Breast cancer affects many women all over the world and odds are you know someone who has it or has had it.
A few statistics
- 1 in 8 women in the United States will develop breast cancer during their lifetime. That’s about 13 percent.
- This year alone it is estimated that 287,850 new cases of invasive breast cancer will be diagnosed in this country.
- 2710 new invasive cases in men are expected this year
- Men carry a higher mortality rate than women because of lack of awareness
- Men’s lifetime risks of getting breast cancer are 1 in 833
- 530 men will die from breast cancer
- Men with breast cancer are more likely to get prostate cancer as well
- 43,250 women are expected to die from breast cancer
- Between 2013-2018 there has been a 1% per year decline in death rates
- Breast cancer has the second-highest death rate
- There are 3.8 million women in the U.S. with a history of breast cancer including those currently being treated and those that have completed treatment
In this month’s blog, we will be discussing the signs and symptoms, what your risk of getting breast cancer might look like, when to call your doctor and the available treatments.
Breast cancer can begin in one or both breasts and it’s more common in women than men, but men can also have breast cancer.
As we age, we develop lumps in our breasts, most are benign or non-cancerous and rarely spread outside of the breast. Most are not life-threatening, however, some types of lumps can elevate a woman’s risk of getting breast cancer.
Cancer can start in different parts of the breast for example the lobules, ducts, nipple, blood vessels or lymph vessels. A less common cancer called angiosarcoma can start in these vessels. Lobules are the glands that make breast milk, cancer that starts here is called lobular cancer. The ducts are small canals that carry milk to the nipple, cancer that starts here is called ductal cancer. A less common cancer called Paget’s disease can start in the nipple.
Breast Cancer Symptoms
Some symptoms include a new lump or mass, swelling in all or parts of the breast, breast pain or nipple pain, retracting (turning inward) of the nipple, skin of the nipple or breast that is dry, flaking, or thickened and nipple discharge other than breast milk. Swollen lymph nodes under the arm or collarbone can be a sign that cancer has spread before the original breast tumor is large enough to be felt.
These symptoms can also be caused by benign or non-cancerous breast conditions. However,
if you are experiencing any of these symptoms you should set up an appointment with your doctor.
Screenings for women of average risk can start as early as age 40-45, women at age 45-54 should have a mammogram annually. Women at age 55 and older can continue with annual mammograms or switch to every other year if they are healthy and have a life expectancy of 10 or more years.
How do you know if you are at risk?
According to the American Cancer Society (ACS), you should include the medical history of first- and second-degree relatives on both the maternal and paternal side of your family. So, be sure to include your parent, sibling, aunts and cousins when trying to determine your risk.
Risk assessment tools help medical professionals estimate a woman’s risk for breast cancer. Estimates are based on different combinations of risk factors and data. Because of these tools more than one result can apply to the same woman. A woman’s risk can also change with age.
Is there a way to lower your risk of breast cancer?
While there is no way to prevent it there are things you can do to lower your risk. Maintaining a healthy weight, getting 150-300 minutes per week of moderate exercise or 75-150 minutes per week of vigorous exercise and avoiding alcohol can help.
In a 2002 landmark study that comprised of about 50,000 breast cancer cases from 47 epidemiologic studies in 30 countries found that the risk for breast cancer in women is reduced by 4.3% for every 12 months a woman breastfeeds and is reduced by 7% for each birth. In 2013 review of 32 studies concluded that the risk of having breast cancer was 14% lower in women who had breastfed compared to women who never breastfed. The effects of breastfeeding regardless of the number of births was even greater for women who had cumulatively breastfed for 12 months or longer. They had a 28% lower risk of breast cancer. Breastfeeding prevents almost 20,000 annual deaths from breast cancer and that an additional 20,000 could be prevented by increasing breastfeeding to 12 months per child.
Hormone therapy to treat symptoms of menopause can increase your risk so if you are experiencing symptoms talk to your doctor about non-hormonal treatment options.
What if you are high- risk?
If you are in the high-risk category, it is recommended that you have a breast MRI and mammogram every year starting at age 30. This includes women who have a lifetime risk of 20%-25% or greater based on family history and risk assessments. If you have a known BRCA1 or BRCA2 gene mutation based on genetic testing or a 1st degree relative with this gene mutation and you have not had genetic testing done. You are also considered high-risk if you had radiation therapy to the chest between 10 and 30 years of age. If you or a first-degree relative have these syndromes, Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome you would be in the high-risk category
MRI is not recommended for women whose lifetime risk is less than 15 percent. For women with a higher risk there is not enough evidence to recommend for or against yearly MRI based on your personal history of breast cancer, ductal carcinoma in-situ (DCIS), lobular cancer in-situ (LCIS), atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH), or extremely dense breasts seen on a mammogram.
If MRI is used, it should be in addition to a screening mammogram and not instead of it. MRI’s are more likely to find cancer but may miss cancer that a mammogram would find.
