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BREAST CANCER What you need to know.
• • • • • •
QUESTIONS AND ANSWERS SIGNS AND SYMPTOMS MANAGING YOUR RISK DIAGNOSING A DIAGNOSIS SCREENING GUIDELINES CANCER CARE NAVIGATORS
A SPECIAL PUBLICATION BROUGHT TO YOU BY WINTER PARK MAGAZINE AND THE AMERICAN CANCER SOCIETY BREAST CANCER 101 | 1
While Fannie Hillman + Associates has a lot to smile about, one statistic that gives us great pause is that we have all been affected by cancer in some way. We stand united as a company, as a family and as caring individuals; we are proud to support The American Cancer Society. We remain steadfast and hopeful that a cure will be found. Fannie Hillman + Associates honors all the cancer survivors and we remember, with fondness, our friends, family, neighbors and colleagues who lost their courageous battle.
KNOWLEDGE IS POWER
Need answers? Here are the most commonly asked questions about breast cancer.
A small number of cancers start in other breast tissues, but these are called sarcomas and lymphomas and aren’t really thought of as breast cancers. Although many types of breast cancer can cause lumps, some don’t. Cancer may be discovered through screening mammograms before it can be felt — and before symptoms develop. It’s also important to know that most breast lumps are benign. Noncancerous breast tumors are abnormal growths — but they don’t spread beyond the breast and aren’t life threatening. However, some benign breast lumps can increase your risk of getting breast cancer. Any breast lump or change needs to be checked by a healthcare professional to determine if it’s benign or malignant, and how (or if) it might affect future cancer risk.
HOW DOES BREAST CANCER SPREAD? Breast cancer is a frightening diagnosis. But knowledge is power. The more you know, the more you’ll be able to understand your disease and the treatment options recommended for you. Here are some commonly asked questions about breast cancer:
HOW DOES BREAST CANCER START? Breast cancer starts when breast cells begin to grow out of control. These cells usually form a tumor that can often be seen on an X-ray or felt as a lump. The tumor is malignant if the cells invade surrounding tissues or spread — metastasize — to other areas of the body. Breast cancer occurs almost entirely in women, but men can get the disease, too. Cells in nearly any part of the body can become cancerous and spread.
WHERE DOES BREAST CANCER START? Breast cancer can start in different parts of the breast. Most are ductal cancers, which begin in the ducts that carry milk to the nipple. Some are lobular cancers, which begin in the glands that make breast milk.
Breast cancer can spread when cancer cells invade the blood or lymph system and are carried to other parts of the body. The lymph system is a network of lymph — or lymphatic — vessels that connect lymph nodes, which are small, bean-shaped collections of immune system cells. The clear fluid inside lymph vessels — called lymph — contains tissue byproducts and waste material as well as immune system cells. Lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, malignant cells can enter lymph vessels and start to grow in lymph nodes. Most lymph vessels of the breast drain into: • Lymph nodes under the arm (axillary nodes). • Lymph nodes around the collarbone, above the collar bone (supraclavicular) and below the collarbone (infraclavicular). • Lymph nodes inside the chest near the breast bone (internal mammary lymph nodes). If cancer cells have spread to the lymph nodes, there’s a higher chance that the cells have traveled through the lymph system and spread to Continued on page 6
American Cancer Society Recommendations for the Early Detection of Breast Cancer Guideline for women at average risk for breast cancer
EVERYY YEAR R
Ages 40 – 44
Ages 45 – 54
Age 55 and older
Women should have the option to start screening with a mammogram every year.
Women should get a mammogram every year.
Women can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.
©2019 American Cancer Society, Inc. No. 046010 Rev. 6/19 The American Cancer Society is a qualified 501(c)(3) tax-exempt organization and donations are tax-deductible to the full extent of the law.
