BREAST CANCER, CAUSES, SYMPTOMS & TREATMENT PART 2

Tests that examine the breasts are used to detect (find) and diagnose breast cancer.

A doctor should be seen if changes in the breast are noticed. The following tests and procedures may be used:

·         Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

·         Clinical breast exam (CBE): An exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.

·         Mammogram : An x-ray of the breast.

Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called asonogram. The picture can be printed to be looked at later.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.

Biopsy : The removal of cells or tissues so they can be viewed under a microscope by apathologist to check for signs of cancer. If a lump in the breast is found, the doctor may need to remove a small piece of the lump. Four types of biopsies are as follows:

 Excisional biopsy : The removal of an entire lump of tissue.

  Incisional biopsy : The removal of part of a lump or a sample of tissue

  Core biopsy : The removal of tissue using a wide needle.

Fine-needle aspiration (FNA) biopsy : The removal of tissue or fluid, using a thin needle.

If cancer is found, tests are done to study the cancer cells.

• Decisions about the best treatment are based on the results of these tests. The tests give information about:
  ·         how quickly the cancer may grow.
  ·         how likely it is that the cancer will spread through the body.
  ·         how well certain treatments might work.
  ·         how likely the cancer is to recur (come back).
  Tests include the following:
  · Estrogen and progesterone receptor test : A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.
  ·         Human epidermal growth factor type 2 receptor (HER2/neu) test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab andlapatinib.
  ·         Multigene tests: Tests in which samples of tissue are studied to look at the activity of many genes at the same time. These tests may help predict whether cancer will spread to other parts of the body or recur (come back).
  o    Oncotype DX: This test helps predict whether stage I or stage II breast cancer that isestrogen receptor positive and node-negative will spread to other parts of the body. If the risk of the cancer spreading is high, chemotherapy may be given to lower the risk.
  o    MammaPrint: This test helps predict whether stage I or stage II breast cancer that is node-negative will spread to other parts of the body. If the risk of the cancer spreading is high, chemotherapy may be given to lower the risk.
  There are three ways that cancer spreads in the body.
  Cancer can spread through tissue, the lymph system, and the blood:
  ·         Tissue. The cancer spreads from where it began by growing into nearby areas.
  ·         Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  ·         Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
  Cancer may spread from where it began to other parts of the body.
  When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
  ·         Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  ·         Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
  
  
  The metastatic tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bone, the cancer cells in the bone are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
  ·         There are different types of treatment for patients with breast cancer.
  ·         Six types of standard treatment are used:
  o    Surgery
  o    Sentinel lymph node biopsy followed by surgery
  o    Radiation therapy
  o    Chemotherapy
  o    Hormone therapy
  o    Targeted therapy
  ·         New types of treatment are being tested in clinical trials.
  o    High-dose chemotherapy with stem cell transplant
  ·         Patients may want to think about taking part in a clinical trial.
  ·         Patients can enter clinical trials before, during, or after starting their cancer treatment.
  ·         Follow-up tests may be needed