Breast Cancer Prevention, Detection, Treatment, and Support.

If you or a loved one has been diagnosed with breast cancer, it’s important to understand how it happens and what steps should be taken. Even if you are cancer-free, it’s vital to know how to monitor your breast health and what lifestyle choices can prevent breast cancer. Frederick Regional Health System offers many services to those diagnosed with cancer, those recovering from the disease, and those who want to take preventative measures against it.

The Facts about Breast Cancer

Unfortunately, breast cancer is a common disease for women in the U.S., second after skin cancer. So, what is it, exactly? The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Commonly, this type of cancer begins in the cells of the lobules, which are milk-producing glands, or the ducts, which drain milk from the lobules to the nipple. Less commonly, cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues in the breast.

Over time, cancer cells can invade healthy breast tissue and travel to underarm lymph nodes. Lymph nodes are responsible for filtering out foreign substances in the body, but if cancer cells get to the lymph nodes, they have a pathway into other parts of the body.

Breast cancer is an all-encompassing term for cancer of the breast, but there are many types of breast cancer. Additionally, women are not the only ones who are at risk. Men can also get breast cancer.

Stages of breast cancer are determined by how far the cancer cells have spread beyond the original tumor. Non-invasive breast cancers are classified as Stage 0, where there is no evidence of cancer cells breaking out of the breast where they started. Stage I describes invasive breast cancer, where cells are breaking through to normal surrounding breast tissue. In contrast, Stage IV describes invasive cancer that has spread beyond the breast and lymph nodes into other organs, such as lungs, skin, bones, liver, or brain.

This type of cancer is caused by a genetic abnormality, but not necessarily an inherited abnormality. 80-90% of breast cancers are caused by genetic abnormalities that occur because of the natural aging process.

There are steps every person can take to help their body stay as healthy as possible. These include:

• Eating a balanced diet
• Maintaining a healthy weight
• Not smoking, or quitting smoking
• Limiting alcohol consumption
• Exercising regularly

However, while these steps can have an impact on your breast cancer risk, they cannot eliminate the risk.

Signs and Symptoms

According to breastcancer.org, symptoms vary widely or there may be no symptoms at all. This is why it is important to incorporate a breast self-exam into your monthly healthcare routine. Additionally, you should visit your doctor if you experience changes to your breasts.

Sometimes, concerning changes to your breast can turn out to be a non-cancerous condition such as an infection or a cyst. When in doubt, you should always visit your doctor. According to the National Cancer Institute, there are many symptoms associated with breast cancer:

• Breast changes. This includes a change in size or shape of your breast, as well as a change in texture.
• Nipple discharge. Discharge can include blood.
• Weight loss or gain with no known reason.
• Feeling weak or unusually tired.
• A thickening or lump on or under the skin.

While these symptoms may be an indicator of cancer, they can be symptoms of other health conditions. If you have symptoms that last for a couple weeks, it is important to visit your doctor for further testing.

Demographics

All women are at risk for breast cancer, and the risk increases as you age. It is estimated that 1 in 8 women will be diagnosed with invasive breast cancer at some point in their lives. The average woman has a 12 to 13 percent risk in developing breast cancer.

Here are some common risks:

• Age. Breast cancer risk increases with age, and the majority of cases occur in women over 50.
• Age of first menstrual period. Women who had their first period before age 12 have a slightly increased risk of breast cancer. The levels of estrogen change with the menstrual cycle, and women who began menstruation at a younger age can be at a higher risk for breast cancer due to their longer lifetime exposure to estrogen.
• Family history. Having one or more first-degree relatives who have had breast cancer increases your risk of developing it.

Screening for Breast Cancer

Mammograms are probably the most important breast-cancer screening and diagnosis tool. It is recommended that mammograms be performed each year, beginning at age 40. Women with a higher risk of developing breast cancer may be advised to begin annual screenings at an earlier age.

FMH Imaging Services is proud to be the only provider to deliver same-day breast imaging services to the Frederick community. A patient-friendly workflow allows us to reduce callbacks for additional images (when needed), ultimately reducing stress for patients and the need for additional follow-up appointments.