BREAST CANCER 101 | 3
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4 | BREAST CANCER 101
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To learn more about us or to get help, visit cancer.org/fightbreastcancer To learn more us or to1-800-227-2345 get help, visit cancer.org/fightbreastcancer or call our live about 24/7 helpline To call learn more us or to1-800-227-2345 get help, visit cancer.org/fightbreastcancer or our live about 24/7 helpline ©2019 American Cancer Society, Inc. No. 005828 or call our live 24/7 helpline 1-800-227-2345 ©2019 American Cancer Society, Inc. No. 005828 ©2019 American Cancer Society, Inc. No. 005828
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BREAST CANCER 101 | 5
SIGNS AND SYMPTOMS Knowing how your breasts normally look and feel is an important aspect of breast health. Finding breast cancer as early as possible increases the chances for successful treatment. But knowing what to look for doesn’t take the place of having regular mammograms and other screening tests, which can help detect the disease in its early stages, before symptoms appear. The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancer — but breast cancer can be tender, soft or rounded. It can also be painful. That’s why it’s important to have any mass, lump or change checked by a healthcare professional experienced in diagnosing breast diseases. Other possible symptoms of breast cancer include:
Continued from page 3
other parts of the body. The more lymph nodes with breast cancer cells, the more likely it is that cancer may be found in other organs. Consequently, finding cancer in one or more lymph nodes usually requires surgery, during which one or more lymph nodes are removed to find out whether the cancer has spread. Still, not all women with cancer cells in their lymph nodes develop metastases, and some women with no cancer cells in their lymph nodes develop metastases later.
HOW COMMON IS BREAST CANCER? In the United States, breast cancer is the second-most common cancer, behind only skin cancer. The average risk of a woman developing breast cancer at some point is about 12 percent. The American Cancer Society’s estimates for breast cancer in the U.S. for 2018 are: • About 266,120 new cases of invasive breast cancer will be diagnosed in women. • About 63,960 new cases of carcinoma in situ (CIS) will be diagnosed. CIS is noninvasive and is the earliest form of breast cancer. • About 40,920 women will die from breast cancer. In recent years, incidence rates have been stable in white women, while they’ve increased slightly in African-American women. Breast cancer is the second-leading cause of cancer death in women, behind only lung cancer. The chance that a woman will die from breast cancer is about 1 in 38, or about 2.6 percent. Death rates from female breast cancer dropped 39 percent from 1989 to 2015. Since 2007, breast cancer death rates have been steady in women age 50 and younger, but they’ve decreased in older women — perhaps because of increased screening and more effective treatments. Today, there are more than 3.1 million breast cancer survivors in the U.S. This includes women still being treated and those who have completed treatment.
6 | BREAST CANCER 101
• • • • • •
Swelling of all or part of a breast, even if no distinct lump is felt. Skin irritation or dimpling, sometimes resembling an orange peel. Breast or nipple pain. Nipple retraction, or a turning inward of the nipple. Redness, scaliness or thickening of the nipple or breast skin. Nipple discharge other than breast milk.
Sometimes, breast cancer can spread to lymph nodes under the arm or around the collarbone and cause a lump or swelling before the original breast tumor is large enough to be felt. Swollen lymph nodes should also be checked by a healthcare professional. Any of these symptoms can be caused by factors other than breast cancer. But if you have them, don’t ignore them.
Making Strides Against Breast Cancer of Orlando Let’s get together and celebrate! Saturday, October 26, 2019
Lake Eola Park Stage Located on Corner of Eola & Robinson 566 E. Robinson St Orlando, FL 32801
7 A.M. Check In 7:30 A.M. Opening Ceremonies 9 A.M. Walk Begins Register your team or donate today at www.OrlandoStrides.com
Š2019, American Cancer Society, Inc. No 031598
MANAGING YOUR RISK There’s no certain way to prevent breast cancer. So how great is your risk? And what can you do to mitigate that risk? There are some factors — such as heredity — over which you have no control. But there are many lifestyle factors that can be modified. Here are breast cancer risk factors that can’t be changed: • GENDER. Being female is the primary risk factor for breast cancer. Men can get breast cancer, too, but it’s about 100 times more common in women than in men. • AGE. The passage of time increases the risk of breast cancer. Most breast cancers are found in women age 55 and older. • HEREDITY. About 5 to 10 percent of breast cancers are thought to be hereditary. Mutations in the BRAC genes are the most common causes of inherited breast cancer. • FAMILY HISTORY. About 80 percent of women who get breast cancer don’t have a family history of the disease. But women with close blood relatives who’ve had breast cancer are at a higher risk. • PERSONAL HISTORY. A woman with cancer in one breast is at a higher risk of developing a new cancer in the other breast, or in another part of the same breast.
