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Deep Dive Articles, Women’s Health FAQs
Publication Date: June 27, 2023
By: NWHN Staff
Risk Factors for Breast Cancer
Prevention (Things You Can Do to Reduce Your Risk of Breast Cancer)
Common Signs and Symptoms of Breast Cancer
*Please note that these symptoms can indicate other conditions, so it is essential to make an appointment with a health care provider and get checked.
(Centers for Disease Control and Prevention, 2022b)
Screening Options for Breast Cancer
A mammogram is an x-ray of the breasts. Currently, the United States Preventive Services Task Force (USPSTF) recommends the following mammography schedule:
Of note, the American Cancer Society (ACS) recommends a slightly different schedule. ACS recommends that women ages 45-55 should get a mammogram every year (American Cancer Society, 2022a).
Becoming familiar with your breasts can help you recognize any changes that may be of concern. Breast self-exams (BSE) can be performed monthly. In menstruating women, a BSE should be performed just after menstruation. A comprehensive BSE includes a visual inspection of the breasts while standing, a manual inspection of the breasts while standing, and a manual inspection of the breasts while lying down.
How to perform a BSE:
(Cleveland Clinic, 2021)
A clinical breast exam is conducted by a health care provider. A health care provider visually inspects the breasts for discoloration or redness, size, shape, and dimpling or puckering and then conducts a manual inspection of the breasts and armpit for lumps or other changes.
Breast Magnetic Resonance Imaging (MRI) – A breast MRI can be used in addition to a mammogram, particularly for women at high risk for breast cancer. An MRI uses magnets and radio waves to produce pictures of the breast (Centers for Disease Control and Prevention, 2022d).
Breast Ultrasound – A breast ultrasound is often used as an adjunct to mammography, as it can differentiate fluid-filled masses (cysts) from solid masses. It can be helpful for analyzing dense breast tissue (American Cancer Society, 2022b).
Breast Biopsy – Often conducted after another screening method has flagged an area of concern. A biopsy is when tissue and/or fluid is removed from the breast to be examined more thoroughly under a microscope to check for abnormal and cancerous cells.
The primary benefit of breast cancer screening is to detect cancer early when it is most treatable. Risks of screening can include false positive test results, false negative test results, overdiagnosis, and overtreatment.
Treatment Options
Surgery – Involves cutting out cancerous tissue. Strive to remove as much cancer as possible and secure clean margins. Used to determine whether cancer has spread to the lymph nodes. Used to reconstruct the breast after a mastectomy.
Surgery types:
(American Cancer Society, 2023b)
Radiation Therapy – Uses high-energy rays to target and kill the cancer cells. Types of radiation include external beam radiation therapy (EBRT) and brachytherapy. EBRT is used more often. Specifically, an external machine focuses the radiation on the area impacted by the cancer. Potential side effects include swelling of the breast, skin changes in the treated area (redness, peeling, darkening), fatigue, breast shrinkage, appearance and healing of breast reconstruction, inability to breastfeed from the affected breast, damage to nerves of the arm, and lymphedema.
Brachytherapy is commonly referred to as internal radiation. It involves the use of radioactive seeds or pellets that are placed into the breast tissue for a short period of time. Potential side effects from intracavity brachytherapy include redness or bruising at the treatment site, breast pain, infection, damage to fatty tissue, fluid collecting in the breast, and, in rare cases, weakness or fracture of the ribs.
(American Cancer Society, 2021a)
Systemic Treatments
Chemotherapy – Medication is used to shrink or kill cancerous cells/tumors; it can be given intravenously (most common) or by mouth. Chemotherapy may be used before surgery, after surgery, and as the primary treatment for metastatic breast cancer. Potential side effects of chemotherapy include hair loss, nail changes, mouth sores, weight changes, nausea and vomiting, diarrhea, fatigue, hot flashes, vaginal dryness, nerve damage, menstrual changes, and fertility issues, problems with concentration and memory (chemobrain), and rarely, heart damage and increased risk of leukemia (due to select chemo medications).
