Breast cancer pain can last for many years. A survey shows that nearly half of the breast cancer survivors suffer from persistent pain after surgery that could last even two to three years. Nearly 60% of the 3,253 women being surveyed experience other symptoms of nerve damage, such as numbness or tenderness, according to a study of all Danish women treated for breast cancer in 2005 and 2006.
Breast cancer patient can experience pain that come from cancer pain and non-cancer pain.
Breast cancer pain may due to the following:
1. Breast tumor: occasionally the mass in the breast may hurt. Moderate to severe pain can be felt within the breast if it is an inflammatory breast cancer. These is due to cancer in the skin above the breast tumor. Pain can also be felt if the tumor has made an ulcer or sore through the skin covering the breast.
2. Metastases: The cancer that have spread into other parts of the body is called metastatic disease. These may produce pain in the involved areas. For instance, when the cancer spreads to the bone, it can cause pain in the back, hips, or other bones. Cancer that has spread to the brain may cause headaches. Severe back pain with leg weakness may be from cancer that has metastasized to the spinal cord. Patient may felt a dull back pain if the cancer spreads to the adrenal glands. If it spreads to the liver, the upper right part of the abdomen can be painful.
3. Treatment: Sometimes the treatment can makes the cancer hurt more. For instance, the commencement of hormone therapy or radiation for bone metastases may cause a burning of bone pain. This occurs because the cancer swells in reaction to treatment and places more pressure on the bone's nerve supply.
4. Breast pain: Although breast pain is typically non-cancerous, new and persistent uncomfortableness in only one breast may be of concern. This is particularly real if the pain is relapsing without any clear explanation. A breast exam, radiology studies, and possibly a biopsy may be recommended.
Pain can also come from these non-cancer sources like, surgery, radiation, chemotherapy, recovery phase, non-cancerous breast changes.
A study show that non-Caucasian patients were 2.52-times more likely than their Caucasian counterparts to experience severe pain. Other predictors for greater pain were inactive performance status and having had radiation treatment beside the race. As noticed, non-Caucasian race was also a risk factor for worsening pain during follow-up.
A research show that Acupuncture may ease breast cancer pain. Women were expected to rate the severity of their pain and its effect on daily functions, on a scale of 0 to 10. At the beginning of the study, the average pain rating was 6.7. After six weeks, the rated pain scale is on average 3.0. In addition to seeing a significant reduction in the severity of their pain, the group also discovered betterment in their overall physical well-being.
Some alternative therapies can also help improve quality of life and control pain for women with breast cancer. For example:
1. Ioining a hypnosis and psychotherapy group. Pain was scaled down significantly for women with metastatic breast cancer who combined hypnosis and therapy .
2. Learn Zen meditation. Individuals who meditate felt reduced perception of pain that can cut down the need for pain medication.
3. Join a laughter yoga group. It is utilized as a complementary way to promote wellness and cope with illness.
Breast Cancer Radiation Short Term Successful
An intense short term breast cancer radiation therapy just as effective. A three-week course found to be just as effective as the standard five-week regime for early-stage breast cancer women.
A professor of oncology of the Michael G. DeGroote School of Medicine at McMaster University, Dr. Tim Whelan, headed a team of researchers to discover that women who accepted the accelerated therapy have a lower risk of the breast cancer for as long as 12 years after treatment.
Women who undergo a three-week treatment - called the accelerated hypofractionated whole-breast irradiation were found to have a low risk of side effects and recurrence of the cancer more than a decade after the treatment. This conclude that short term breast cancer radiation therapy is just as effective as the standard five-week course of radiation following surgery to remove the malignancy.
These study's results will change cancer treatment practice not just in Canada, but throughout North America and around the world, said Dr. Whelan .
Dr. Whelan, who is also a radiation oncologist at the Juravinski Cancer Centre at Hamilton Health Sciences, said "This is win-win: shorter intense treatment is better for the patient and less costly to provide."
A lot of women with early-stage breast cancer are able to undergo breast-conserving therapy to keep their breast after treatment. Generally, this implies that they first will have a lumpectomy to get rid of the cancer followed by a feed of radiation therapy to kill any unexpanded cancer cells.
Researchers randomly designated 1,234 women from Ontario and Quebec to be addressed with either accelerated radiation or standard radiation between April 1993 and September 1996, The participants were observed for 12 years to ascertain if the accelerated whole-breast radiation was as effective as the standard treatment.
After a decade of treatment, the breast cancer recurrence is 6.2 percent in patients treated with the accelerated radiation therapy, compared to 6.7 percent for patients treated with standard therapy. Both groups of patients also had a good or excellent cosmetic result from the radiation treatments.
