Overview of Breast cancer
Breast cancer is a common cancer that impacts mostly women, but has a history of impacting 1% of men. Breast cancer is characterized by the formation of cancer cells in the breast tissue. Some common symptoms of breast cancer are lumps within the breast tissue, changes in size, shape, or appearance, changes in skin around the breast and nipple. Regular mammograms and self-examinations can assist in early detection and resulting better prognosis (Mayo Clinic, April 2022).
Types of breast cancer
There are eight types of breast cancer.
- Cancer cells in the lining of blood vessels and lymph vessels
- This a a rare cancer
Ductal carcinoma in situ (DCIS)
- Abnormal cells in the milk duct
- Earliest type of breast cancer that is noninvasive, and has a low risk of spreading
INFLAMMATORY BREAST CANCER
- A type of breast cancer that develops rapidly
- Symptoms include red, swollen, and tender breasts
- This is a rare cancer
invasive lobular carcinoma
- A cancer that begins at the lobules of the breast (the milk producing glands)
- These cancer cells have the ability to spread to the lymph nodes and other areas of the body
Lobular carcinoma in situ (LCIS)
- Abnormal cell formation in the lobules
- Not a cancer, however individuals with this diagnosis have an increased risk of developing breast cancer
- This is an uncommon condition
Male Breast Cancer
- Cancerous cells in the male breast tissue
- This is a rare condition
Paget’s Disease of the Breast
- The disease starts at the nipple and extends outwards to areola
- This condition is a rare type of cancer
Recurrent Breast Cancer
- Breast cancer that reoccurs after treatment
- Cancerous cells evade treatment
Risk Factors that impact Breast Cancer
The following are risk factors that can affect the development of breast cancer. However, having one or more of the following factors, does not necessarily imply that one will develop breast cancer.
- Physically a female
- Older in age
- Personal or family history of breast cancer
- Genes (BRCA1 & BRCA2 are known genes that increases the risk of cancer)
- If you have been exposed to radiation
- Start of menstruation before 12 years old
- Starting menopause at a later age
- Having your first child after the age 30 or not having been pregnant
- Postmenopausal hormone therapy
- Drinking alcohol
Prevention and treatment
Breast cancer prevention involves lifestyle changes from diet and movement, and regular self exams and breast cancer screenings. In cases of high risk, your physician may recommend preventive medications or surgery.
Despite risks and prevention, sometimes an individual may still develop breast cancer. Due to intensive research, there are several treatments available.
There are several different types of surgeries which is contingent on the severity of the breast cancer. Lumpectomy is utilized to remove the specific region around the tumor. A mastectomy is the removal of the entire breast, depending on the spread of the cancer it may involve the removal of both breasts. Another type of surgery involves the removal of certain lymph nodes; the amount of lymph nodes removed depends on the spread of the cancer. After the removal of the tissue, some patients may want to get a referral to a plastic surgeon for reconstructive surgery.
Radiation therapy is another treatment strategy used to treat cancer. It involves x-ray or proton energy that targeted to the infected region. These beams of energy can be externally implemented or internally implemented, as in brachytherapy. Common side-effects of radiation therapy are fatigue, swollen or redness around the targeted region
Chemotherapy is a type of cancer treatment that involves utilizing medication to treat the cancerous cells. This treatment may be used prior to surgery to decrease the size of the tumors in the breast tissue. Other times, chemotherapy may be used post-surgery in high risk cases of the cancer returning. Chemotherapy is also used to treat cancer that has spread to other areas of the body. This treatment is known to have several side effects, from hair loss to vomiting, and a compromised immune system.
Hormone therapy blocks certain hormones, mainly estrogen or progesterone, depending on the specific cancer. Much like chemotherapy, this treatment may be used before surgery (to shrink the tumor), during, or after surgery. This treatment have several side effects depending on the type of treatment received. Common side effects are hot flashes, vaginal dryness, or night sweats.
Immunotherapy is a type of therapy that utilizes the patient’s own immune system to attack the cancer cells. This therapy impedes the cancer from hijacking the patient’s immune system. Immunotherapy is effective in cases where the patient does not have receptors for estrogen, progesterone, or HER2.
This type of treatment strategy uses specific medications to target specific abnormalities in the infected cells. Through research, scientists have found specific abnormalities called the HER2, this is type of protein that assists the cancer cells to grow and survive. By targeting the HER2, it can attack the protein without harming the healthy cells and restricting the growth of cancer cells.
the impact of diagnosis on mental health
Receiving the diagnosis of breast cancer and the subsequent treatments can understandably impact one’s mental health. From experiencing the stages of grief of what was to the treatments’ side effects as well as the impact of the treatment on the patient, there are several areas that can influence the patient’s and their family’s mental health.
One’s mood can be impacted at any stage of breast cancer. In the initial stage of being diagnosed with breast cancer, it can come as a shock if it was a sudden diagnosis. Some patients and their families noted experiencing The Kübler-Ross Five Stages of Grief or anticipatory grief. Certain aforementioned treatments can impact mood by causing hormonal changes, resulting in fluctuations in mood.
Other treatment strategies can also affect mood as a result of the physical side-effects. Increased fatigue and decreased energy can result in depressed mood due the lack of engagement in previously enjoyable activities, energizing movement activities, or general functionality. Surgery can affect how one view’s themselves which impact their self-esteem and mood.
Anxiety is another common mental health condition connected to the diagnosis and treatment of breast cancer. Patients may experience concern and worry about their prognosis and the impact of treatment. Some people who have experienced recurrent breast cancer or other cancers may feel anxious about the effectiveness of treatment this time.
Some individuals who have experienced recurrent breast cancer or other cancers may also experience medical trauma. Medical trauma is an experiential response to pain, serious illness, and medical procedures. Considering that breast cancer can lead to a person feeling a sense of shock, loss of the sense of control, life-altering or even life-threatening treatments/prognoses, and conditions experienced at the hospital and with clinicians, patients develop medical trauma.
Strategies for managing mental health
As important it is to seek medical treatment for breast cancer, it is also important to take care of one’s mental health. As previously mentioned, there are several factors that can impact a patient’s and their family’s mental health. It is important to seek help.
Community support groups are a great resource for patients’ and their families to support each other and to receive support in difficult times. In the Chicagoland area, Lurie Cancer Center lists several local support groups. The National Breast Cancer Foundation also provides some resources on finding support groups nation-wide. American Society of Clinical Oncology also provides some international resources and support in several languages for several different types of cancers.
Individual or family therapy is another strategy that can assist patients and their families cope with the mental health conditions that impact them. In therapy, individuals will have a safe space to process their diagnosis, prognosis, treatment process, and other aspects that may arise during the process. Therapist also assist individuals in the development of coping strategies to manage whatever stressors may arise outside of therapy.
On Death & Dying: What the Dying Have to Teach Doctors, Nurses, Clergy, and Their Own Families. 50th Anniversary Ed., Dr. Elisabeth Kübler-Ross, Aug 2014.
Anticipatory Grief: Mourning a Life before it’s Gone, A. Drakulich, 2021.
This month’s post was written by our Chronic Illness specialist, Aarti S. Felder, MA, LCPC, BCN.