Breast Cancer

Index of Breast Cancer

2009-12-21T01:08:00.000-08:00

Index of Breast Cancer

Welcome to health vision

Breast Cancer

« Main Index of Chest Disease
»What Is Breast Cancer?

Breast Cancer Prognosis

2009-12-21T00:46:00.000-08:00

Breast Cancer Prognosis

In the U.S., about 40,410 women will die from breast cancer this year, making it the second most lethal cancer in women. (Lung cancer is the leading cancer killer in women.) The good news is that early detection and new treatments have improved survival rates. The 5-year survival rate for women diagnosed with cancer is 80%. About 88% of women diagnosed with breast cancer will survive at least 10 years. Unfortunately, women in lower social and economic groups still have significantly lower survival rates than women in higher groups.

Several factors are used to determine successful treatment and the possibility for a cure. They include:

The location of the tumor and how far it has spread
Whether the tumor is hormone receptor-positive or -negative
Genetic factors
Tumor size and shape
Rate of cell division
Biologic markers

The good news is that women are living longer with breast cancer, and at this time more than 2 million American women are survivors. Survivors must live with the uncertainties of possible recurrent cancer and some risk for complications from the treatment itself.

Recurrences of cancer usually develop within 5 years of treatment. However, 25% of recurrences and half of new cancers in the opposite breast occur after 5 years. One study suggested that the risk factors for a first breast cancer do not necessarily place a woman at any higher risk for recurrence. (Women with a first cancer, however, do have a higher risk for a new cancer in the opposite breast. The outlook for such new cancers is independent from those of the first one.)

Location of the Tumor:

The location of the tumor is a major factor in outlook:

If the cancer is ductal carcinoma in situ (DCIS) or has not spread to the lymph nodes (is node-negative), the 5-year survival rates with treatment are up to 98%. However, cancer recurs in 9 - 30% of such node-negative cancers. Recurrence is a potentially life-threatening problem, even if the disease relapses locally in the same breast. In one study of DCIS patients with locally invasive recurrence, 8-year mortality rates were only 12%.
If the lymph nodes contain cancer cells (are node positive) then survival rates fall. If the tumor is larger than 5 cm or there is widespread involvement in the lymph nodes, the cancer is sometimes referred to as locally advanced. In such cases, the survival rate drops to about 75% and below.
If the cancer has spread to other sites (most often the lung, liver, and bone), the average survival time for patients treated with chemotherapy is 1 - 2 years (with some patients living for many years). New combinations of drugs are improving these averages.
The location of the tumor within the breast is an important prognostic factor. Tumors that develop toward the outside of the breast tend to be less serious than those that occur more toward the middle of the breast.

Hormone Receptor-Positive or -Negative:

Breast cancer cells may contain receptors, or binding sites, for hormones like estrogen or progesterone. Cells containing these binding sites are known as hormone receptor-positive cells and if they lack them are called hormone receptor-negative cells.
Hormone receptor-positive cells grow more slowly than receptor negative cells. Women have a better prognosis if their tumors are receptor-positive because these cells grow more slowly than receptor-negative cells and they have more treatment options. (Hormone receptor-negative tumors can be treated only with chemotherapy.)

The Influence of Genes:

Determining a "genetic signature" for a tumor may prove to be a very powerful predictor of the aggressive nature of a breast cancer. Researchers have focused on 70 genes whose activity patterns may help make such predictions.

The relevance of the inherited BRCA1 or BRCA2 mutations to survival is controversial. Some studies have suggested that these mutations offer a survival advantage, while others suggest that they make no difference or even worsen prognosis. Women with these genetic mutations do have a greater risk for a new cancer to develop. Patients with BRCA1 mutations tend to develop tumors that are hormone receptor negative, which can behave more aggressively.

Tumor Markers:

Researchers are investigating numerous substances in tumor cells that may indicate whether or not a cancer is likely to spread. Such chemical markers may help doctors determine treatments, and some may even prove to be targets for future drugs. The following are only a few of the more well-researched markers.

HER-2. The HER-2 protein is part of the epidermal growth factor receptor family and is becoming an important marker in breast cancer. It is involved in the growth and spread of breast cancer cells, and about 25 - 30% of patients with breast cancer have high levels of this protein. The presence of HER-2 may suggest aggressive cancer. It is proving to be important in determining treatment choices. For example, women who have HER-2 positive cancers tend to benefit from anthracycline-based chemotherapy.

Angiogenesis Factors. Angiogenesis is the growth of new blood vessels. High levels of angiogenesis factors indicate that the tumor is developing its own supply of blood vessels, which enable the tumor to send colonies of cancer cells into the blood stream and spread to other parts of the body. Specific angiogenesis factors, such as vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), may turn out to be important markers for determining treatment and prognosis. The monoclonal antibody bevacizumab (Avastin) targets VEGF. The drug is showing promise in clinical trials for prolonging progression-free survival in women with metastatic breast cancer.
Others. Many other markers are being investigated, including p53, cathepsin-D, protein c-erbB-2, bcl-2, Ki-67, telomerase, thymidylate synthase, CA 15-3, and carcinogenic embryonic antigen (CEA). The American Society of Clinical Oncology (ASCO) cautions, however, that the value of many of these factors has not yet been confirmed.

Other Factors for Predicting Outlook:

Tumor Size and Shape. Large tumors pose a higher risk than small tumors. Undifferentiated tumors, which have indistinct margins, are more dangerous than those with well-defined margins.
Rate of Cell Division. The more rapidly a tumor grows, the more dangerous it is. Several tests measure aspects of cancer cell division and may eventually prove to predict the disease. For example, the mitotic index (MI) is a measurement of the rate at which cells divide. The higher the MI, the more aggressive the cancer. Another test measures cells at a certain phase of their division.

« Index of Breast Cancer
«Learn About Breast Cancer Treatments

Breast Cancer Treatments:

2009-12-21T00:34:00.000-08:00

Learn About Breast Cancer Treatments:

Breast Cancer Treatment:

Find out what your breast cancer treatment options are.

Surgery:

Get detailed information on surgical procedures associated with breast cancer. From biopsy to reconstruction, we’ve got the situation covered.

Lymphedema:

Lymphedema has been a “forgotten” side effect of breast cancer, not getting nearly the attention that, say, hair loss or the fatigue of radiation has gotten Learn how to identify, prevent and treat lymphedema.

