Detecting & Living with Breast Cancer For Dummies
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Breast cancer is a particularly devastating and intimate disease. Although not as deadly as some other forms of cancer — five-year survival rates in the United States are between 80 percent and 90 percent — the toll that breast cancer takes on the body, mind, and psychology make it an especially difficult disease to contend with.

The good news is that it is a relatively easy cancer to detect early, and usually the earlier it is caught, the better the prognosis. Breast cancer survivors have several treatment avenues, including chemotherapy, radiation, therapy, hormonal therapy, and a few different surgery options, including different mastectomies.

Things that can cause breast pain

Breast pain isn’t necessarily a sign of breast cancer. Here are some common reasons your breast may be in pain:

  • A poorly fitting bra: You should get refitted for a bra when you gain or lose weight. If your breast jiggles or moves while you are walking, your bra is not fitting well. When your breast isn’t supported well in a bra, the weight of the breast is being supported by your chest wall muscles and connective tissue, which causes trauma and pain to those structures.
  • Breast lump or mass: Any structure that presses against nerves in your breast can send a message to your brain that it interprets as pain. A breast cyst is a lump filled with fluid, and a breast mass is a lump filled with solid material. Both cysts and masses can cause breast pain. Breast pain caused by a cyst often occurs from hormonal changes before and during menstruation.

    A breast mass will usually cause breast pain when it has increased in size. Taking an over-the-counter non-steroidal anti-inflammatory drug (NSAIDS) such as aspirin, ibuprofen, or naproxen at least 24 hours prior to menstruation can significantly reduce breast pain caused by a cyst. Remember to first ask your doctor if NSAIDS are okay for you to take. Some people can’t take NSAIDS due to their medical history and may have to be prescribed an alternative drug.

  • Breast surgery: Any time you cut the skin by accident or intentionally from a surgery, there will be pain. The most intense pain from surgery is usually felt within the first two weeks, and the pain should gradually reduce over the next four weeks. Sharp, shooting, electric shock-like sensations or pain felt in the breast after surgery is normal. This sharp pain usually occurs because the nerves got irritated and inflamed when they were disrupted during surgery. As the nerves heal, the pain will be reduced and become less frequent. This may last six to nine weeks after surgery and is normal.
  • Tight clothing: Tight clothing especially under the arm and across the chest when worn for several hours can cause breast pain. The best treatment for breast pain caused by tight clothing is to wear your size. Don’t try to fit into small clothing because it can reduce circulation and cause injury to your skin in addition to pain.
  • Trauma to the breast: If you play sports or fall face down, you may bruise the breast and may develop a hematoma (collection of blood in the breast tissue) from the injury. A hematoma can take at least two weeks to heal or longer if you’re taking medications to thin the blood, such as aspirin or Warfarin.

Detecting breast cancer early

The earlier breast cancer is detected and diagnosed, the better the chances for successful treatment. Here are the best things you can do to improve your odds of catching breast cancer early:

  • Do regular breast self-exams. Feel all over the breast for any lumps or masses on a regular basis. In the shower is a good time and place as the fingers glide more smoothly. Tell your doctor immediately if you notice anything unusual.
  • Know your family history. Identify family members on both your maternal and paternal sides who have a history of breast and ovarian cancer. You must share this information with your doctor to determine if you are high risk.
  • Have screening mammograms. If you have a mother diagnosed with breast cancer, then you should start having screening mammograms ten years before her age at diagnosis.
  • Participate in high-risk screening. Have a TOMO mammogram alternating with a breast MRI, if available,  if you have a 20 percent or more chance in a lifetime of developing breast cancer. Talk to your doctor to help you assess your breast cancer risk.
  • Follow up. Get additional testing when you have new breast symptoms or if your mammogram is abnormal and make sure you complete the entire treatment recommended for you.

What to know about mastectomies

The surgery known as mastectomy is sometimes a necessary treatment for breast cancer, but not all mastectomies are the same. Here are some basic facts about mastectomies to be aware of:

  • You have options. With a total mastectomy, the entire breast is removed. A modified radical mastectomy is where the entire breast along with the lymph nodes under the arm are removed. A prophylactic mastectomy occurs when a person chooses to remove one or both breasts because of familial or genetic risk factors. A mastectomy with reconstruction is where reconstruction is performed at the same time as removal of the breast. Many types of reconstruction include placement of an implant or tissue expander, or the use of your own tissue to reconstruct the breast.
  • Saline and silicone implants are equally safe for breast reconstruction.
  • If you chose to have a mastectomy without breast reconstruction, your insurance will likely pay for you to have prosthesis, bras, and sometimes even camisoles. Contact your insurance to find out your specific coverage.
  • If you had a mastectomy many years ago and have now decided to have breast reconstruction, most health insurance will still cover the cost. Contact your insurance to find out your coverage.
  • If you develop excess tissue at the mastectomy site (sometimes called dog ears), especially under the arm, your health insurance will likely cover revision surgery to remove the excess tissue.

About This Article

This article is from the book:

About the book authors:

Marshalee George, PhD, is Faculty and Oncology Nurse Practitioner at the Johns Hopkins University School of Medicine, Division of Surgical Oncology at Johns Hopkins Breast Center.

Kimlin Tam Ashing, PhD, is Professor and Founding Director of City of Hope's Center of Community Alliance for Research and Education. Together they have over 40 years combined experience in treating breast cancer patients through diagnosis, treatment, recovery, and recurrent illness, as well as survivorship and follow-up care.

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