Mammograms are not perfect either, they can miss some cancers. If something is found on a mammogram you will likely need other tests such as an ultrasound to confirm the diagnosis. With mammograms there is also a small chance of being diagnosed with a cancer that would never have caused any problems had it not been found on a screening. They call this overdiagnosis. It’s important to understand the benefits and limitations of a screening.
Digital breast tomosynthesis is a 3D mammogram and it’s getting to be more common than the 2D mammogram. It’s more expensive, not always covered by insurance and it’s not available everywhere. It does find more cancers which is more helpful for women with dense breasts.
Clinical breast exams and self-breast exams have no clear benefit although it’s important to be familiar with how the breasts look and feel so you can report any changes or abnormalities to your doctor.
If you are in the high-risk category, some things to consider are getting genetic counseling and/or testing, talking to your doctor about medication to reduce your risk, preventive surgery or close observation.
Medications that reduce the risk of breast cancer are Tamoxifen before you reach menopause. The Raloxifene you would take after menopause. Both of these medications block the effects of estrogen on breast tissue. This may stop the development of tumors that need estrogen to grow and is used to treat all stages of hormone receptor positive breast cancer in both women and men. Aromatase inhibitors are also taken after menopause. Talk to your doctor about potential the side effects of these and all medications.
Other treatment options include local surgery or radiation which allows treatment of the tumor without affecting the rest of the body. Surgery options range from breast-conserving also called lumpectomy, quadrantectomy, partial mastectomy or segmental mastectomy, where the cancer is removed along with some healthy tissue to radical surgery where the entire breast(s) is removed along with the lymph nodes.
Other Surgery Options include:
- Sentinel Lymph Node Biopsy (SLUB)-dye is injected, then the lymph node under the arm is removed that has absorbed the dye. Cancer would likely spread there first.
- Axillary Lymph Node Dissection-does not use dye, instead the surgeon removes many lymph nodes under the arm. This is procedure is not done as frequently as in past years.
After surgery you might be thinking about breast reconstruction. Some have the reconstruction done immediately after the breasts are removed and some choose to wait awhile. Either way, it’s important to discuss your options with your doctor prior to your initial surgery. The type of reconstruction surgery depends on the individual situation.
Metastatic breast cancer or MBC has four stages, and is considered advanced breast cancer. Stage 3 means that it has spread beyond the breast into nearby lymph nodes and muscles.
Stage 4 means that is has spread to the liver, brain, or bones. Metastatic breast cancer can show up 5, 10, or even 15 years after early-stage diagnosis.
Symptoms of metastatic breast cancer are fever, poor appetite, bloating, unintended weight loss, pain or discomfort in the midsection and jaundice among others.
There is no cure for metastatic breast cancer so the concentration by medical professionals is to slow the progression with treatment. With treatment, the five-year survival rate is 23%. If cancer has spread to the liver and the patient decides to discontinue treatment due to age or some other reason the survival rate drops to 4-8 months.
Alternative or Integrative therapies
Studies have shown that acupuncture can help reduce the effects of chemo and other cancer treatments. Side effects of treatment can cause nausea, vomiting, fatigue, hot flashes and pain. In a study by Duke University in 2002 acupuncture worked better than Zofran an anti-nausea medication before breast cancer surgery. Thirty-six percent of patients saw a reduction in pain after two months of acupuncture according to a French study in 2003. In 2004 Memorial Sloan-Kettering Cancer Center saw a 31% reduction in post-chemotherapy fatigue in patients experiencing various cancers. In 2005 a study in Sweden showed acupuncture helped reduce hot flashes by half.
Massage therapy can also help to significantly reduce the effects of breast cancer treatments, such as reducing pain, and alleviating stress, nausea, vomiting, depression, and anxiety, it can help improve sleep and lessen fatigue, help to prevent chemotherapy-induced peripheral neuropathy and relieve lymphedema.
Pain is the most common and debilitating symptom among cancer patients. Depending on the type and stage of the cancer studies show that 50% of patients undergoing cancer therapy and 90% of patients with advanced cancer experience pain.
Chemotherapy is an aggressive form of treatment and most often comes with severe nausea and sometimes vomiting. In a 2018 study, consisting of 3 groups, 1 group received massage therapy, the second group received inhalation therapy and the 3rd was a controlled group receiving routine treatment. The group receiving a 20-minute foot massage before the 2nd, 3rd and 4th chemo cycles significantly reduced nausea when compared to patients receiving 3-minute inhalation therapy on the same schedule and a group of patients in a controlled study.
If lymph nodes were removed it’s important to have the upper extremity drained using light pressure, this keeps the lymph vessels open and working. It’s important to have awareness because the effects of lymphedema are long-lasting and do not fade easily.