Radiation:

Radiation may be used before or after surgery, and may accompany chemotherapy. Read on to learn the facts about

radiation.
Medication

The most important advances in the cure of breast cancer have come through the use of drug therapy. Find out about the different types and what may be the best options for you.

Chemotherapy:

Chemotherapy has—with good reason—developed a scary reputation. But just like all treatment regimens aren’t the same, one size doesn’t fit all with chemotherapy either. Here you'll find a guide to complete guide to chemotherapy.

Hormone Therapy:

Learn about hormone therapy to make an informed decision on which hormones may be best for you.

Integration of Natural Medicine into Conventional Oncology Treatment :

There's integration happening between traditional cancer care and adjunct alternative therapies. Find out if new developments could help you.

« Index of Breast Cancer
«Living with Metastatic Disease
»Breast Cancer Prognosis

Metastatic Disease

2009-12-21T00:25:00.000-08:00

Living with Metastatic Disease

Expert Quote

“If the fear of cancer keeps you from moving forward, enjoying life, being with loved ones, laughing, then the cancer won, even if it never comes back. But if you reclaim your life, then even if the cancer comes back, it didn't win, because YOU, the PERSON, survived.”

Lisa Weissmann M.D.

Metastatic breast disease is breast cancer that has not just come back, but has made its way through the bloodstream and spread to other organs of the body, such as the bones, liver, or brain. Cancer spread may be present at first diagnosis or after recurrence. Many women can live for years with metastatic cancer that's under control. For these women, living with a diagnosis of metastatic breast cancer is like living with a chronic disease. It can go into remission, be active sometimes and not others, or move quickly. It frequently involves trying one treatment after another, ideally with breaks in between treatments when you feel good. The goal of treatment is to help you feel as well as possible and live a longer life.

No one can tell you how long you will live with metastatic disease. That's because every woman's experience is different. Some women live for more than a decade. Others live for just a few seasons. But new and more effective treatments keep being developed. This means that you may do much better today with metastatic disease than someone who had it only a few years ago.

In this phase of breast cancer, the treatment goal is to extend life as long as possible with the best QUALITY of life possible. This means relieving symptoms and putting cancer into remission with the fewest side effects.

Metastatic breast cancer responds best if:

The cancer has not spread to any organs, such as the liver, lung, and brain.
If it has spread throughout the body, no more than three organs or parts of the body are involved (the fewer the better).
Estrogen and/or progesterone hormone receptors are present in these cancer cells.
There's no evidence that the tumor has stopped responding (become resistant) to hormonal therapy, Herceptin (chemical name: trastuzumab), or chemotherapy.
You haven't already had many different kinds of therapy or many rounds of treatment.

But even if you don't have these encouraging signs, many treatments are available to you. Many women can live for years even without these signs.

« Index of Breast Cancer
«Regional Recurrence
»Learn About Breast Cancer Treatments

Regional Recurrence

2009-12-20T23:58:00.000-08:00

Regional Recurrence

If you develop breast cancer that recurs in lymph nodes near the breast, you probably will need both local and whole-body treatment.

Local treatment might include surgery to remove the affected lymph nodes, and possibly also radiation therapy. Whole-body treatment might include chemotherapy, targeted therapies such as Herceptin (chemical name: trastuzumab), and hormonal (anti-estrogen) therapy.

The following pages will give you more information on the three types of breast cancer recurrence. If you have not had a recurrence, but are just reading this section to keep informed, your mind may play tricks on you. You might develop some suspicious symptoms that seem like recurrence. This is a very natural reaction. If those symptoms don't go away within a day or so, make an appointment with your doctor to be sure.

« Index of Breast Cancer
«Recurrence in the chest wall
»Living with Metastatic Disease

Recurrence in the chest wall

2009-12-20T23:46:00.000-08:00

Recurrence in the chest wall

Cancer that returns after a mastectomy in the place where the breast used to be is called a chest wall recurrence. You might have surgery first to remove the tumor. But surgery is rarely recommended if you have:

several tumors that are widely scattered
a red rash indicating that cancer is spreading through the skin

If you have recurrence within a reconstructed breast, occasionally your doctor may recommend that the flap or implant be removed.

After you recover from surgery, radiation therapy is usually the next treatment given if you haven't had it before. If you have had radiation in the past, limited additional radiation therapy may still be an option. But in that case you will be more likely to develop significant side effects from the extra radiation, including:

a skin rash that doesn't heal
an increased risk of rib fractures
scarring and tightness of the muscles

To reduce side effects that can occur after repeat radiation, your doctor might make changes in your treatment. He or she might alter:

the amount of radiation in each dose
the frequency of each treatment
the size of the area treated

For example, your doctor might recommend smaller doses of radiation given twice a day.

If you haven't had radiation therapy before, your side effects will be less severe. You will probably just get a sunburn-like reaction that's red, sore, tight, and itchy and might peel and ooze. Your doctor may recommend one or a combination of things to help avoid, reduce, or relieve these problems, including:

Biafene
Jeans cream
Lindi Skin cream
aloe vera
Aquaphor
A & D ointment
Silvadene ointment
1% hydrocortisone
a prescription steroid cream such as betamethasone

During your treatment, if the side effects on your skin and soft tissue get worse, your nurse or doctor might recommend a stronger combination of medicines.

You may also get twinges of pain or stiffness of the chest wall that can be relieved by Tylenol (acetaminophen) or anti-inflammatory medicines. In some women who have breast implants, radiation therapy may cause a hard capsule of scar tissue to form around the implant. This capsule can be painful and distort the shape of the breast.

Systemic (whole-body) therapy, such as chemotherapy, hormonal therapy, or targeted therapies, may be recommended after chest wall recurrence. About half the women who develop a chest wall recurrence have cancer cells that eventually spread beyond the chest area. Medicines that work on the entire body can help get rid of those cells.

But you may not need chemotherapy if ALL of these categories apply to you:

You are post-menopausal.
You have only one small, removable chest wall tumor.
Your recurrence developed 10 years or more after your first treatment for breast cancer.

The type of treatment that's recommended depends partly on what treatments you've had before. Sometimes, cancer comes back in the chest wall while you're on hormonal therapy. In this situation, your doctor will probably recommend that you switch to another type of hormonal therapy. The hormonal therapy itself did not trigger the occurrence. It's just that you have been on one medicine long enough so that it's stopped fighting the cancer adequately, and another hormonal therapy might be able to do that.