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• RACE AND ETHNICITY. Overall, white women are slightly more likely to develop breast cancer than African-American women. But in women under age 45, breast cancer is more common in African-Americans. • EARLY MENSTRUATION. Women who’ve had more menstrual cycles because they started menstruating early — especially before age 12 — are at a slightly higher risk of breast cancer. This may be due to a longer lifetime exposure to the hormones estrogen and progesterone. • LATE MENOPAUSE. Women who’ve gone through menopause at age 55 or older are at a slightly higher risk of breast cancer. This, too, may be due to a longer lifetime of exposure to the hormones estrogen and progesterone. • RADIATION TREATMENT TO THE CHEST. Women who were treated with radiation therapy to the chest for another cancer are at a higher risk for breast cancer. The risk is most pronounced for those who were treated as teenagers or young adults. Radiation after age 40 doesn’t seem to increase breast cancer risk. • DENSE BREAST TISSUE. Dense breasts can be six times more likely to develop cancer because they have less fatty tissue and more nonfatty tissue compared to breasts that aren’t dense. Density also makes it more difficult for mammograms to detect breast cancer. However, there are plenty of identifiable risk factors that are related to lifestyle choices. These can be changed or modified to reduce your risk: • ALCOHOL CONSUMPTION. Compared with nondrinkers, women who have one alcoholic drink a day are at a very small increased breast cancer risk. Those who have two to three drinks a day, however, are at about a 20 percent higher risk compared to women who don’t drink at all. Excessive alcohol consumption is known to increase the risk of other cancers, too. The American Cancer Society recommends that women who drink have no more than one drink a day. • WEIGHT AND OBESITY. Before menopause, the ovaries make most of the body’s estrogen. After menopause, the hormone comes primarily from fat tissue. Having more fat tissue can raise estrogen levels and increase breast cancer risk. Also, women who are overweight tend to have higher blood insulin levels, which has also been linked to some cancers — including breast cancer. • INACTIVITY. Evidence is growing that regular physical activity reduces breast cancer risk, especially in women past menopause. The American Cancer Society recommends that adults engage in at least 150 minutes of moderate activity, or 75 minutes of vigorous activity, every week. • NOT HAVING CHILDREN. Women who haven’t had children, or who had their first child after age 30, are at a slightly higher breast cancer risk. Having many pregnancies and becoming pregnant at an early age reduces breast cancer risk. Still, the effect of pregnancy seems to vary, depending upon the type of breast cancer. For a breast cancer known as triple-negative, pregnancy seems related to an increased risk. • NOT BREASTFEEDING. Some studies suggest that breastfeeding may slightly lower breast cancer risk, especially if it’s continued for up to two years. It may be that breastfeeding reduces a woman’s total number of lifetime menstrual cycles — the same as starting menstrual periods at a later age or going through early menopause. • BIRTH CONTROL. Some birth control methods use hormones, which might increase breast cancer risk. These include oral contraceptives and birth control injections as well as birth control implants, IUDs, patches and vaginal rings. When considering hormonal birth control, women should discuss their other breast cancer risk factors with a healthcare professional.