Acupuncture and massage therapies have shown great success in alleviating some of the debilitating symptoms and side effects of breast cancer treatments. If you or a loved one are experiencing any of these symptoms ask your doctor if acupuncture and massage are appropriate for you. Going through cancer and treatment is traumatic. Acupuncture and massage can help relieve and reduce some of the symptoms and have you feeling better so you can enjoy life more.
Something else to consider is the effect of diet in relation to cancer. According to the Mayo Clinic’s website (see link below) people who eat less meat or none at all have a much lower cancer rate than those that do. Vegans, who don’t eat any animal products at all, have the lowest cancer rate followed but vegetarians who may eat some animal products such as fish, milk and eggs, have the second lowest rate of cancer. The reason? Phytochemicals or plant chemicals protects cells from damage. Plant-based foods help boost fiber consumption. Young women who have diets that are high in fiber are 25% less likely to get breast cancer later in life.
Red meat produces a chemical compound when cooked that is thought to be cancer-causing. Processed meats also contain a compound that is found to contribute.
Making a dietary change and finding balance can sometimes be difficult, especially if you love eating meat, but it doesn’t have to be. Adopt a “Meatless Monday” to start and then increase slowly. Experiment with plant-based food and recipes. You’re more likely to stick to a healthy habit at the beginning of the week. Try bulking up on beans, lentils and vegetables. Treating meat as a condiment and using it to add flavor instead of the main course can also be beneficial. For example, try cutting turkey bacon into small pieces and sprinkling it on a pita pizza.
Slow Cooker Minestrone Soup
- 1 small red or yellow onion diced
- 2 small carrots diced
- 2 celery stalks diced
- 4 cloves garlic minced
- 1 1/2 cups fresh green beans trimmed and cut into 1/2-inch pieces
- 1 28 oz can diced tomatoes, with juices
- 6 cups vegetable broth
- 1 15 oz can red kidney beans, rinsed and drained
- 1 15 oz can cannellini beans or Great Northern beans, rinsed and drained
- 2 bay leaves
- 1 teaspoon dried oregano
- 1 teaspoon dried basil
- 1/2 teaspoon dried rosemary
- 1/8 teaspoon red pepper flakes
- 1 small zucchini diced
- 1/2 cup dried whole wheat elbow pasta can use gluten-free pasta
- 1 cup chopped fresh spinach
- Salt and black pepper to taste
- Freshly-grated Parmesan cheese for serving, optional
- Combine the onion, carrots, celery, garlic, green beans, tomatoes, broth, and beans in a 6-quart slow cooker. Add the bay leaves, oregano, basil, rosemary, and red pepper flakes. Cover and cook on low for 6-8 hours or on high for 3-4 hours.
- 30-40 minutes before the soup is done cooking, add in the zucchini, pasta, and spinach. Cook until pasta is tender. Season with salt and black pepper, to taste. Remove bay leaves. Ladle soup into bowls and serve with Parmesan cheese, if desired.
- Note-for vegan, don’t use the Parmesan cheese and for gluten-free, use gluten-free pasta.
Creamy Chocolate Date Mousse
- 8-10 Medjool dates, pitted
- 1/2 cup light coconut milk, canned + 1/4 cup water
- 1 ripe avocado, peeled
- 1/4 cup unsweetened cocoa powder
- 1/4 cup semi-sweet chocolate chips, melted
- Chop the dates into small pieces.
- Add chopped dates, coconut milk, and water into a blender or food processor and blend until smooth.
- Add the avocado, melted chocolate chips, and cocoa powder. Blend again until creamy.
- Pour into four small ramekins or bowls.
- Chill in the fridge for at least 1-3 hours (or even overnight).
*Option to garnish with raspberries, chopped nuts or a sprinkle of Himalayan sea salt.
If you are going through treatment like chemotherapy for prostate cancer or any cancer really, it’s important to eat so you can keep up your strength to fight the fight. Chemotherapy and other medications taken for treatment can sometimes rob you of your sense of taste or make your food have a metallic flavor, making food unappetizing. Anything that can be done to entice you to want to eat is a good thing. So, try these recipes and see the links below for more recipes.
Acupuncture doesn’t prevent cancer but it can aid in the symptoms related to prostate cancer such as nausea and vomiting and anxiety due to chemotherapy. It can also help control cancer-related pain, insomnia, lethargy and hot flashes. So, if you are dealing with these symptoms acupuncture might be worth checking into.
Please check out the links below for more information about breast cancer statistics, screenings, treatments, diet and recipes.
According to the Southern Maine Healthcare website all support groups have been suspended until further notice due to Covid -19, but I have included two other links that I hope are helpful to you.
As always, this blog is not meant to give medical advice but to bring awareness to medical issues that can affect us or those we love. However, if you or someone you know is experiencing any of the symptoms mentioned I urge you to contact your doctor as soon as possible.
All of us here at MassageCraft wish you good health and happiness.
For support groups here are a couple of links.