Breast Cancer: What Do I Do?

Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women and is the leading cause of cancer death among women. Breast cancer is now the most common cancer diagnosed in women in China. China’s contribution to global breast cancer rates has increased in comparison to other countries’ in recent decades, likely due to the population’s rising socioeconomic status, with accompanying changes in diet and activity level, as well as reproductive patterns.

In studies looking at breast cancer diagnosis in different countries, Chinese women are of younger age at onset of breast cancer and are diagnosed at a more advanced stage of disease. It is important to increase awareness about breast cancer among women in China, as early detection is the key to effective treatment of the disease.

The prognosis of a woman with breast cancer is based on factors such as the size of the cancer and the extent of its spread. Breast cancers that are found because they are causing symptoms tend to be larger and are more likely to have already spread beyond the breast. Breast cancers found during screening exams are more likely to be small and still confined to the breast. Although specific recommendations for screening depend on a woman’s risk level, which may include age, family history of breast cancer, and personal history of environmental exposure, physicians agree that breast cancer screening is an important tool for early detection.

Screening for breast cancer can include the following:

• Breast self-examination
• Clinical breast examination
• Mammography
• Ultrasonography
• Magnetic resonance imaging

Early breast cancers may be asymptomatic, and pain is typically not present. If a lump is discovered, the following signs are suspicious for breast cancer:

• Change in breast size or shape
• Hardness
• Fixation to the skin or muscle
• Skin changes including dimpling, ulceration and changes in color or texture
• New nipple inversion
• Nipple discharge, particularly if blood-stained
• Axillary lump

Often breast cancer is detected as an abnormality on a mammogram before it is felt on breast exam by the patient or physician. If breast cancer is suspected on clinical examination and/or imaging, a core needle biopsy with imaging guidance is performed to confirm the diagnosis.

Surgery is considered primary treatment for early-stage breast cancer, and many patients are cured with surgery alone. The goals of breast cancer surgery include complete removal of the primary tumor with negative margins to reduce the risk of local recurrence, as well as pathologic evaluation of the tumor and axillary lymph nodes to provide information related to prognosis.

Surgical therapy may involve removal of a portion of the breast (lumpectomy) or removal of the whole breast (total mastectomy). Radiation therapy may follow surgery with the purpose of eradicating residual disease and reducing recurrence rates. Additionally, hormone therapy or chemotherapy is used when indicated.

A large percentage of women, some studies show up to 70%, are not aware of the last step in dealing with breast cancer. There are many options for breast reconstruction after breast cancer surgery. These include using tissue from the abdomen or muscle from the back, sometimes with breast implants, to recreate the form of the breast. Breast reconstruction is an important part of the healing process for breast cancer survivors, and women who opt for breast reconstruction often describe the choice as restorative and empowering. Many women view it as a significant step in putting cancer behind them.

There is life beyond breast cancer!

Reference:  

Fan L, Strasser-Weippl K, Li JJ, St Louis J, Finkelstein DM, Yu KD, Chen WQ, Shao ZM, Goss PE, “Breast Cancer in China,” Lancet Oncol 2014 Jun; 15(7): e279-89.