• HORMONE THERAPY AFTER MENOPAUSE. Hormone therapy with estrogen — often combined with progesterone — has been used for many years to help relieve symptoms of menopause and prevent osteoporosis. The decision to use hormone therapy should be made by a woman and her doctor after weighing the possible risks and benefits — including the severity of her menopausal symptoms and her risk factors for heart disease, breast cancer and osteoporosis. If they decide she should try hormone therapy, it’s best to use it at the lowest effective dose and for as short a time as possible. There are many factors that research has shown are not linked to breast cancer, despite sometimes widespread belief to the contrary. It’s important to learn the facts: • ANTIPERSPIRANTS. Internet and e-mail rumors have suggested that chemicals in underarm antiperspirants are absorbed through the skin, interfere with lymph circulation and cause toxins to build up in the breast, eventually leading to breast cancer. Based upon the available evidence, there’s little if any reason to believe that antiperspirants increase the breast cancer risk. • BRAS. Internet and e-mail rumors and at least one book have also suggested that bras cause breast cancer by obstructing lymph flow. There’s no good scientific or clinical basis for this claim. Indeed, a 2014 study of more than 1,500 women found no association between wearing a bra and breast cancer risk. • INDUCED ABORTION. Several studies have provided very strong data showing that neither induced nor spontaneous abortions — miscarriages — increase breast cancer risk. • BREAST IMPLANTS. Silicone breast implants can cause scar tissue to form in the breast, making breast tissue harder to see on standard mammograms. But additional X-ray pictures called implant displacement views can be used to examine breast tissue more completely. If cancer develops after an implant, it can show up as a lump, pain, swelling, fluid near the implant or breast asymmetry. It usually responds well to treatment. For women without other risk factors, the American Cancer Society’s advice is to maintain a healthy weight — especially following menopause — and to stay physically active. Limit or avoid alcohol. Women who have existing risk factors can take additional precautions, if they choose. Medicines such as tamoxifen and raloxifene block the action of estrogen in breast tissue. Tamoxifen can be taken premenopause, while raloxifene is only for post-menopausal women. Drugs called aromatase inhibitors may be another option for post-menopausal women. However, all these medicines can have side effects, so it’s important to understand the benefits and risks. For a small number of women who are at a very high risk for breast cancer, surgery to remove the breasts before the disease develops may be an option. Another option may be to remove the ovaries, which are the main source of the body’s estrogen. While surgery can lower the risk of breast cancer, it can’t eliminate it completely. And surgery, of course, has its own side effects. Before deciding which, if any, of these options may be right for you, talk with your healthcare professional to understand the extent to which any of these approaches might lower your risk factor. For women at increased risk who don’t want to take medicines or have surgery, another option is to schedule more frequent physician visits and tests.
DIAGNOSING A DIAGNOSIS Although breast cancer is sometimes found after symptoms appear, many women who develop the disease have had no symptoms. If your doctor finds an area of concern following a screening mammogram, or if you have symptoms that could mean breast cancer, you’ll likely need follow-up tests, possibly including: • • • •
Additional mammograms. Breast ultrasounds. Breast MRI scans. Newer and experimental breast imaging tests.
A biopsy is performed when such tests indicate breast cancer. If the disease is confirmed, and your doctor suspects that it may have spread, you may need chest X-rays, bone scans, CT scans, PET scans or MRI scans on other parts of your body. You’ve probably heard many different terms used to describe your cancer. Doctors use information from your biopsy to learn important information about the kind of cancer you have. There are many types of breast cancer. The most common types are ductal carcinoma in situ, invasive ductal carcinoma and invasive lobular carcinoma. The type of breast cancer you have is determined by the specific breast cells affected. Most breast cancers are carcinomas, which are tumors that start in the epithelial cells that line organs and tissues throughout the body. Continued on page 12
BREAST CANCER 101 | 9
Breast Cancer Fact Sheet Breast cancer develops from cells in the breast. The most common sign of breast cancer is a new lump or mass, but most are benign. Other signs include a generalized swelling of part of a breast (even if no lump is felt), skin irritation or dimpling, nipple pain or retraction, redness or scaliness of the nipple or breast skin, or a spontaneous discharge other than breast milk. Opportunities Prevention We don’t know how to prevent breast cancer, but it’s possible for a woman of average risk to reduce her risk of developing the disease. Lifestyle factors, such as reducing alcohol use, breast-feeding, engaging in regular physical activity, and staying at a healthy weight, are all associated with lower risk. Estrogen-blocking drugs, such as tamoxifen and raloxifene, can reduce the risk of developing breast cancer in some high-risk women. Some risk factors can’t be changed, such as age, race, family history of disease, and reproductive history.
•
Women ages 45 to 54 should get mammograms every year.
•
Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.
•
Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.
•
All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.
Detection The earlier breast cancer is found, the better the chances for successful treatment. A mammogram can often show breast changes that may be cancer before physical symptoms develop. For this reason, the American Cancer Society recommends the following guidelines for finding breast cancer early:
•
Screening MRI is recommended for women at high risk of breast cancer, including women with a strong family history of breast or ovarian cancer, those with a lifetime risk of breast cancer of about 20% to 25% or greater according to risk assessment tools that are based mainly on family history, those with a known breast cancer gene mutation, and women who were treated with radiation therapy to the chest when they were between the ages of 10 and 30.