« Index of Breast Cancer
« Recurrence in the breast
»Regional Recurrence

Recurrence in the breast

2009-12-20T23:26:00.000-08:00

Recurrence in the breast

Careful imaging, or pictures of areas inside the body, is critical in determining treatment options. Even if you have already had several imaging tests in order for your doctor to make a diagnosis, you may have more mammography, MRIs, CAT or PET scans, ultrasound, and if necessary, chest X-rays.

If the cancer has come back in the area of the original lumpectomy, but you have no signs of disease elsewhere, then your outlook is probably quite good.

If the cancer came back just as a small lump in your breast, you may need only local treatment. Local treatment is successful in 8 out of 10 women who have a breast cancer recurrence that is limited to the breast.

If your initial treatment was lumpectomy and radiation therapy, then the standard of care for a recurrence is complete removal of the breast (mastectomy). Another lumpectomy followed by radiation therapy is usually only an option if you haven't had radiation therapy before and your risk of cancer spread is very low. Here are some signs that your situation would be considered encouraging:

The breast cancer came back only at the place where it first appeared.
The cancer lump is at most four centimeters wide and can be completely removed.
The recurrent cancer is not invasive (DCIS [ductal carcinoma in situ]).
It's been a long time between when you were last treated and when the cancer came back.
The cancer does not appear to be very aggressive and has not spread to nearby lymph nodes.

If you already had lumpectomy and radiation therapy, you may be able to get into a study or clinical trial using partial breast radiation as an alternative to mastectomy.

If the cancer has some features that are less encouraging, your doctor may recommend some sort of systemic (whole-body) treatment. The purpose of this treatment is to get rid of any cancer cells that might be outside the breast but can't be seen on tests. Find out about systemic (whole-body) treatments here.

« Index of Breast Cancer
«Treatments for Local and Regional Recurrence
» Recurrence in the chest wall

Regional Recurrence

2009-12-20T23:16:00.000-08:00

Treatments for Local and Regional Recurrence

There are many effective treatments for a local or regional recurrence of breast cancer.

Local treatments include surgery and radiation. Systemic (whole-body) treatments include chemotherapy, hormonal therapy, and targeted therapies, such as Herceptin (chemical name: trastuzumab). Find out about a test that may help decide which treatments are right for you.

Which local and systemic therapies you get, and how much, depends on many of the same factors that were important when you were first diagnosed. For starters, what treatments will work best for you depends, in part, on where the cancer comes back and its "personality" features.

« Index of Breast Cancer
«Descriptions of cancer in your report
» Recurrence in the breast

Descriptions

2009-12-20T23:04:00.000-08:00

Descriptions of cancer in your report

DCIS (Ductal Carcinoma In Situ): This is a cancer that is not invasive. It stays inside the milk ducts.
LCIS (Lobular Carcinoma In Situ): This is a tumor that is an overgrowth of cells that stay inside the milk-making part of the breast (called lobules). LCIS is not a true cancer. It is a warning sign for an increased risk of having an invasive cancer in the future, in either breast.
IDC (Invasive Ductal Carcinoma): This is a cancer that begins in the milk duct but grows into the surrounding normal tissue inside the breast. This is the most common kind of breast cancer.
ILC (Invasive Lobular Carcinoma): This is a cancer that starts inside the milk-making glands (called lobules), but grows into the surrounding normal tissue inside the breast.

«Index of Breast Cancer
«Is the Breast Cancer Invasive?
»Treatments for Local and Regional Recurrence

Is the Breast Cancer Invasive

2009-12-20T22:44:00.000-08:00

Is the Breast Cancer Invasive?

The single most important fact about any breast cancer is whether it has grown beyond the milk ducts or lobules of the breast where it first started.

Normal Cells

Non-invasive Cells

Non-invasive cancers stay within the milk ducts or milk lobules in the breast. They do not grow into or invade normal tissues within or beyond the breast. These are sometimes called in situ or pre-cancers.

Invasive Cells

If the cancer has grown beyond where it started, it is called invasive. Most cancers are invasive. Sometimes cancer cells can also spread to other parts of the body through the blood or lymph system. You may see these through description of cancer in your report.

«Index of Breast Cancer

«Where Breast Cancer Might Come Back and How to Detect It?

»Descriptions of cancer in your report

Cancer Might Come Back

2009-12-20T22:30:00.000-08:00

Where Breast Cancer Might Come Back and How to Detect It?

"Living with the fear of breast cancer is having a whale move into your living room. One day, it just appears and is always in the way. Over time, the whale can get smaller, but it never quite goes away. Maybe, sometimes, it gets down to the size of a magazine rack and once in a while you bump into it. Sometimes, it swells up in your face again, like when you have a mammogram and they call you back for extra views." —Barbara

When breast cancer comes back, it may return in the same place. This is called a "recurrence," because it is not a new cancer. But a recurrence can also appear in a place not directly related to the first breast cancer. This is called a "metastasis", and if cancer is detected in several areas, these are called "metastases". Find out more about treatments for metastatic (advanced) breast cancer. When breast cancer comes back, it tends to show up in specific areas of the body:

the breast or the area where the breast used to be
the chest wall
the lymph nodes
the bones
the lungs or around the lungs
the liver
the brain

Cancers from other parts of the body rarely spread to the breast or the chest wall. If you have a tumor in your lymph nodes, lungs, liver, bones, or brain, it probably is a re-growth or recurrence of the original breast cancer rather than a new and different cancer. In other words, if you had breast cancer and you now have cancer in your bones, liver, or other places, it is probably not bone or liver cancer, but breast cancer that has spread to the bones or the liver. This is important because breast cancer—even when it has spread—is usually more treatable than a cancer that starts in the bones or liver.

Breast cancer that returns in other parts of the body is invasive cancer. However, cancer that comes back in the breast after surgery and/or radiation therapy can be either non-invasive or invasive.

If you have developed a cancer in the opposite breast from the one that was originally treated, it is probably not a recurrence. Most cancers that develop on the other side represent a new cancer rather than a recurrence.

Breast cancer can return in three general locations. It can be:

Local: in the breast where it started, or in the skin and underlying tissues where the breast used to be.
Regional: in the lymph nodes next to the breast.
Metastatic: in another part of the body, such as the lung, liver, bone, or brain, or in lymph nodes far from the breast.

«Index of Breast Cancer
«How to Start
»Is the Breast Cancer Invasive?