Further research is now looking at even shorter more intensive therapy, said Whelan .
"We're now in the middle of further study on more intense radiation over an even shorter time, and we're seeing positive results."
A professor of oncology of the Michael G. DeGroote School of Medicine at McMaster University, Dr. Tim Whelan, headed a team of researchers to discover that women who accepted the accelerated therapy have a lower risk of the breast cancer for as long as 12 years after treatment.
Breast Cancer Radiation Short Term Successful
The study concluded that a more intense but shorter course of therapy is as safe and efficient as the standard treatment for chosen women who have undergone breast-conserving surgery.Women who undergo a three-week treatment - called the accelerated hypofractionated whole-breast irradiation were found to have a low risk of side effects and recurrence of the cancer more than a decade after the treatment. This conclude that short term breast cancer radiation therapy is just as effective as the standard five-week course of radiation following surgery to remove the malignancy.
These study's results will change cancer treatment practice not just in Canada, but throughout North America and around the world, said Dr. Whelan .
Dr. Whelan, who is also a radiation oncologist at the Juravinski Cancer Centre at Hamilton Health Sciences, said "This is win-win: shorter intense treatment is better for the patient and less costly to provide."
A lot of women with early-stage breast cancer are able to undergo breast-conserving therapy to keep their breast after treatment. Generally, this implies that they first will have a lumpectomy to get rid of the cancer followed by a feed of radiation therapy to kill any unexpanded cancer cells.
Researchers randomly designated 1,234 women from Ontario and Quebec to be addressed with either accelerated radiation or standard radiation between April 1993 and September 1996, The participants were observed for 12 years to ascertain if the accelerated whole-breast radiation was as effective as the standard treatment.
After a decade of treatment, the breast cancer recurrence is 6.2 percent in patients treated with the accelerated radiation therapy, compared to 6.7 percent for patients treated with standard therapy. Both groups of patients also had a good or excellent cosmetic result from the radiation treatments.
Further research is now looking at even shorter more intensive therapy, said Whelan .
"We're now in the middle of further study on more intense radiation over an even shorter time, and we're seeing positive results."
Breast Cancer Patient Protection Act
Breast Cancer Patient Protection Act to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations.
In January 1997, representative Rosa DeLauro of Connecticut sponsored H.R. 135, the Breast Cancer Patient Protection Act of 1997, in the 105th Congress. The bill tried to "amend the Public Health Service Act and Employee Retirement Income Security Act of 1974 to ask that group and individual health insurance coverage and group health plans furnish coverage for a minimum hospital stay for mastectomies and lymph node dissections executed for the treatment of breast cancer." Among other provisions, the suggested law mandated that the welfares of patients covered under group insurance plans not be confined "for any hospital length of stay in connection with a mastectomy for the treatment of breast cancer to less than 48 hours.
This bill was never conveyed to the floor for a ballot after its introduction to Congress. It was brought up to various congressional committees, where it faded without action until it expired with the end of the 105th Congress. Rep. DeLauro sponsored the same bill five more times: as H.R. 116 to the 106th Congress in January 1999 (the Breast Cancer Patient Protection Act of 1999), as H.R. 536 to the 107th Congress in February 2001 (the Breast Cancer Patient Protection Act of 2001), as H.R. 1886 to the 108th Congress in April 2003 (the Breast Cancer Patient Protection Act of 2003), as H.R. 1849 (the Breast Cancer Patient Protection Act of 2005) to the 109th Congress in April 2005, and as H.R. 119 (the Breast Cancer Patient Protection Act of 2007) to the 110th Congress in January 2007. In each case, the bill's destiny was the same: it was brought up to committees and exited without being brought to a ballot. In September 2008 the House finally took up H.R. 758 (a revised edition of the Breast Cancer Patient Protection Act of 2007, which had been introduced 21 months earlier) and authorized it; but the bill was not approved by the Senate before the end of the 110th Congress.
The Breast Cancer Patient Protection Act passed the House last year by a vote of 421-2. The legislation would permit a woman and her doctor to choose whether she should recuperate from a mastectomy or lumpectomy for at least 48 hours in the hospital or whether she has enough support to get quality care at home. This is a bill in the U.S. Congress originating in the House of Representatives (”H.R.”). A bill must be passed by both the House and Senate and then be signed by the President before it becomes law. Bill numbers resume from 1 every two years. Each two-year cycle is called a session of Congress. This bill was created in the 111th Congress, in 2009-2010.
