What is inflammatory breast cancer?

Inflammatory breast cancer is a type of breast cancer that is both rare and presents with different warning signs. This type of breast cancer accounts for about 1% to 5% of breast cancers in the United States. Inflammatory breast cancer, also called IBC, tends to be an aggressive and fast-paced cancer.

With IBC, it is important to know that the warning signs can be very different from the traditional breast cancer signs. It is less common with IBC that you will be able to feel a lump in the breast. Some of the warning signs include:

  • Swelling or enlargement
  • Change in the color of the breast, can be red, pink or purple tones
  • Dimpling of skin
  • Pulling in of the nipple

Additionally, these symptoms tend to arise quickly over the course of weeks or months. With other forms of breast cancer, symptoms tend to occur on a much less rapid timeline and can occur over the course of years.

Mammograms may not show IBC due to appearance as inflammation or skin thickening and due to the rapid onset of the cancer. Sometimes, IBC is mistaken as an infection, however any symptoms that last longer than a week should be discussed with your doctor. It is also important to remember to perform regular breast self-awareness and self-exams as this can lead to earlier detection.

There is a 30% rate of metastasis diagnosis with the initial diagnosis of IBC. With treatment, 65% of women who are diagnosed with IBC will live at least 5 years. Of these women, 35% will have no sign of breast cancer after 10 years from the initial diagnosis. Unfortunately these prognosis numbers are not as high as they are for women with other forms of cancer. However, clinical trials and improved rates of self-awareness testing can help lead to earlier detection and better treatment options.

Want to learn more about IBC? Click here.

Source: Susan G. Komen

Breast Cancer in Men

Although not always known nor talked about, men can get breast cancer. Approximately 1% of all breast cancer cases in the United States occur in men. This number seems small, but 1% equates to about 2,000 men impacted by breast cancer per year. In 2017, this number is estimated to be higher at 2,470 cases.

As it is both rare and not often discussed, some men do not know that they can get breast cancer, leading to failure to notice early warning signs. Additionally, men who recognize changes may be embarrassed and delay seeking treatment. It is important to understand that all men have breast tissue and that it is not anything to be embarrassed of if these signs are recognized.

The risk of breast cancer in men may be elevated with a family history of breast cancer, in either gender family member, as well as older age. A BMI greater than 25, genetic predisposition, and levels of estrogen in the body also are recognized as potential risk factors.

Warning signs in men can be similar to the warning signs in women. It is important to understand these signs and look for any areas of concern. Whenever one of the following signs is noticed, seek your doctor’s attention. Warning signs in men are as follows:

  • Lump, hard knot, or thickening of the breast or armpit
  • Dimpling, puckering, or skin redness
  • Change in the size and shape
  • A nipple or area of the breast that begins to invert

Treatment of breast cancer in men involves some combination of the same procedures and therapies to treat breast cancer in women. Often times in men breast cancer is treated using hormone therapies. If you are diagnosed with breast cancer, it is important to speak with your doctor about the appropriate treatment plan.

Source: Susan G. Komen Breast Cancer in Men

Can one glass of wine every day protect against breast cancer?

We have all heard the comment that one glass of wine, especially red wine, per night can lower your chance of heart disease, protect against some cancers, and positively impact lifespan and mental health. In fact, there are medical studies which show the benefits of drinking wine related to your health. However, does this benefit apply to breast cancer risk?

Studies suggest no.

The National Cancer Institute notes that more than 100 studies consistently found an increased risk of breast cancer associated with increased alcohol intake. The risk of breast cancer increased by an observed 7% for every 10 grams of alcohol consumed. An average glass of wine is estimated to have 17 grams of alcohol. The reason for this may be an alcohol related increase in blood levels of estrogen, which is a hormone related to breast cancer.

So, should you not drink?