How to Start

2009-12-20T22:22:00.000-08:00

How to Start

First, check the top of the report for your name, the date you had your operation, and the type of operation you had. Make sure they are right for you.

Parts of Your Report

Specimen: This section describes where the tissue samples came from. Tissue samples could be taken from the breast, from the lymph nodes under your arm (axilla), or both.
Clinical history: This is a short description of you and how the breast abnormality was found. It also describes the kind of surgery that was done.
Clinical diagnosis: This is the diagnosis the doctors were expecting before your breast tissue sample was tested.
Gross description: This section describes the tissue sample or samples. It talks about the size, weight, and color of each sample.
Microscopic description: This section describes the way the cancer cells look under the microscope.
Special tests or markers: This section reports the results of tests for proteins, genes, and how fast the cells are growing.
Summary or final diagnosis: This section is the short description of all the important findings in each tissue sample.

«Index of Breast Cancer
«Your Diagnosis
»Where Breast Cancer Might Come Back and How to Detect It?

Your Diagnosis

2009-12-20T22:02:00.000-08:00

Your Diagnosis

“As soon as you're diagnosed with breast cancer, you desperately try to figure out how it could have happened. You analyze your life a thousand times over, rack your brains searching for THE reason, beat your head against the wall, experience endless guilt. All you get is a headache. Drop it! Save your precious energy for your health and well–being. ”

Getting tests done and waiting for their results can create a lot of anxiety. Here are some suggestions to help you manage your anxiety:

Get to know the people on your medical team and make every effort to meet them in person. You'll find out who is the best communicator, who can answer which questions, who is available to help you when you need it most.
Find a doctor who communicates with you who invites your questions and takes your concerns seriously, who gives you as much or as little information as you feel comfortable with.
Make plans with your doctor about how to receive test results in a prompt way. Try to schedule important tests early in the beginning of the week, so you don't have to wait over a long weekend, when lab work may slow down or doctors aren't communicating with each other.

In this section you'll find the web version of the Breastcancer.org booklet: Your Guide to the Breast Cancer Pathology Report.

Wait for the Whole Picture

Waiting is so hard! But just one test can lead to several different reports. Some tests take longer than others. Not all tests are done by the same lab. Most information comes within one to two weeks after surgery, and you will usually have all the results within a few weeks. Your doctor can let you know when the results come in. If you don't hear from your doctor, give her or him a call.

Get All the Information You Need

Be sure that you have all the test information you need before you make a final decision about your treatment. Also, don't focus too much on any one piece of information by itself. Try to look at the whole picture as you think about your options.

Different labs and hospitals may use different words to describe the same thing. If there are words in your pathology report that are not explained in this booklet, don't be afraid to ask your doctor what they mean.

«Index of Breast Cancer
«10 Ways to Manage Fear after Diagnosis
»How to Start

10 Ways

2009-12-20T21:40:00.000-08:00

10 Ways to Manage Fear after Diagnosis

As you begin gathering information to make decisions, get to know the people on your medical team and make every effort to meet them in person. Turn faceless doctors into known resources. These are the people you've hired onto your team to help you. You'll find out who is the best communicator, who can answer which questions, who is available to help you when you need it most.

Find a doctor who communicates with you in a way that is comfortable for you, who invites your questions and takes your concerns seriously, who gives you as much or as little information as you feel comfortable with at any given moment.

Find out what to expect from tests, procedures, and treatments. Minimize surprises.

Make plans with your doctor about how to receive test results in a prompt way. If possible, try to schedule important tests early in the week, so you don't have to wait over a long weekend when lab work may slow down or doctors aren't communicating with each other.

Find a mammography center where the radiologist will talk with you about the results before you go home, so you don't have to wait for a letter or a call from your doctor.

When you know you're going to have a challenging week (a mammogram coming up or a round of chemotherapy), don't plan to do things that are stressful for you (for example: balance the checkbook, cook dinner for 20, or run a big meeting at work). Use your support systems — friends, movies, yoga, prayer — to help you get through it.

If well-meaning people try to tell you stories about others struggling with cancer, stop them right away and say, "I only listen to stories with happy endings!"

If you reach a point where difficult emotions are getting in the way of your functioning or taking care of yourself, speak with your doctor about the role of medications that might help ease your anxiety, depression, or sleeping problems.

Join a breast-cancer-related group. This can be a support group or online discussion board - a place to share your breast cancer experience openly with people who understand. If you are more action-oriented, look for a breast-cancer-related athletic group, an organization that holds breast cancer education programs, or an advocacy group that lobbies for more research funding or free mammograms. Do whatever makes you feel connected to others in a positive way as a person who is moving beyond breast cancer.

Work on ways to feel more positive about your life. Seek out productive, life-enhancing experiences; accept yourself for who you are; and spend time with positive people who affirm who you are and how you've chosen to deal with this disease.

«Index of Breast Cancer
«Stages of Fear after Diagnosis
»Your Diagnosis

Stages of Fear

2009-12-20T21:17:00.000-08:00

Stages of Fear after Diagnosis

Most people go through several stages of fear when they are first diagnosed. The stages, and the order in which they happen, are very similar in most people:

You just can't believe what you've heard and completely deny it.

You get angry at the doctor who told you and anyone else, such as a lab technician or nurse, who read a result to you.

You appeal to a higher power and ask over and over, “Why did this happen to me?” or “What did I do to deserve this?”

You feel resigned, as if there’s nothing you can do to help yourself.

You accept the truth, hard as it may be, and decide to fight with everything you’ve got in you.

A big part of the fear of breast cancer diagnosis is all the uncertainty and the feeling that you’ve lost control of your life — being swept away on an uncharted journey that you don’t want to take. It’s hard to imagine how anything good could happen on this particular trip.

It turns out that this isn’t necessarily so. While no one wants to be diagnosed with breast cancer, many people in treatment or finished with treatment say that the experience made them stronger and helped them to become closer to their families and friends and learn more about themselves. Being diagnosed is never easy, but once you start the process of getting the best available doctors, the best information, and the best support you can from those who love you, you are in good hands.

« Index of Breast Cancer
«Is it Breast Cancer?
»10 Ways to Manage Fear after Diagnosis

Is it Breast Cancer

2009-12-20T00:36:00.000-08:00

Is it Breast Cancer?

Common Breast-Cancer-Related Fears:

Are you worried about a lump or other symptom you think might be breast cancer? Find out what the symptoms of breast cancer are and what to do if you think you have one.