•
Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so.
cancer.org | 1.800.227.2345
Treatment Treatment is most successful when breast cancer is detected early. Depending on the situation and the patient’s choices, treatment may involve breast conservation surgery or mastectomy. In both cases, lymph nodes under the arm may also be removed. Women who have a mastectomy have several options for breast reconstruction.
Breast cancer in the United States: 2018 estimates • New cases • Women: 266,120
Other treatments are radiation therapy, chemotherapy, hormone therapy, and monoclonal antibody therapy. Often 2 or more methods are used in combination. Patients should discuss all treatment options with their doctors.
• Men: 2,550
Who is at risk?
• 5-year relative survival rate for localized stage: 99%
Gender Being a woman is the greatest risk factor for breast cancer; however, men also can develop breast cancer. Age The risk of developing breast cancer increases with age. Most invasive breast cancers are primarily found in women age 55 or older. Heredity Breast cancer risks are higher among women with a family history of the disease. Having a first-degree relative with breast cancer increases a woman’s risk, while having more than one first-degree relative who has or had breast cancer before the age of 40 or in both breasts increases a woman’s risk even more. However, it’s important to remember that most women with breast cancer don’t have a first-degree relative with the disease.
• Deaths • Women: 40,920 • Men: 480
• 5-year relative survival rate for all stages combined: 92% for white women and 83% for African American women
Quality-of-life issues From the time of diagnosis, the quality of life for every cancer patient and survivor is affected in some way. They may be affected socially, psychologically, physically, and spiritually.
•
Post-menopausal hormone therapy with estrogen and progesterone therapy
•
Being overweight or obese, especially after menopause
•
Alcohol use
•
Physical inactivity
•
Long menstrual history
Concerns that patients and survivors most often express are fear of recurrence; chronic and/or acute pain; sexual problems; fatigue; guilt for delaying screening or treatment, or for doing things that may have caused the cancer; changes in physical appearance; depression; sleep difficulties; changes in what they are able to do after treatment; and the burden on finances and loved ones. Women with breast cancer often feel uncertainty about treatment options and have concerns about their fatigue, sexuality, and body image.
•
Never having children or having first live birth after age 30
Bottom line
•
Previous history of breast cancer or certain benign breast conditions
Other risk factors
Regular mammograms can help find breast cancer at an early stage, when treatment is most successful. A mammogram can find breast changes that could be cancer years before physical symptoms develop. Some things that may help reduce a woman’s risk of getting breast cancer include being physically active, staying at a healthy weight, and limiting alcohol use.
Written January 2017
©2017, American Cancer Society, Inc. No.300202 Rev. 3/18 Models used for illustrative purposes only.
Continued from page 9
There are much less common types of breast cancer, such as sarcomas, phyllodes, Paget disease and angiosarcomas, which start in the cells of the fat, muscle or connective tissue. Sometimes a single breast tumor can be a combination of different types. And in some very rare cases, the cancer cells may not form a lump or tumor at all. Cancer cells are given a grade when they’re removed from the breast and checked under a microscope. The grade is based on how much the cancer cells look like normal cells. Sometimes words such as “well differentiated,” “moderately differentiated” and “poorly differentiated” are used instead of numbers to describe the grade: • GRADE 1, OR WELL DIFFERENTIATED. The cancer cells are slowergrowing and look more like normal breast tissue. • GRADE 2, OR MODERATELY DIFFERENTIATED. The cancer cells are growing at a speed somewhere between grades 1 and 3, and look like cells somewhere between grades 1 and 3. • GRADE 3, OR POORLY DIFFERENTIATED. The cancer cells look very different from normal cells, and will probably grow and spread faster. Doctors will then try to determine if the cancer has spread and, if so, how far. This process is called staging. The stage describes how much cancer is in the body and informs the most appropriate treatment options. A cancer’s stage is also used in discussions about survival statistics. The earliest-stage breast cancer is Stage 0 (carcinoma in situ). It then ranges from Stages I through IV. As a rule, the lower the number, the less the cancer has spread. Survival rates show what portion of people with the same type and stage of cancer are still alive after a certain amount of time — usually five years — has elapsed since they were diagnosed.
