Breast Cancer Resource Center Savannah, GA USA

Education

Information is meant to empower us, not cripple us!  Ask questions!  Be proactive!  You are your number one advocate!

What is Cancer?

Cancer is the uncontrollable growth of cells that destroys body tissue.

What are the different stages of a cancer diagnosis and why is early detection so critical?

The American Cancer Society (ACS) states the 5 year survival rate after diagnosis for each breast cancer stage.  The 5 year survival rate is the probability (based off of data collected from others with a similar diagnosis) of an individual living 5 years or more past their diagnosis.  Please note, that these are estimates not absolutes.  There are no guarantees; no one can predict with absolute certainty your longevity.  Be sure to talk to your medical providers about your cancer, prognosis, and treatment plans.  A cancer stage is determined based off of a series or requirements, including: size, location, lymph node involvement, and metastasis. 

Stage 0 – (also called carcinoma in situ) refers to abnormal cells that haven’t broken free of their duct or lobule, depending on where it originated within the breast.

Stage 1– cancer is localized and small

Stage 2 and Stage 3 – cancer is larger, spread to nearby tissue or lymph nodes

Stage 4 – (also called metastatic breast cancer) cancer has spread to other parts of the body.  Although there is no cure for metastatic, there are treatment options.  Consult with your doctor.

5 Year Survival Rate Based off of Breast Cancer Diagnostic Stage, According to the ACS

5yr survival rate
5yr survival rate ACS

The data speaks for itself.  Early diagnosis equates to a more favorable prognosis.

Early Detection:

So, we know early detection is critical.  Now, what does that actually mean?  What does early detection look like?

Self-breast exams

Hear what survivors urge women and young girls to know: Visit the Survivor link to hear their interviews.

“Everyone has fingers and can do a self-exam.”

“Know your own geography.”

“The best person that knows us, is us.”

“It’s never too early to do your own breast exam.”

Here are directions on how to do a self-breast exam.

Mammograms

Women who are 40 and over should talk to their doctors about when to start and how often they should get a screening mammogram done.  It’s recommended that women have the mammogram performed yearly as part of their regular health maintenance.  A mammogram is essentially an x-ray of the woman’s breast; and it is used as a tool to screen for cancer.  DenseBreast-Info explains the differences in the types of mammography.  You can also learn what your breast density is from a mammogram (and that in and of itself can be indicative of your risk for developing cancer; and your breast density can also help determine what your personal best tools for screening should be.) 

Ultrasounds

Ultrasounds use soundwaves to ‘investigate’ the breast tissue.  The waves create an echo and bounce back off of masses, helping to create an image.  Ultrasounds can be used to discern whether a discovered mass is solid or fluid filled.  Fluid filled masses are cysts and are benign.  Solid filled masses can either be fibroids (benign) or cancer (malignant).  It’s possible that your provider may refer you for a biopsy if a solid mass is noted.

MRIs

MRI stands for Magnetic Resonance Imaging.  This is the test where you lie in a tube for 30-45 minutes while a machine makes a whole bunch of racket around you.  MRIs are LOUD!  They also use a contrast material that is administered intravenously prior to the imaging.  MRIs are sensitive machines; and although they may be capable of seeing things that a mammogram can miss, they do create some “false-positives” because of their sensitivity.  MRIs are also much more expensive.

Does this mean that they shouldn’t be performed?  Well, that’s a matter of perspective; and again, you should talk with your own medical provider to review your personal medical necessity. 

For me personally, the MRI is what found my cancer.  I have dense breasts, and my mammogram had been unable to find it.  (Dense breasts can be like driving in a snowstorm with the windshield wipers on turbo; visibility is low).

What is breast density?

Know your breast density!  Not all breasts are created equal.  Of course they come in different sizes and shapes, but density is a thing too (and that’s not something you can discern just from touching).  Some breasts have dense tissue that makes it difficult to distinguish tissue from masses on mammogram screenings.  I was told that dense breasts look on imaging like you’re driving through a snowstorm with your windshield wipers on turbo, but you still can’t see anything.  Talk to your doctors about your own breast density and what that means for you and your surveillance.  Do you have dense breasts or not?  And what does that mean?