You should fully discuss your drinking habits with your physician to completely understand your risks. Physicians will be able to give specific advice regarding whether there is an increase in your risk due to alcohol intake. If you still want to enjoy a festival or relax at the end of the day in the New Orleans’ spirit, consider a mock-tail alternative. Touro Infirmary offers recipes for healthy beverages without alcohol that could be used as a delicious substitute at your next event, including a recipe for a Strawberry-Kiwi Spritzer.

Click here to learn more about the relationship between alcohol and breast cancer from the NIH National Cancer Institute.

Long Term Impact of Treatment

After your treatment ends you will see the most of the short-term side effects of treatment go away. But what about after, will there be other impacts of the treatment?

The answer? There may be late effects or symptoms of breast cancer treatment. This can be frustrating as you have finished your treatment and are looking at life after breast cancer. It is important to remember that these late symptoms vary from person to person and may be impacted by the treatments that you had.

Common late effects include the following:

  • Early Menopause: for women over 40, this may be permanent, while women under 40 may have periods that return months or years after chemotherapy ends. Menopause can signal a loss of bone density or more severe than normal menopause symptoms.
  • Infertility: Fertility might be lost as a result of chemotherapy either from damage to the ovaries or early menopause.
  • Depression: depression is common after breast cancer but can be treated with medical care and social support.

Late effects may be specific to the treatment that you had during cancer care. Late term effects of surgery may include chronic pain or lymphedema, while radiation therapy may also lead to lymphedema.

You may see an impact on the quality of your life afterwards. The quality of your life is a combination of your mental and physical health, ability to perform daily roles, sexual function, and pain levels. Researchers are looking for new and innovative ways to positively impact the quality of life of breast cancer survivors. Exercise or meditation may have a role in improving mood, fatigue and social well-being as well as prayer for your spiritual health.

Sources: Susan G. Komen – Long Term Side Effects of Treatment 

Follow up Care after Cancer

After completing treatment for breast cancer, it is important to continue to see your doctor on a regular basis. Experts recommend that follow up care after cancer should include the following:

  • Physical exams
  • Mammograms
  • Bone health tests
  • Pelvic exams

While it may be hard to want to continue to see your doctors, it is important to maintain your health, manage side effects and medications, and monitor for reoccurrence. Your physician will tell you the number of times per year that they would like you to come back. These visits also help provide you with continuing support resources.

You may feel depressed after completing treatment and anxious that your cancer could return. Your physician can suggest support groups, provide education, or recommend medication to help. Additionally, long term impacts of treatment may cause concerns and the doctor will be able to speak to you about them.

Touro’s Supportive Cancer Care Center

Touro offers supportive care as a part of our comprehensive cancer program. The Touro Supportive Cancer Care Center offers mental, emotional, spiritual and social support following diagnosis, treatment and beyond. The programs and services are just as important towards staying healthy and follow up medical care after treatment. These services are also complimentary to our Touro patients and their family members, with no additional costs.

The goal of this center is to serve as an addition to our cancer and continuing medical services. With this center and the team dedicated towards working here, we hope to provide and better help our patients who are struggling with the transition to post treatment care.

You do not have to go through this experience or your experience afterwards alone. If you have additional questions about the center, visit our website or give us a call at (504) 897-8678.

What is genetic testing?

Genetic testing, especially in relation to breast cancer risk, has become a common topic in the medical world as technology for detection has advanced. Genetic testing looks for gene changes that are linked to typical cancer syndromes. Genes, which are hereditary and passed down from your parents, determine your potential for growth and cellular function, but do not ensure the outcome.

With breast cancer, about 5% to 10% of all breast cancer cases are due to hereditary cases. In those 5% to 10% of cases, genetic testing would be useful to predict risk for breast cancer. While this is a very small number of cases that could be identified, genetic testing may be useful in taking preventative measures.

Genetic testing may be performed using saliva, skin cells, or blood samples. Before, having the test, you should discuss your options with your doctor about whether or not this test makes sense or is right for you. Once the test is performed, you will wait a few weeks before receiving results from a genetic counselor.