Fear of first diagnosis:

Most people think their risk of getting breast cancer for the first time is higher than it really is. Try to get a realistic idea of your risk from your doctor. Your risk is affected by many factors. Many people who review their risk factors find out that their risk is lower than they expected.

The fear of being diagnosed with breast cancer makes some people avoid going to the doctor. But the sooner you see a doctor, the sooner you can know what your situation is. Never let fear stop you from making a good choice when it comes to your healthcare.

Fear of recurrence:

Are you concerned that a change in your body, or symptoms that don’t involve your breast, mean that cancer has come back or spread?

If you have a personal history of the disease, you have very different worries. You may already have had a good deal of treatment, and now you are being followed carefully to make sure you are okay and free of any signs of recurrence. You obviously want to do everything possible to lower the risk of cancer returning.

Living with advanced disease:

If you are dealing with recurrence or metastatic disease, you may be worried about what tests and treatments you need, whether your current treatment is working, and what therapies you might need in the future.

Lowering breast cancer risk:

How do you know you're doing everything you can to keep your breast cancer risk as low as possible? Is there anything you could do to lower the risk further? Find out in our Lower Your Risk section.

« Index of Breast Cancer
«Managing Breast Cancer Fears
»Stages of Fear after Diagnosis

Breast Cancer Fears

2009-12-20T00:23:00.000-08:00

Managing Breast Cancer Fears

So many women you know may have had breast cancer — friends and neighbors, coworkers, relatives. It seems as if every time you turn around, breast cancer is being talked about in the newspaper or on TV. You may be fearful of developing breast cancer or of receiving a diagnosis after a mammogram or other testing. If you’ve had breast cancer, you may be fearful of a possible recurrence or even of the possibility that breast cancer could take your life.

Even though you may have some of these fears, you are not necessarily going to get breast cancer. If you have had breast cancer before, it doesn’t mean that the cancer will recur. Still, it's normal to have concerns about a disease that you hear about and see around you relatively often — and that you may have experienced yourself or through a loved one. Don't let the discussion of fear in this section feed into your own fears. Throughout Breastcancer.org the information our medical experts provide and the support offered by our community members can help you manage the fears, instead of letting them manage you.

The fear of breast cancer is unlike any other — psychologists and other experts agree on that. The fear can take many different forms, depending upon where you are in the breast cancer experience and how much your fears are shared by others. While fears are normal, they are uncomfortable to live with. We'll help you figure out how you can manage fear so you can focus on living a happy and healthy life.

« Index of Breast Cancer
«Some Symptoms of Advanced (Metastatic) Breast Cancer
»Is it Breast Cancer?

Metastatic Breast Cancer

2009-12-19T23:54:00.000-08:00

Some Symptoms of Advanced (Metastatic) Breast Cancer

Stage 4 or Metastatic Breast Cancer:: Metastatic breast cancer is the most advanced stage of this disease. Metastatic breast cancer is defined as having spread beyond the breast and underarm lymph nodes into other parts of the body.

bone pain (bone metastases)
shortness of breath (lung metastases)
drop in appetite (liver metastases)
unintentional weight loss (liver metastases)
headaches, neurological pain or weakness (could be brain metastases)

Symptoms of Breast Cancer Recurrence:

Recurrence of breast cancer is classified as local, regional, and distant. A distant recurrence is the same as advanced (metastatic) breast cancer. A local recurrence is breast cancer that has returned after treatment, in or close to the original tumor location. It can often be effectively treated. Regional recurrence may be in the chest wall muscles, or in lymph nodes located beneath your sternum, just above your collarbones, and around your neck.

Local Recurrence Symptoms:

a small lump or rash in the excision scar, on or under the skin

Regional Recurrence Symptoms:

swollen lymph node in the same armpit where cancer was previously removed
swollen lymph nodes above collarbones or sides of neck

A New Tumor Is Not a Recurrence:

If a new tumor appears and has a different pathology than the original breast cancer, it is not considered a recurrence. It is called a new primary, and can occur in a different area of the breast that was originally affected, or in the opposite breast. A new cancer is diagnosed and treated independently from the original tumor.

«Index of Breast Cancer
«Tips for performing BSE
»Managing Breast Cancer Fears

Tips for performing BSE

2009-12-19T22:58:00.000-08:00

Tips for performing BSE

Breast self-exam (BSE), or regularly examining your breasts on your own, can be an important way to find a breast cancer early, when it's more likely to be treated successfully. Not every cancer can be found this way, but it is a critical step you can and should take for yourself.

Over the years, there has been some debate over just how valuable BSE is in detecting breast cancer early and increasing the likelihood of survival. For example, in summer 2008, one study of nearly 400,000 women in Russia and China reported that breast self-examination does not reduce breast cancer mortality and may even cause harm by prompting unnecessary biopsies (removal and examination of suspicious tissue). Because of the ongoing uncertainty raised by this and other studies, the American Cancer Society has chosen to advise women that BSE is an “optional” screening tool.

Few women really want to do a breast self-exam, or BSE, and for many the experience is frustrating — you may feel things but not know what they mean. However, the more you examine your breasts, the more you will learn about them and the easier it will become for you to tell if something unusual has occurred. Breastcancer.org believes that BSE is an essential part of taking care of yourself and lowering your risk of breast cancer.

Some tips for BSE:

Try to get in the habit of doing a breast self-examination once a month to familiarize yourself with how your breasts normally look and feel. Examine yourself several days after your period ends, when your breasts are least likely to be swollen and tender. If you are no longer having periods, choose a day that's easy to remember, such as the first or last day of the month.

Don’t panic if you think you feel a lump. Most women have some lumps or lumpy areas in their breasts all the time. In the United States, only 20% of women who have a suspicious lump biopsied turn out to have breast cancer.

Breasts tend to have different “neighborhoods.” The upper, outer area — near your armpit — tends to have the most prominent lumps and bumps. The lower half of your breast can feel like a sandy or pebbly beach. The area under the nipple can feel like a collection of large grains. Another part might feel like a lumpy bowl of oatmeal.

What’s important is that you get to know the look and feel of YOUR breasts' various neighborhoods. Does something stand out as different from the rest (like a rock on a sandy beach)? Has anything changed? Bring to the attention of your doctor any changes in your breasts that last over a full month's cycle OR seem to get worse or more obvious over time.

