It is important to have frank, open discussions with  cancer care team. Don't be afraid to ask questions, no matter how minor  might think they are.


Be sure to write down any questions that occur that are not on this list. For instance want specific information about recovery times so that can plan your work schedule or  may want to ask about second opinions. Taking another person and/or a tape recorder to the appointment can be helpful. Collecting copies of  medical records, pathology reports, and radiology reports may be useful in case wish to seek a second opinion at a later time.


FRIENDS!!!BREAST CANCER-PARTC--Why  need an Early Detection Plan --1 in 8 women will be diagnosed with breast cancer in her lifetime.The best way to fight breast cancer is to have a plan that helps detect the disease in its early stages. Create Early Detection Plan to receive reminders to do breast self-exams, and schedule  clinical breast exams and mammograms based on age and health history.When breast cancer is detected early (localized stage), the 5-year survival rate is 100%.There are many ways  can support those affected by breast cancer.
Support will help  provide mammograms, education and support services to women in need
Volunteer to help educate women about breast cancer..Volunteers Make a Difference!
Spread the word about the importance of early detection and the services.
Join a charity that will work  to create a custom campaign and help make a difference in the fight against breast cancer.Host a Fundraiser to help provide mammograms for women/men in need.
Show support. Donation helps provide mammograms for women/men in need.
http://www.cancer.org/cancer/breastcancer/detailedguide.
http://www.medicalnewstoday.com/articles/37136.php

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