Common cancer syndromes may be identified by the following gene mutations:

  • APC gene
  • BRCA 1 and BRCA 2
  • MSH2, MLH1, MSH6, PMS2, and EPCAM genes
  • PTEN gene
  • TP53 gene

The most commonly discussed gene test for breast cancer is BRCA 1 and BRCA 2, however, over 50 different hereditary cancer syndromes may be identified by these genetic tests.

To learn more about the BRCA 1 and BRCA 2 test, click here. To learn more about genetic testing for cancer, click here.

Does birth control pills affect the risk of breast cancer?

Birth control pills are a common medication today taken by women for multiple medical and personal reasons. Some myths say that birth control pills cause or increase your risk of breast cancer. But what do experts say?

Experts suggest yes.

Women who take birth control have a slight increase in risk for breast cancer. This increased risk is approximately 20% to 30%. However, this risk is small because women who take birth control are relatively young. Breast cancer risk for women under 40 years old is lower than for women above 55. Women under 40 are the primary users of birth control.

Does the risk associated with birth control go away if you stop the medication?

Yes. The additional risk from the medication goes away completely 9 years after stopping the medication. At 4 years, the risk is cut by half.

So should I stop taking birth control?

You should speak to your doctor before starting a birth control regimen or before stopping your current medication. Your doctor will be able to appropriately direct you to a course of action that best meets your needs, risks and concerns.

Is there any positive impact from birth control?

Yes. Even though there is an elevated risk of breast cancer, there are many positive benefits of birth control. Here are some:

  • Controlling menstrual symptoms
  • Reducing risk of ovarian cancer by 50% with long term use
  • Reducing risk of colon cancer by around 40% with 8 years of use

Source: Susan G. Komen – Some Questions, Some Answers: Birth Control Pills, Fertility, Drugs and Breast Cancer Risk

What does skin and nail care have to do with Lymphedema?

Lillian O’Cain, LOTR, CAPS and Elizabeth Urquhart, LOTR, CLT

Cancer Rehabilitation is relatively new in the healthcare system. So much focus has always been on removing or decreasing cancer in the body that the sequela of treatment of the cancer leads to impairment. This impacts everyday life during treatment or after treatment. The goal of Cancer Rehabilitation Care for breast cancer patients is to provide education and treatment for lymphedema.

What is Lymphedema?

Lymph is a clear fluid that develops in tissue spaces throughout the body. It accumulates as a result of trauma or surgery to the lymph nodes. It usually affects an arm or a leg, but can also occur in the face, neck, abdomen or other parts of the body. It is different from edema, as it does not resolve on its own.

Lymphedema usually develops slowly over time. The swelling can range from mild to severe, and it can develop soon after surgery or radiation treatment. Doctors are not able to fully understand why some patients are more likely to have problems with fluid build-up than others.

Signs of Lymphedema

  • Swelling of an arm, which may include fingers
  • A full or heavy feeling in an arm
  • A tight feeling in the skin.
  • Trouble moving a joint in the arm
  • A feeling of tightness when wearing clothing, bracelets, watches, or rings.
  • Difficulty fitting the arm into jacket or shirt sleeves.

Lymphedema often occurs in breast cancer patients who had all, or part of their breast removed, and axillary lymph nodes removed. If you have had lymph nodes removed surgery, or radiation treatment, you may want to examine your body in front of a mirror. If you notice any of the signs listed above, and if they last for one or two weeks, call your doctor.

The most common form of lymphedema in the United States is secondary lymphedema. Secondary lymphedema most often affects those who have survived cancer and have undergone surgery and/or radiation of the lymph nodes.

If you are diagnosed with lymphedema, therapy offers effective treatment to reduce the swelling, keep it from getting worse and limit the risk of infection. Education to breast cancer patients about lymphedema, includes the need for good skin care, avoiding injections and having blood pressure taken in the affected arm.