ASK DETAILED QUESTIONS It’s important to have frank, open discussions with your cancer-care team so that you can make informed treatment decisions. Don’t be afraid to take notes and tell doctors or nurses when something they say is unclear. You might want to bring another person with you on appointments and have that person take notes for you. Not all the questions below will apply to you, but they should help get you started. Be sure to write down some questions of your own. And keep in mind that doctors aren’t the only ones who can provide information. Other healthcare professionals, such as nurses and social workers, can be helpful and informative.. Here are some questions to ask when you’re told that you have breast cancer: • • • • • • • • • • • • •
Exactly what type of breast cancer do I have? How big is the cancer? Where exactly is it? Has the cancer spread to my lymph nodes or other organs? What’s the stage of the cancer? What does that mean? Will I need any other tests before we can decide on treatment? Do I need to see any other doctors or healthcare professionals? What’s the hormone receptor status of my cancer? What does this mean? What’s my HER2 (a gene that can play a role in the development of breast cancer) status? What are the implications? How do these factors affect my treatment options and long-term prognosis? What are my chances of survival, based on my cancer as you see it? Should I think about genetic testing? What are my testing options? Should I take a home-based genetic test? What would the pros and cons of testing be? How do I get a copy of my pathology report? If I’m concerned about the costs and insurance coverage for my diagnosis and treatment, who can help me?
Here are some questions to ask when you’re deciding upon a treatment plan: • • • • • • • • • • • • • •
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How much experience do you have treating this type of cancer? Should I get a second opinion? How do I do that? What are my treatment choices? What treatment do you recommend and why? Should I consider taking part in a clinical trial? What would the goal of treatment be? How soon do I need to start treatment? How long will treatment last? What will it be like? Where will it be done? What should I do to get ready for treatment? What risks or side effects are there to the treatment you suggest? What can I do to reduce these side effects? How will treatment affect my daily activities? Can I still work full time? Will I lose my hair? If so, what can I do about it? Will I go through menopause because of treatment? Will I be able to have children after treatment? Will I be able to breastfeed? What are the chances the cancer will recur after treatment?
• What would we do if treatment doesn’t work or if the cancer comes back? • What if I have transportation problems getting to and from treatment? Here are some questions to ask if you’re told that you’ll need surgery as part of your treatment: • Is breast-conserving surgery (lumpectomy) an option for me? Why or why not? • What are the pros and cons of breast-conserving surgery versus mastectomy? • How many surgeries like mine have you done? • Will you have to take out lymph nodes? If so, would you advise a sentinel lymph node biopsy? Why or why not? • What side effects might lymph node removal cause? • How long will I be in the hospital? • Will I have stitches or staples at the surgery site? Will there be a drain coming out of the site? • How do I care for the surgery site? Will I need someone to help me? • What will my breasts look and feel like after treatment? • What will the scar look like? • Is breast reconstruction surgery an option if I want it? What would it mean in my case? • Can I have reconstruction at the same time as surgery to remove the cancer? What are the pros and cons of having it done right away versus waiting until later? • What types of reconstruction might be options for me? • Should I speak with a plastic surgeon about reconstruction options? • Will I need a breast prosthesis and, if so, where can I get one? • Do I need to stop taking any medications or supplements before surgery? • When should I call your office if I’m having side effects?
Here are some questions to ask during the course of your treatment: • • • • • • •
How will we know if treatment is working? Is there anything I can do to help manage side effects? What symptoms or side effects should I tell you about right away? How can I reach you on nights, holidays or weekends? Will I need to change what I eat during treatment? Are there any limits on what I can do? Can I exercise during treatment? If so, what kind of exercise should I do, and how often? • Can you suggest a mental health professional I can see if I start to feel overwhelmed, depressed or distressed? • Will I need special tests, such as imaging scans or blood tests? How often? Here are some questions to ask after the course of your treatment is complete: • Will I need a special diet after treatment? • Are there any limits on what I can do? • Am I at risk for lymphedema (swelling most commonly caused by the removal of lymph nodes)? • What can I do to reduce my risk for lymphedema? • What should I do if I notice swelling in my arm? • What other symptoms should I watch for? What kind of exercise should I do now? • What type of follow-up will I need after treatment? • How often will I need to have follow-up exams, blood tests or imaging tests? • How will we know if the cancer has come back? What should I watch for? • What will my options be if the cancer comes back?