Hear what Deborah Rhodes has to say about a new type of screening that is more efficient with detecting tumors in dense breasts

Breast Basics

The breast is made up of a series of ducts that connect lobules (milk producing glands) to the nipple.

See diagram.

Breast Cancer Defined

I used to think that cancer was distinguished solely by where it was found.  Breast cancer, I concluded, was therefore cancer found in the breast.  This would imply that all breast cancers were created equal; however, that is not the case.  There are several different kinds of breast cancer.  Here’s a quick look at how they are distinguished.

1) Lobular vs Ductal

Cancer can originate in the lobules or the ducts. The lobules are the milk producing glands and the ducts are the tunnels that connect them to the nipple.

2) In Situ vs. Invasive

Your breast is made of a series of ducts that link lobules.  Cancer cells usually begin in one of those locations.  If it stays contained in the duct for example, it is called in situ; whereas once it’s eaten a whole through those ducts and into regular breast tissue, it is called invasive.  Invasive ductal carcinoma is therefore cancer that originated in the ducts, but has broken free into the surrounding breast tissue.  At that point, it can travel to the lymph nodes.

3) How ‘wonky’ is the cancer cell’s nuclei?

They also rank the cancer on a scale based off of how “wonky” the nuclei of the cell looks.  The higher that score, the more “wonky” the nuclei are.

4) Hormone Receptors; HER2

When they biopsy your tumor, they will run tests that determine the presence of hormone receptors.

If someone is estrogen or progesterone positive – that means that their tumor cells have receptors that allow their cancer to grow within the presence of those hormones.  You can think of it like food for the cancer. Estrogen/progesterone positive cancers like to eat (and grow) with those hormones.  When you take those hormones away, then the cancer’s food source is cut off and the cancer is less likely to flourish.  (Estrogen and progesterone negative would mean that the tumor doesn’t have those receptors…aka they don’t eat that food). 

Consequently, estrogen and progesterone positive tumors can be treated with medicine that limits those hormones in the body. However, this hormone therapy would not prove beneficial for estrogen and progesterone negative cancers (because those tumors don’t feed off of that food).

HER2 – refers to the presence of a protein that the cancer makes.

Triple Negative: Means that a cancer is estrogen and progesterone negative (hormone therapy won’t work) AND HER2 negative.  Therefore, triple negative breast cancer is typically more aggressive and harder to treat.

Triple Positive: Means that the cancer is estrogen and progesterone positive AND HER2 positive.  Drugs that lesson the hormone presence AND those that target HER2 could be used

Estrogen and Progesterone positive/ HER2 negative:  Means that the cancer is fed by those hormones and can thus be treated with hormone therapy; but it does not have HER2.

5) Stage 0-4

(grade is given based off a series of criteria: size, location, whether or not it has spread)  See graph above.

Interesting point:  If breast cancer makes it to the lymph nodes and travels (metastasizes) to say, your bones…. That is not referred to as bone cancer.  Rather, it’s stage 4 metastatic BREAST CANCER. (The cancer originated in your breast but moved to a new location).

6) IBC — Inflammatory Breast Cancer

Not all breast cancer has a lump.  IBC, although rare, is an aggressive breast cancer that essentially blocks the lymph system in the breast’s skin causing it to appear inflamed.  For more information about IBC, read what the National Cancer Institute has to say.

Genetics

Genetic testing can examine your genes and find out whether or not you’re at an increased risk for cancer. BRCA 1 and BRCA 2 (commonly referred to as the breast cancer genes) can be detected in this manner. BRCA1 is found on chromosome 17 and BRCA2 is found on chromosome 13. These genes can be inherited from one’s mother or father. Read more on our Genetics post.