The latest Hologic 3D Mammography screening technologies are available at our Rose Hill and Crestwood facilities; providing convenient access to FMH Imaging Services, no matter where you live and work within Frederick County. Click here to view our locations, hours of operation, and contact details.

Treatment Options

Many people diagnosed with breast cancer will get more than one type of treatment; usually surgery is needed to remove the tumor. Depending on the type and stage of the cancer, you may need other types of treatment before or after surgery. Sometimes, you may want to seek a second opinion so you can feel more confident about your treatment plan. Here are some of the treatment options available:

• Surgery: There are two main types of surgical approaches to removing cancerous tumors from the breast. Breast-conserving surgery (also called a lumpectomy) removes only the part of the breast that contains cancer. A mastectomy removes the entire breast, including all of the breast tissue, and sometimes, nearby tissue.
• Radiation therapy: This treatment uses high-energy rays to destroy cancer cells. There are two types of radiation: external beam and internal radiation. External beam radiation comes from a machine outside the body, and internal radiation includes a radioactive source that is put inside the body for a short time.
• Chemotherapy: Not all people with breast cancer will need chemo, but there are a few situations where it may be recommended. After surgery, chemo can kill any cancer cells that may have been left behind or spread. This can reduce the risk of cancer returning. Before surgery, chemo can be given to shrink the tumor so that it may be removed with less extensive surgery. For advanced breast cancer, chemo can be a main treatment. The length of treatment depends on how well the chemo works and how well you tolerate it.
• Hormone therapy: Since some types of breast cancer are affected by hormones in the blood, hormone therapy can help. It is often used after surgery to help reduce the risk of cancer returning, but sometimes it is started before surgery. It is often used for at least five years.
• Targeted therapy: Targeted drugs can block the growth and spread of cancer cells, and work differently from chemotherapy drugs that attack all quickly growing cells.

Quick Statistics

According to NIH, the number of new cases of breast cancer in women was approximately 125 per 100,000 women per year. The number of deaths was approximately 21 per 100,000 women per year. These statistics are based on the 2010-2014 cases. From 2007-2013, 89.7% of women diagnosed with breast cancer survived at least 5 years.

Local Services Available

The Monocacy Health Partners Center for Breast Care, located at FMH Crestwood, offers many services for people with breast cancer, benign breast disease, and those who are at high risk for developing breast cancer. The team consists of two fellowship-trained breast surgeons, nurse practitioners, nurse navigators, and social workers who are all dedicated to patient needs and support for the patient’s loved ones.

At the Center for Breast Care, all services are located in a single facility, which maximizes convenience and minimizes stress for their patients. Services offered include:

• Axillary Lymph Node Dissection
• Breast cancer treatment
• Conservation surgery
• Insertion of partial breast balloon radiotherapy catheters
• Lumpectomies
• Mastectomies with immediate breast reconstruction
• Modified radial mastectomy
• Nipple exploration
• Nipple sparing mastectomy
• Prophylactic mastectomy
• Sentinel lymph node biopsy
• Skin-sparing mastectomy
• Wire localized excisional biopsy

Additionally, the Center for Breast Care provides total care, not just for the patient under active treatment. At the end of treatment, patients receive a survivorship plan that lays out a long-term follow-up strategy, along with resources for wellness. There is also a wellness program offered at FMH Crestwood that incorporates exercise and nutritional counseling, overseen by an oncology-certified exercise physiologist and licensed dietician.

Genetic counseling and testing, risk modification, and surveillance services are available to those individuals who may be at increased risk for developing breast cancer.

While a breast cancer diagnosis can be scary, technology is continually advancing to improve detection and treatment outcomes. Whether you want to prevent, treat, or learn more about the disease, it is always important to educate yourself so you can have peace of mind and take control of your health.

Frederick Regional Health System has made significant investments in talent and technology to bring the latest in cancer treatment to Frederick County. To learn more about screening and prevention programs, treatment options, our MD Anderson Certified Physicians, and much more, visit FMH.org/CancerCare.