Touro’s Occupational Therapist and Certified Lymphedema Therapist can evaluate, educate, and treat lymphedema when ordered by a physician. Therapy can include:

  • Meticulous skin care
  • Massage
  • Special bandaging
  • Therapeutic exercise
  • Fitting for a compression garment
  • Manual lymph drainage
  • Self-care treatment
  • Customized home care program

Getting treatment early should lead to a shorter course of treatment to get your lymphedema under control. The safest, most effective treatment for lymphedema is MLD/CDT (manual Lymph drainage) by a trained therapist.

Source: National Cancer Institute

OCain, LilLillian O’Cain, LOTR, CAPS has over 25 years experience as an Occupational Therapist at Touro Infirmary and in 2013 was promoted to Program Manager for Touro’s STAR Program (Survivorship, Training and Rehabilitation). Lil received a bachelor of science in Occupational Therapy from Louisiana State University School of Allied Health Professions in 1986. She has developed a passion in the field of study for both fall prevention and Aging in Place and regularly volunteers her time to offer innovative programming and opportunities to educate seniors, caregivers, physicians and Touro staff.

Is Chemobrain a real side effect?

Chemotherapy has a long list of side effects that can occur due to the aggressive nature of the treatment. As chemotherapy attacks the cancer cells, it also attacks the cells of your body. Side effects can include fatigue, nausea, vomiting, and hair loss. Additionally, people report that they have difficulty with memory and concentration. But is this real or just imagined?

Yes, Chemobrain is a real side effect of chemotherapy.

Researchers do not completely understand what causes chemobrain and hypothesize that it is caused by the extensive impact of the drugs. However, thinking skills, attention, memory, and concentration are all areas that can be impacted by chemobrain. The impact and extent of chemobrain varies for each individual person. It can be frustrating and frightening if you are unsure of what is happening.

How do I live with chemobrain?

For someone with chemobrain, there are ways to cope and limit the impact on your life. Consider the following tips:

  • Avoid distractions when trying to focus on one task. Limit the background noise of a TV or kids playing.
  • Practice complex tasks until they become easy.
  • If you feel your mind wander, ask yourself “What am I thinking about?” to refocus.
  • Write down what you need to do or are thinking on a post note, to-do list, or journal.
  • Have specific places in your house and office for each item.
  • Remember to sleep and get enough physical activity.
  • Exercise your mind with Sudoku or play with your kids.

It is vital to ask for help if you need it. Consider talking to your friends, family or doctor about living with chemobrain. If you have serious concerns, your doctor may recommend a neuropsychologist or specialist to talk to.

Want more information about coping with chemobrain? Click here for a link to the Touro Infirmary health library. Looking for help coping? Contact our team at the Supportive Cancer Care Center to get specialized and individualized help.

Signs of Breast Cancer that Women Ignore

Even with an increase in screenings and checkups, breast cancer symptoms can still go ignored. This is sometimes the case with younger women. As breast cancer is often referred to as an “older person’s disease”, young women can miss early signs. This can also be the case in men, who may not recognize the symptoms. Cancer does not, however, discriminate.

Experts from the American Cancer Society have compiled a list of symptoms often overlooked that are opportunities to diagnose cancer earlier.

  1. Weight loss of 10 pounds or more without trying or changes to diet and exercise
  2. Unexplained fever without infection
  3. Extreme tiredness that does not get better with rest
  4. Unexplained pain that does not improve
  5. Changes to skin, especially the skin around the breasts
  6. Bowel and bladder changes in regularity
  7. Long lasting sores that do not heal
  8. Unusual bleeding such as bloody discharge from the nipple
  9. A lump that can be felt in the breast area or under the armpit
  10. Red or thickened skin of the breast
  11. Indigestion or trouble swallowing
  12. Consistent cough that cannot be explained

Source: The American Cancer Society – Cancer Symptoms You Shouldn’t Ignore

These symptoms do not mean that you have cancer nor are they the only signs that mean you may have cancer. For all symptoms that you notice and that have been persistent, speak to your physician.