In January 1997, representative Rosa DeLauro of Connecticut sponsored H.R. 135, the Breast Cancer Patient Protection Act of 1997, in the 105th Congress. The bill tried to "amend the Public Health Service Act and Employee Retirement Income Security Act of 1974 to ask that group and individual health insurance coverage and group health plans furnish coverage for a minimum hospital stay for mastectomies and lymph node dissections executed for the treatment of breast cancer." Among other provisions, the suggested law mandated that the welfares of patients covered under group insurance plans not be confined "for any hospital length of stay in connection with a mastectomy for the treatment of breast cancer to less than 48 hours.
This bill was never conveyed to the floor for a ballot after its introduction to Congress. It was brought up to various congressional committees, where it faded without action until it expired with the end of the 105th Congress. Rep. DeLauro sponsored the same bill five more times: as H.R. 116 to the 106th Congress in January 1999 (the Breast Cancer Patient Protection Act of 1999), as H.R. 536 to the 107th Congress in February 2001 (the Breast Cancer Patient Protection Act of 2001), as H.R. 1886 to the 108th Congress in April 2003 (the Breast Cancer Patient Protection Act of 2003), as H.R. 1849 (the Breast Cancer Patient Protection Act of 2005) to the 109th Congress in April 2005, and as H.R. 119 (the Breast Cancer Patient Protection Act of 2007) to the 110th Congress in January 2007. In each case, the bill's destiny was the same: it was brought up to committees and exited without being brought to a ballot. In September 2008 the House finally took up H.R. 758 (a revised edition of the Breast Cancer Patient Protection Act of 2007, which had been introduced 21 months earlier) and authorized it; but the bill was not approved by the Senate before the end of the 110th Congress.
The Breast Cancer Patient Protection Act passed the House last year by a vote of 421-2. The legislation would permit a woman and her doctor to choose whether she should recuperate from a mastectomy or lumpectomy for at least 48 hours in the hospital or whether she has enough support to get quality care at home. This is a bill in the U.S. Congress originating in the House of Representatives (”H.R.”). A bill must be passed by both the House and Senate and then be signed by the President before it becomes law. Bill numbers resume from 1 every two years. Each two-year cycle is called a session of Congress. This bill was created in the 111th Congress, in 2009-2010.
Breast Cancer Radiation
Breast cancer radiation therapy is a treatment that applies high energy x-rays to destruct cancer cells. Breast cancer radiation is a local treatment aimed at the breast and sometimes the surrounding lymph node area to destroy any isolated cells that may have been left behind to cut down the chance of a breast cancer recurrence. Radiation treatments are nomally given after a lumpectomy, or a mastectomy, but only if there is a high risk of a local recurrence.
Radiation breaks the DNA in cancer cells, so they cannot divide and multiply. The non-cancerous cells will survive radiation treatments. Patients who need systemic therapy, such as chemotherapy, may receive their radiation after chemotherapy is accomplished.
External Beam Radiation
The most common and standard type of breast cancer radiation treatment is the External Beam Radiation. Collimated beams of radiation is aimed from external of the body by a machine at the treatment area. Treatments will not begin only after the patient have healed from the breast surgery, or completed chemotherapy.
Accelerated Breast Irradiation
Accelerated Breast Irradiation treatments is used over a relatively short period of time for some patients. It is called Accelerated Partial Breast Irradiation (APBI). This method of breast radiation appears to work similarly as the standard program.
Internal Breast Radiation - Brachytherapy
Internal breast radiation is performed after a lumpectomy, and only uses small seeds or pellets of radioactive material to render a dose of radiation from within the breast tissue. The dose of radiation is given directly to the tumor bed, and greatly reduces potential damage to healthy breast tissue nearby. The size and location of the tumor will determine whether or not a patient is suitable for brachytherapy.
Radiation During Breast Surgery
There is an experimental method of intraoperative radiation therapy (IORT) used during the breast surgery. IORT uses one large dose of radiation, applied directly into the tumor bed, after the tumor has been removed with a lumpectomy when the incision is still open. After the radiation, the incision is then closed, and no any further radiation therapy is needed. The surgical margins must be clear in order to be a suitable for this type of treatment.
The choice of breast cancer radiation treatments will be determined by several details of your diagnosis:
* Cancer stage
* Lymph node status
* Tumor size
* Type of surgery
* Surgical margins
* Location of tumor
* Location, and of extent of metastasis
 |
| Breast Cancer Radiation |
Radiation breaks the DNA in cancer cells, so they cannot divide and multiply. The non-cancerous cells will survive radiation treatments. Patients who need systemic therapy, such as chemotherapy, may receive their radiation after chemotherapy is accomplished.