You may want to start a journal where you record the findings of your breast self-exams. This can be like a small map of your breasts, with notes about where you feel lumps or irregularities. Especially in the beginning, this may help you remember, from month to month, what is “normal” for your breasts. It is not unusual for lumps to appear at certain times of the month, but then disappear, as your body changes with the menstrual cycle (if you are still menstruating). Only changes that last beyond one full cycle, or seem to get bigger or more prominent in some way, need your doctor's attention.

Step 1:: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.; Here's what you should look for:; Breasts that are their usual size, shape, and color.; Breasts that are evenly shaped without visible distortion or swelling; If you see any of the following changes, bring them to your doctor's attention:; Dimpling, puckering, or bulging of the skin. A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out) Redness, soreness, rash, or swelling

Step 2:: Now, raise your arms and look for the same changes.

Step 3:: While you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).

Step 4:: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.; Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.; Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.

Step 5:: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in Step 4.

SYMPTOMS AND DIAGNOSIS

Breast cancer symptoms vary widely — from lumps to swelling to skin changes — and many breast cancers have no obvious symptoms at all. Symptoms that are similar to those of breast cancer may be the result of non-cancerous conditions like infection or a cyst.

Breast self-exam should be part of your monthly health care routine, and you should visit your doctor if you experience breast changes. If you're over 40 or at a high risk for the disease, you should also have an annual mammogram and physical exam by a doctor. The earlier breast cancer is found and diagnosed, the better your chances of beating it.

The actual process of diagnosis can take weeks and involve many different kinds of tests. Waiting for results can feel like a lifetime. The uncertainty stinks. But once you understand your own unique “big picture,” you can make better decisions. You and your doctors can formulate a treatment plan tailored just for you.

« Index of Breast Cancer
«Symptoms & Diagnosis
»Some Symptoms of Advanced (Metastatic) Breast Cancer

Symptoms and Diagnosis

2009-12-19T21:56:00.000-08:00

Symptoms & Diagnosis

Remember that breast cancer symptoms vary widely:

Breast that is warm to the touch:

A breast that always feel warm, sometimes hot to the touch is a symptom of inflammatory breast cancer, a dangerous and rare type of the disease.

Flat or inverted nipple:

A nipple that is flat or inverted is also a symptom of breast cancer. This does not include having an inverted nipple since birth.

A breast that is often itchy:

If you have itchy breasts or nipples, talk to your doctor. These are both symptoms of breast cancer.

The skin around the breast is dimpled or looks like an orange peel:

Breast and surrounding skin can take on a dimpled appearance, looking like an orange peel. Many women are too embarrassed to show a doctor, thinking it is cellulite or from being overweight. This is not the case.

Swollen or breast that does not change with menstrual cycle or size increase:

It's normal for a woman's breast to become swollen and tender during a normal menstrual cycle, but when it's constant, it need to be evaluated by a doctor. Women also need to be aware of a sudden breast size increase.

Breast that is red or blotchy:

A breast that is red or blotchy, even having a rash-like appearance should be evaluated by a doctor. It is a symptom of inflammatory breast cancer. Inflammatory breast cancer is a type of cancer that is often undetected by a mammogram and self breast exam.

An abnormal lump or thickening in or near the breast or underarm area

Any change in the size or shape of the breast

Abnormal discharge from the nipple

Any dimpling or puckering of the breast

Swelling in the armpit (lymph nodes)

Pain in the nipple

These changes also can be signs of less serious conditions that are not cancerous, such as an infection or a cyst. It’s important to get any breast changes checked out promptly by a doctor.

But even if you have one or more of these signs, it still doesn't mean you have breast cancer. Remember that most breast lumps turn out to be benign (not cancerous).

Still, it's extremely important that you SEE YOUR DOCTOR RIGHT AWAY if you're worried that you might have breast cancer. Having your doctor take a look will ease your worry, and if anything is found, you'll be able to take care of it quickly

The classic symptom for breast cancer is a lump found in the breast or armpit. An aggressive type of this disease, inflammatory breast cancer (IBC), grows in sheets of tumor cells that invade the skin and resembles a rash. Doing your monthly breast self-exam (BSE) is a great way to be familiar with your breasts’ texture, cyclical changes, size, and skin condition. Early detection is the best way to protect your health and improve your odds of survival. Don’t hesitate to see your doctor or nurse for a clinical breast exam (CBE) if you have a question about a change in your breasts.

REMEMBER:

Breast cancer begins in a cell, which divides and multiplies at an uncontrolled rate. A small clump of cancer cells are too tiny to be felt, so the earliest stages of breast cancer usually have no symptoms. A mammogram can detect cancer before you can feel a lump, that is why your annual screening mammogram is so important. Some benign breast conditions can seem like cancer, so it’s good to know the difference, and get a health professional to check out worrisome lumps.

« Index of Breast Cancer
«Lowering Risk For Everyone
»Tips for performing BSE

Lowering Risk For Everyone

2009-12-19T21:47:00.000-08:00

Lowering Risk For Everyone

Every woman wants to know what she can do to lower her risk of developing breast cancer. If you have no personal history of the disease, you want to do what you can to stay clear of it. And if you have had breast cancer, you never want to get it again. You want to know how to lower your risk of the cancer coming back, and you want to reduce your risk of getting an unrelated new breast cancer.

The best defense against breast cancer is a good offense. There are no perfect solutions, but you can do many things to reduce your risk.

Regular screening tests for breast cancer, such as an annual mammogram and a breast exam during your annual checkup, allow you and your doctor to ensure that your breasts are as healthy as they can be. Screening also increases the likelihood that your doctor will find breast cancer early, when it's most treatable.

« Index of Breast Cancer
«What to Do if Your Genetic Test Results Are Uncertain
»Symptoms & Diagnosis

If Results Are Uncertain

2009-12-19T21:35:00.000-08:00

What to Do if Your Genetic Test Results Are Uncertain

In some cases, your doctor and genetic counselor may not be able to tell for sure whether or not you are at increased risk of cancer, even after BRCA testing. You may be told that your results are:

Uninformative or inconclusive: If your test and your family members’ test results are negative, but many young women in your family (younger than age 50) have been affected by breast and/or ovarian cancer, the cancer in your family could be due to an inherited genetic abnormality that has not yet been identified. The same holds true if your results were negative but you were unable to have a family member with cancer tested. In these cases, you still could be high-risk due to another genetic abnormality besides BRCA.
Showing a "variant of uncertain significance": Sometimes a genetic test finds an unusual change or "variant" in the BRCA1 or BRCA2 genes, but not one that has been clearly associated with increased cancer risk. As more family members are tested, it may become clearer as to whether or not the variant is associated with cancer risk. Or, you may need to keep in touch with your genetic counselor to find out whether more information becomes available about the particular change that was found in your gene.

