Understanding Breast Cancer

Breast cancer can affect anyone, and there’s no way to predict with certainty who will get it. In fact, more than 70% of women who develop breast cancer have only two risk factors: being a woman and getting older.

The risk of breast cancer increases after age 50. However, women of all ages should perform monthly self‑exams to:

• Feel for any lumps or unusual skin changes
• Look for any changes in your breasts’ appearance

If you notice any changes in your breasts, it doesn’t mean you have cancer. But your doctor should evaluate you soon after you notice any changes, including:

• A lump in your breast or underarm area
• An appearance of unevenness
• An itchy rash on your nipple
• Nipple discharge that is either clear, yellow or bloody
• Nipples that point inward
• Redness
• Thickening, dimpling or pitting of your breast tissue

If you notice any changes in your breasts, your doctor will likely order imaging tests to get a closer look at your breast tissue. You may have:

• Mammogram: Mammograms are low‑dose X-rays performed while your breast is compressed. A mammogram is often the first step after you notice a change in your breast.
• Breast ultrasound: Ultrasounds use sound waves to get an image of your body’s internal structures. We may use ultrasound to get a closer look at a mass spotted on a mammogram.
• Breast MRI: MRIs use magnets and radio waves to get detailed pictures of your soft tissues. We may use an MRI if the results of a mammogram and ultrasound are unclear. MRIs can also be useful for helping us determine the exact location and size of a tumor.

If your doctor suspects you could have breast cancer, they’ll typically perform a biopsy. A biopsy involves removing a small tissue sample and looking at it under a microscope for cancerous cells. You may have a:

• Needle‑localized breast biopsy: Your provider inserts a small hollow needle and thin wire into the area of your breast they’re concerned about. Then a surgeon uses the wire to locate and remove a small amount of breast tissue.
• Stereotactic breast biopsy: We take X‑rays from different angles while your breast is under compression. This confirms the exact location of irregular tissue. Then we use a biopsy needle to take a small tissue sample.

Detecting and treating breast cancer early can save lives and increase the chance of a woman having:

• A better outlook
• A complete recovery
• More treatment options, including breast‑conserving treatments

New advancements in cancer treatments are discovered every day, and Cedars‑Sinai is a leader in innovative care. Your doctor can discuss each treatment option in detail. Generally, your treatment may include:

• Radiation therapy to destroy cancer cells with high doses of radiation
• Hormone therapy to lower hormone production or prevent hormone receptors from attaching to cancer cells
• Chemotherapy to destroy fast‑growing cells in your body, including cancer cells
• Surgery to remove the tumor (lumpectomy) or to remove the entire breast (mastectomy). Our surgeons use advanced techniques to preserve healthy breast tissue and provide optimal reconstructive results. We may also operate to find out if cancer has spread to your lymph nodes. These surgeries are called sentinel lymph node biopsy and axillary lymph node dissection.

After a lumpectomy or mastectomy, you may experience common side effects such as:

• Pain or tightness that restricts arm mobility
• Mild weakness due to discomfort
• Swelling of your lower arm, or lymphedema, that sometimes happens after surgery to remove the lymph nodes

In addition to these physical risks, cancer can return or spread after surgery. This can happen soon after surgery or years later. When treating breast cancer, your doctor will try to estimate the risk of cancer returning and use this information to determine how much treatment to recommend. Your doctor’s estimate is based on:

• How aggressive the cancer looks under the microscope
• The size of your cancer
• Whether the cancer has certain receptors on its surface
• Whether the cancer has spread to your lymph nodes

Breast Reconstruction

Breast reconstruction, or surgery to rebuild the shape of a breast, is often an option after mastectomy. Many women choose breast reconstruction to improve their self‑image and sense of wellbeing.

Reconstructive results are typically better when your plastic surgeon is involved at the start of treatment. You and your plastic surgeon work together to identify the breast size and shape you want and create a treatment plan.

Our Journey to Wellness Program was designed to help you get your health back after breast cancer treatment and to help you move on to the next phase of your life. Your wellness care plan, created especially for you, decreases the risks of your cancer coming back and helps you take an active role in your health.

Journey to Wellness is run by nurse practitioners. These specialists ensure that your follow‑up care is handled—from scheduling doctor visits to finding any extra support you need. By the end of your first session, your nurse practitioner will see that your exams are set up and that you know what you need to do next.

We bring a team together in the same place at the same time, so you can tend to body and spirit in one visit. Your ongoing wellness plan may include:

• Physical therapy: Physical therapy quickens healing and helps improve range of motion after surgery. Physical therapists also use their hands to loosen body tissue that could grow together and scar.
• Acupuncture: Acupuncture uses needles to help increase energy and promote healing. This treatment can be combined with breast cancer treatment at every stage of your journey to wellness.
• Exercise: Regular exercise lowers the chance of cancer coming back. Your team includes an exercise physiologist, an expert in the link between your physical efforts, medical record and present health.
• Meditation and relaxation: A meditation volunteer helps you focus on breathing and awareness. These techniques can help you live more fully and heal well.
• Nutrition support: Registered dietitians, board‑certified experts in oncology nutrition, teach and guide you so you can get stronger and healthier.
• Social work services: You may have some things to talk through after your treatment. Our oncology clinical social workers support you through short‑term psychotherapy, support your caregivers and connect you to many cancer support groups and programs.