Previvors, Survivors, Thrivers

Most of us are familiar with the term ‘survivors.’  The statement, “I’m a breast cancer survivor,” means that one has dealt with a cancer diagnosis, gone through treatment, and emerged on the other side of the battlefield with no evidence of disease.  They have…survived.  We celebrate their victories and applaud their triumphs, as we should.  After all, they survived and their stories often exude hope and courage.  However, hope and courage do not belong exclusively to our survivors.  Previvors and thrivers own them too!  So, what exactly do those terms mean and who are they? 

Previvors’ refers to those who don’t yet have cancer but have an extremely high risk of developing it (often noted by a genetic mutation, such as BRCA).  A BRCA mutation can, for example, increase one’s lifetime susceptibility of developing breast cancer from the general population’s 7.3% risk to an 84% cancer risk!!  THAT is significant. Previvors can choose to get out ahead of cancer by means of prophylactic surgeries.  Prophylactic means: intended to prevent a disease.  So, a prophylactic mastectomy would therefore mean a mastectomy done in order to reduce ones risk of developing breast cancer. For more information on previvors, read our BRCA POST.   

Thrivers’ is a term that some women prefer to use in place of survivor.  Sometimes women feel that if they haven’t reached the end of their treatments, they are unable to claim the mark of ‘survivorhood’.  They may choose to identify themselves as a ‘thriver.’  This term can be used by those who are currently in the midst of their storms as well as those who are dealing with a recurrence and living with metastatic breast cancer.

Epigenetics

Genetics is the study of how traits get passed down from one generation to the next. Epigenetics, having the prefix epi (meaning ‘on top’), refers to how our DNA interacts with proteins and receives notifications of what genes are to be turned on and which are to be turned off.

Tumor suppressor genes- genes that tell old cells when they’ve reached the end of their life cycle and are to die off. If the old cells don’t get the message to die off, then they continue to replicate out of control. That is essentially cancer. So, tumor suppressor genes are good because they prevent those old cells from growing out of hand. Tumor suppressor genes therefore suppress tumor growth.

Analogy: If your DNA is like the blueprint for your house, then epigenetics helps determine which lights in the house are on. (what genes are turned on or off inside individual cells).

Your DNA is the same inside each of your cells. Your skin cells, blood cells, neurons – they all have identical DNA — YOUR DNA. However, these cells look and function differently. Why? Because skin cells have skin cell genes turned on and liver ones turned off. Epigenetics is essentially the study of how certain genes get turned on/off. Remember, we don’t want those tumor suppressor genes to be turned off.

VOCABULARY

DCIS –(Ductal Carcinoma In Situ) – cancer that originated in the ducts and has NOT broken out into surrounding tissue….cancer is contained in its original spot. 

Invasive ductal carcinoma – cancer that originated in the ducts and HAS broken free into surrounding tissue.

Lymph nodes– part of the body’s immune system.  There are 100s throughout the body, connected by a series of vessels; and their job is to help filter and protect your body from harmful substances.  However, if cancer cells reach the lymph nodes, it’s like they’ve made it to your body’s train station.  Cancer can easily hitch a ride to another destination in your body: bones, liver, brain, etc.  It terms of cancer, you do NOT want it to have reached the lymph nodes.

Lymphodema– a condition caused by the removal of lymph nodes; can cause swelling.  Surgeon’s will often remove lymph nodes during surgery to ascertain whether or not cancer had made it there.  It’s an important piece of information to acquire because it can help determine your stage of cancer, treatment plans, and prognosis.  However, the more nodes you have removed, the higher your risk is for developing lymphedema. Read about Risk Reduction practices for lymphedema here.

Metastatic – cancer that has moved to another part of the body.

Neuropathy – loss of feeling/numbness/tingling in your hands or feet due to nerve damage.  It’s a possible side-effect of chemotherapy.

Added Notes

  • Early detection is critical towards maximizing your survival rate. Because when cancer cells reach the lymph nodes, they can then travel to anywhere in the body.  If this happens, it’s considered metastatic breast cancer, and there is no cure.  The earlier you detect and treat breast cancer, the lower your recurrence rate becomes and the higher your survival rate becomes.
  • Bottom line: if you have a concern, bring it up with your doctors.  They don’t know what you don’t tell them.