In either case, not getting a definite result from genetic testing could cause you and your family members a great deal of anxiety. You can work with your doctor and genetic counselor to figure out what steps you should take moving forward. You may still be considered high-risk based on family history alone; if so, you might consider following the strategies followed by other high-risk women:

Talk to your doctor about beginning annual mammograms at age 25, or 10 years before the earliest age at which a family member was diagnosed — whichever comes first. Digital mammography may provide added benefit. MRI (magnetic resonance imaging) of the breasts performed by experienced centers can also be very useful. Consider participating in a clinical trial evaluating newer methods of early detection.
If you have a family history of ovarian cancer, begin annual screening at age 25, including pelvic exams by a gynecologist, annual pelvic ultrasound with an intravaginal probe, and blood tests for a special protein called CA-125. Consider participating in a clinical trial evaluating newer methods of early detection.
Have a clinical breast exam every 6 months, and examine your breasts monthly.
Consider participating in a clinical trial of cancer prevention strategies.
Maintain a healthy lifestyle, and follow recommended nutrition and exercise guidelines.
Consider discussing preventive (also called prophylactic) surgery with your healthcare provider.

«Index of Breast Cancer
«What to Do if Your Genetic Test Results Are Positive
»Lowering Risk For Everyone

Test Results

2009-12-19T08:26:00.000-08:00

What to Do if Your Genetic Test Results Are Positive

If you test positive for a BRCA1 or BRCA2 mutation, and you have never had breast cancer, you now know that you are at much higher-than-average risk of developing it over the course of your lifetime. For women, the risk of getting breast cancer in your lifetime if you have a BRCA1 or BRCA2 abnormality is between about 40% and 85% -- about 3 to 7 times greater than that of a woman who does not have the mutation. Your lifetime risk of ovarian cancer is significantly elevated as well: 16% to 60%, versus just under 2% for the general population. Men with BRCA abnormalities are considered to have a higher lifetime risk of male breast cancer, especially if the BRCA2 gene is affected. One study found that men with a BRCA2 mutation have a 7% lifetime risk of developing breast cancer. They also may be at increased risk of developing prostate cancer.

Whether you are a man or a woman, an abnormal genetic test result means there is a 50% chance you could have passed the BRCA1 or BRCA2 mutation on to your children.

Researchers have been working to build their understanding of how breast cancers in women with BRCA mutations may differ from other breast cancers. Some of their findings include:

Breast cancers in women with BRCA1 abnormalities are more likely to be estrogen-receptor-negative — meaning that the cancer’s growth is not fueled by the hormone estrogen — and to have “high-grade” cell growth. Both of these characteristics mean that chemotherapy will be more effective than hormonal (anti-estrogen) therapy in treating these cancers.
BRCA1- and BRCA2-related cancers often test negative for over-expression of the gene known as HER2/neu. This genetic abnormality is not inherited, as BRCA1 and BRCA2 mutations are, but can develop in women over time. When the HER2 gene is over- expressed, the cancer cells have too many HER2 receptors (human epidermal growth factor receptor). HER2 receptors receive signals that stimulate the growth of breast cancer cells. HER2-positive breast cancer is considered to be a more aggressive form of the disease, but it can be treated with Herceptin (chemical name: trastuzumab), a medication that targets HER2. Most BRCA1- and BRCA2-related cancers cannot be treated with Herceptin because they are HER2-negative.
Women with BRCA1 or BRCA2 gene abnormalities have no greater risk than other women of having multiple cancers in the same breast when their breast cancer is diagnosed.
A 2005 study suggested that women with DCIS (ductal carcinoma in situ) are just as likely to have inherited gene abnormalities as those with invasive breast cancer.

If you have breast cancer gene abnormality

If you have a breast cancer gene abnormality and you develop breast cancer, your doctor will work with you to determine how your BRCA status might affect your treatment decisions. For example, if you have a BRCA1 mutation, the breast cancer is less likely to be estrogen receptor-positive, which means that you may not be a candidate for treatment with hormonal therapy. If you have a BRCA2 mutation, however, you are more likely to be a candidate for hormonal therapy.

You’ll also want to talk with your doctor about reducing the risk of a new, second breast cancer or ovarian cancer. Women with breast cancer and a BRCA1 or BRCA2 abnormality have a significantly greater risk of developing a new, second breast cancer, as well as ovarian cancer.

If you want to lower your risk of a future breast cancer or ovarian cancer

Whether or not you’ve ever had breast cancer, knowing that you have a BRCA mutation means that you are at much greater risk of developing breast and possibly ovarian cancer in the future. The latest research offers these insights about strategies for lowering those risks:

Preventive or "prophylactic" mastectomy, or removal of both breasts, has been found to reduce the risk of breast cancer in high-risk women by about 90%. After a diagnosis of one breast cancer in a woman with a genetic abnormality, the risk of her getting a new breast cancer is approximately 3% every year (for example, 15% over 5 years). Without BRCA1 or BRCA2, the risk of developing a new breast cancer after one episode of breast cancer is only 1% per year.
Preventive or prophylactic oophorectomy, or removal of both ovaries, can reduce breast cancer risk when it is done before menopause, because it takes away the body’s main source of the hormone estrogen. It also can greatly reduce ovarian cancer risk. However, a 2008 study involving more than 1,000 women with BRCA mutations showed that the benefits of ovary removal may be different depending on the type of mutation:
- BRCA1 carriers: Ovary removal reduced ovarian cancer risk in BRCA1 carriers by 85%, but it did not significantly reduce their breast cancer risk. Women with BRCA1 mutations are more likely to develop breast cancers that are not fueled by the hormone estrogen (estrogen-receptor-negative breast cancer). So removing the ovaries, the body’s main source of estrogen, did not provide significant benefit in terms of breast cancer risk.
- BRCA2 carriers: Women with a BRCA2 mutation had a 72% decrease in their risk of breast cancer after ovary removal. That’s because breast cancer in BRCA2 carriers is more likely to be estrogen-receptor-positive. The study did not find a significant reduction in ovarian cancer risk for these women. BRCA2 mutations have not been found to play as important a role in ovarian cancer risk as BRCA1 mutations do.