Hormone or Endocrine Therapy – Blocks hormones (estrogen and/or progesterone) from cancerous cells/tumors. Often used after surgery for five years. Selective estrogen receptor modulators (SERMs), like Tamoxifen and Toremifene (Fareston), are used to block estrogen from attaching to cancer cells, thus preventing them from continuing to grow and divide. Common side effects include hot flashes, vaginal dryness or discharge, and changes in the menstrual cycle. Rare side effects include an increased risk of endometrial cancer and uterine sarcoma, blood clots, eye problems, and various effects on bones. Other drugs include selective estrogen receptor degraders (SERDs) (used in women past menopause), aromatase inhibitors (AIs) (lower estrogen levels), and ovarian suppression through oophorectomy, luteinizing hormone-releasing hormone agonists, and chemotherapy drugs.
(American Cancer Society, 2023a)
Targeted Drug Therapy – Targets specific cancer cells. Usually, it causes less harm to normal cells compared to chemotherapy and radiation. Examples include monoclonal antibodies, tyrosine kinase inhibitors, cyclin-dependent kinase inhibitors, mammalian target of rapamycin (mTOR), and PARP inhibitors.
Immunotherapy – “Uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer” (National Cancer Institute, 2022).
Complementary and alternative health methods can often be safely used as an adjunct to standard cancer treatment. The American Cancer Society provides the following list of methods that are likely safe to use:
(American Cancer Society, 2021b)
Recommended Sources, Clinical Trials, and Support Groups
American Cancer Society. (2023a, January 31). Hormone therapy for breast cancer.
https://www.cancer.org/cancer/breast-cancer/treatment/hormone-therapy-for-breast-cancer.html
American Cancer Society. (2023b, January 11). Surgery for breast cancer.
https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer.html
American Cancer Society. (2022a, January 14). American Cancer Society recommendations for
the early detection of breast cancer. https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html
American Cancer Society. (2022b, January 14). Breast ultrasound.
https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/breast-ultrasound.html
American Cancer Society. (2021a, October 27). Radiation for breast cancer.
https://www.cancer.org/cancer/breast-cancer/treatment/radiation-for-breast-cancer.html
American Cancer Society. (2021b, August 25). Which complementary methods are likely safe?
https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/complementary-and-integrative-medicine/complementary-and-alternative-methods-and-cancer/which-methods-are-likely-safe.html
American Cancer Society. (2020, June 9). Alcohol use and cancer.
https://www.cancer.org/healthy/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html
Centers for Disease Control and Prevention. (2022a, September 26). What are the risk factors for
breast cancer? https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm
Centers for Disease Control and Prevention. (2022b, September 26). What are the symptoms of
breast cancer? https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm
Centers for Disease Control and Prevention. (2022c, September 26). What can I do to reduce my
risk of breast cancer? https://www.cdc.gov/cancer/breast/basic_info/prevention.htm
Centers for Disease Control and Prevention. (2022d, September 26). What is breast cancer
screening? https://www.cdc.gov/cancer/breast/basic_info/screening.htm
Cleveland Clinic. (2021, January 9). Breast self-exam.
https://my.clevelandclinic.org/health/diagnostics/3990-breast-self-exam
National Cancer Institute. (2022, October 6). Breast cancer treatment (adult) – Patient version.
https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#_185
Susan G. Komen. (2022a, March 14). Birth control pills.
https://www.komen.org/breast-cancer/risk-factor/birth-control-pills/
Susan G. Komen. (2022b, October 3). Research table: Smoking and breast cancer risk.
https://www.komen.org/breast-cancer/facts-statistics/research-studies/topics/smoking-and-breast-cancer-risk/#:~:text=Women%20who%20are%20current%20smokers,increased%20risk%20of%20breast%20cancer.
Szkiela, M., Kusidel, E., Makowiec-Dabrowska, T., & Kaleta, D. (2021). How the intensity of
night shift work affects breast cancer risk. International Journal of Environmental Research and Public Health, 18(9), 4570. https://doi.org/10.3390/ijerph18094570