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SCREENING GUIDELINES The American Cancer Society’s breast cancer screening guidelines are developed to save lives by finding breast cancer early, when treatment is more likely to be successful. The society regularly reviews current research, and updates screening recommendations when new evidence suggests that a change may be needed. Here’s a summary of current guidelines: • Women with an average risk of breast cancer — most women — should have yearly mammograms from age 45 to 54. • Women from age 40 to 44 should have the option of yearly mammograms if they so choose. • Women at age 55 should switch to mammograms every other year — but can continue yearly mammograms if they so choose. • Women should continue regular mammograms as long as they’re in good health and can expect to live for 10 more years or longer. These guidelines are for women at average risk for breast cancer. Women at high risk — because of family history, a breast condition or another reason — need to be more proactive. For those women, a screening MRI is recommended. The goal for all women is to detect and treat cancer early. But remember, mammograms aren’t perfect. They find most, but not all, cancers. Sometimes, mammograms raise suspicions that turn out to be nothing significant. These seemingly abnormal findings must be investigated using additional tests that carry risks of pain, anxiety and other side effects. Healthcare professionals and their patients should weigh benefits against risks when determining who should be screened and to what extent. Breast self-exams are no longer recommended because research doesn’t show that they provide a clear benefit. Still, the American Cancer Society says that all women should be familiar with how their breasts normally look and feel — and report any changes right away. Learn more about breast cancer screening by calling the American Cancer Society at 1-800-227-2345 or visiting cancer.org/breastcancer.
HELP IS JUST A CALL AWAY Have you or someone you know just been diagnosed with any kind of cancer? The American Cancer Society offers a nationwide cancer information line 24 hour a day, seven days a week. Since 1997, the National Cancer Information Center (NCIC) has been there every step of the way for millions of cancer patients and their loved ones, answering questions, suggesting resources, locating clinical trials, offering health insurance assistance, assisting with transportation and lodging requests or just lending a compassionate ear. Cancer patients who may benefit from the NCIC Health Insurance Assistance Service (HIAS) speak to specialists who work to address their specific needs. Help is available for those who are: • • • • •
Seeking health insurance coverage. Losing health insurance in the short term. Experiencing life changes that impact their health insurance status. Facing unmet needs despite having health insurance. Fighting claim denials and other difficulties with coverage.
HIAS will also speak with concerned family members, friends and healthcare professionals. To learn more, call 1-800-227-2345 anytime, day or night, or visit cancer.org/breastcancer.
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NAVIGATING CANCER CARE If you have breast cancer — or any kind of cancer — you need information and resources fast. What If there was a person who could help you find answers? There is — through the American Cancer Society’s Patient Navigator Program. Patient navigators will help guide you through every step of the journey, from diagnosis through treatment and beyond. You can talk to a patient navigator about whatever your concerns are — and be assured of privacy as well as help and compassion from someone trained to give you all the information you need. You can meet one-on-one with a patient navigator as many times as you please, and the service is free. A patient navigator can help you learn about your cancer and treatment options, and can assist in finding lodging and transportation. He or she can also assist in formulating questions for your physicians, locate support groups you may wish to join and get answers to your questions about finances and insurance. Ask your healthcare professional about the Healthcare Navigator Program. You can also call 1-800-227-2345 or visit cancer.org/breastcancer.
LEND A HAND, GIVE A RIDE Every day, thousands of cancer patients need rides to treatment. But some don’t have a way to get there. The American Cancer Society Road to Recovery program provides a solution. The society currently has nearly 10,000 Road to Recovery drivers nationally. But the need for drivers is greater than the number of volunteers. In many communities, due to the lack of drivers, transportation needs can go unmet. That’s why volunteer drivers are needed. The society offers training and coordination, while drivers donate their time and offer as many rides as they wish according to their schedules. Can you help? All drivers must have: • • • • •
A current, valid driver’s license. A good driving record. Access to a safe, reliable vehicle. Regular desktop, laptop or tablet computer access. Proof of car insurance.
The American Cancer Society stands shoulder to shoulder with cancer patients and those supporting them and is focused on improving patient access to quality care — including transportation. To learn more about volunteering for the Road to Recovery program, call 1-800-227-2345 or visit cancer.org/breastcancer.
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