More research is needed, but this study suggests that women may wish to consider preventive ovary removal in relation to the type of BRCA mutation they have. Your doctor can help you sort through this information and figure out how the surgery might benefit you. The surgery can only be performed if you are certain that you are finished having children.

Tamoxifen is a hormonal therapy that blocks the effects of estrogen on breast tissue. In the late 1990s, a clinical trial called the Breast Cancer Prevention Trial first found that tamoxifen reduced breast cancer risk by 45% to 50% in women considered to be at high risk for breast cancer. However, later results revealed that the risk-reduction benefit of tamoxifen appears to be greatest for women with BRCA2 mutations, who tend to develop breast cancers that are fueled by the hormone estrogen. The trial found that in women 35 years of age or older who had not been diagnosed with breast cancer and who took tamoxifen, those who were BRCA2-positive had a 62% reduction in breast cancer risk, while those who were BRCA1-positive did not have a significant reduction in breast cancer risk. It’s not clear whether tamoxifen treatment lowers breast cancer risk in BRCA1-positive women younger than 35 who've never been diagnosed with breast cancer. Other research has shown that both BRCA1-positive and BRCA2-positive women previously diagnosed with breast cancer in one breast can lower their risk of developing a new breast cancer in the opposite breast by taking tamoxifen.

For more information on these strategies, visit our sections on Prophylactic Mastectomy, Prophylactic Ovary Removal, and Tomoxifen.

If you want to try to increase the odds of early detection

Another option besides preventive surgery is to undergo more frequent cancer screenings in an effort to catch cancer early, should it ever develop. Although more frequent screenings do not guarantee early detection of cancer, they are generally recommended for women who do not wish to have preventive surgery.

You can work with your doctor to come up with a screening schedule that is right for you. For example, you might take the following steps:

Begin annual mammograms at age 25, or 10 years before the earliest age at which a family member was diagnosed — whichever comes first. Digital mammography may provide added benefit. MRI (magnetic resonance imaging) of the breasts performed by experienced centers can also be very useful. Consider participating in a clinical trial evaluating newer methods of early detection.
If you have a family history of ovarian cancer, begin annual screening at age 25, including pelvic exams by a gynecologist, annual pelvic ultrasound with an intra-vaginal probe, and blood tests for a special protein called CA-125. Consider participating in a clinical trial evaluating newer methods of early detection.
Have a clinical breast exam every 6 months, and examine your breasts monthly.
Consider participating in a clinical trial of cancer prevention strategies.

«Index of Breast Cancer
«What to Do if Your Genetic Test Results are Negative
»What to Do if Your Genetic Test Results Are Uncertain

Test Results

2009-12-19T08:12:00.000-08:00

What to Do if Your Genetic Test Results are Negative

The following recommendations are based on currently available but admittedly limited information — and common sense.

If your family has a defined breast cancer gene abnormality that you do not share, your risk of breast cancer is considered to be equal to that of a woman in the general population: 13% over the course of your lifetime. Men who test negative for BRCA1 and BRCA2 have the same very low risk of developing breast cancer as men in the general population. Whether you are a woman or a man, testing negative also means that you could not have passed the genetic abnormality on to your children.

As a woman considered to be at average risk of developing breast cancer, you can follow the screening and lifestyle guidelines recommended for most women:

Practice regular breast self-examination and get annual or semiannual clinical breast exams (depending on your doctor's recommendation).
Have screening mammograms following the current guidelines for women of average risk: a baseline mammogram at age 40 and annual mammograms after age 40.
Maintain a healthy lifestyle: eat a low-fat, well-balanced diet, exercise regularly, keep your weight under control, and minimize your intake of alcohol. These strategies will improve your sense of well-being and general health and possibly lower your breast cancer risk.

If your test and your family members’ test results are normal, but many young women in your family (younger than age 50) have been affected by breast cancer, the cancer in your family could be due to an inherited genetic abnormality that has not yet been identified. The same holds true if your results were normal but you were unable to have a family member with cancer tested first. These genetic test results are sometimes called “uninformative” or “inconclusive” results.

«Index of Breast Cancer
«Getting Genetic Test Results
»What to Do if Your Genetic Test Results Are Positive

Genetic Test Results

2009-12-19T00:05:00.000-08:00

Getting Genetic Test Results

“I advise women to share their genetic test results with every blood relative in their family! Although I have heard some convincing reasons why someone would not share results (particularly if the relative doesn't want to know) I encourage people who test positive to let family members know—this includes 2nd and 3rd degree relatives. Many genetic counselors provide patients with a letter that they can send to relatives if they don't have a particularly close relationship or don't feel comfortable sharing the information by phone or in person. I like the idea of involving the genetic counselor because then the family member knows where to go for more information. I also encourage women to share their test results with their health care providers. It's important information for your health care provider to have. In my case I chose to share my test results with my entire health care team.”

Sue Friedman

How long does it take to get the results?

Commercial labs often give faster results (usually within 4 weeks) than research centers (a minimum of 4 weeks, often longer).

How will you get your results?

Typically, results are sent to your doctor or genetic counselor, who reports them to you. A critical part of genetic risk assessment is the responsible and sensitive disclosure of test results. Be sure to ask your doctor or genetic counselor when, how, and where you will find out the results.

You may wish to bring someone along when you get your results. If you are told you have a genetic mutation, having someone who cares about you at your side can be very reassuring. Because a great deal of information is discussed, it may also be helpful to have another person to listen and help remember what was said.

Of course, genetic information can affect the whole family. You might be going through this process with your family involved, in which case they may join you when you get the results. Or you may be the only one in your family who can get this information or who wants it. In fact, some family members may have strong feelings against genetic testing. And sometimes, they may ask you to keep the results secret from them and the rest of the world. But keeping a secret doesn't mean you should pursue this process alone and without support. This is one reason why having a genetic counselor to help you through it is so important.

If you’re concerned about privacy

You may decide to share your test results with your family members or doctors. This is a personal decision.

Even though there are laws in place to protect against genetic discrimination, you still might want to keep your results confidential. You can request that test results NOT be written on any chart or noted in any record.

If it turns out that you do have a genetic abnormality, you can protect your privacy by removing your name from the test results before providing your relatives with a copy.

«Index of Breast Cancer

«Genetic Testing Facilities and Cost

»What to Do if Your Genetic Test Results are Negative