Breast Cancer Radiation
External Beam Radiation
The most common and standard type of breast cancer radiation treatment is the External Beam Radiation. Collimated beams of radiation is aimed from external of the body by a machine at the treatment area. Treatments will not begin only after the patient have healed from the breast surgery, or completed chemotherapy.
Accelerated Breast Irradiation
Accelerated Breast Irradiation treatments is used over a relatively short period of time for some patients. It is called Accelerated Partial Breast Irradiation (APBI). This method of breast radiation appears to work similarly as the standard program.
Internal Breast Radiation - Brachytherapy
Internal breast radiation is performed after a lumpectomy, and only uses small seeds or pellets of radioactive material to render a dose of radiation from within the breast tissue. The dose of radiation is given directly to the tumor bed, and greatly reduces potential damage to healthy breast tissue nearby. The size and location of the tumor will determine whether or not a patient is suitable for brachytherapy.
Radiation During Breast Surgery
There is an experimental method of intraoperative radiation therapy (IORT) used during the breast surgery. IORT uses one large dose of radiation, applied directly into the tumor bed, after the tumor has been removed with a lumpectomy when the incision is still open. After the radiation, the incision is then closed, and no any further radiation therapy is needed. The surgical margins must be clear in order to be a suitable for this type of treatment.
The choice of breast cancer radiation treatments will be determined by several details of your diagnosis:
* Cancer stage
* Lymph node status
* Tumor size
* Type of surgery
* Surgical margins
* Location of tumor
* Location, and of extent of metastasis
Breast Cancer Lymph Nodes
 |
| Breast Cancer Lymph Nodes |
Breast Cancer Lymph Nodes
Basically, there are three types of lymph node involvement in breast cancer:1. Minimal (or microscopic) lymph node involvement:
The lymph nodes are found with only a small number of cancer cells.
2. Significant (or macroscopic) lymph node involvement:
The cancer has spread to a particular lymph node or group of nodes and most of the time it can be felt by hand or seen without a microscope.
3. Extra-capsular lymph node extension:
The whole lymph node is taken over by a breast cancer tumor and spills beyond the wall of the lymph node into the surrounding fat.
Generally, the more extensive the lymph node involvement, the more aggressive the breast cancer will be. But the extent of disease within a particular lymph node is less important than the total number of lymph nodes affected. The more lymph nodes that are involved, the more threatening the breast cancer may be.
The following categories are used to describe the overall level of breast cancer lymph nodes involvement:
* no lymph nodes involved
* 1–3 nodes involved
* 4–9 nodes involved
* 10 or more nodes involved
Negative and Positive Breast Cancer Lymph Nodes:
If lymph nodes are clear of cancer, they are considered negative or clear, and rated N0. Lymph nodes are considered positive or cancerous and rated N1, N2, or N3 depending on the number affected and the location when it contain cancer cells or micro-metastasis. Rating positive breast cancer lymph nodes:
* N1: Cancer is found in 1-3 lymph nodes under the arm or lymph nodes within the breast
* N2: Cancer is found in 4-9 lymph nodes under the arm or lymph nodes within the breast
* N3: Cancer is found in 10 or more lymph nodes under the arm, or has spread under or over the collarbone. It may have been found in the underarm nodes as well as lymph nodes within the breast.
Determining whether the lymph nodes are free of cancer or not is an essential part of the breast cancer staging process and will help determine treatment and prognosis. Tumor size and the extent to which breast cancer has metastasized (spread) to other regions of the body is also examined.
| Stage | Tumor Size | Lymph Node Involvement | Metastasis (Spread) |
|---|---|---|---|
| I | Less than 2 cm | No | No |
| II | Between 2-5 cm | No or in same side of breast | No |
| III | More than 5 cm | Yes, on same side of breast | No |
| IV | Not applicable | Not applicable | Yes |
An axillary node dissection is a standard way to examine the lymph nodes. This procedure is normally done during the lumpectomy or mastectomy operation. It involves removing 10 to 30 lymph nodes for pathological examination using a microscope. The most common side effect of an axillary node dissection is lymph-edema (chronic swelling) of the arm, which may affect up to 10% of patients. Lymph-edema is caused when fluid to build up in the arm due to disruption or blocking of the normal process of draining lymph from the arm.
Sentinel node biopsy is another surgical option being used on selected breast cancer patients to determine whether breast cancer is present in the lymph nodes. A sentinel node biopsy involves removing only one to three sentinel lymph nodes (the first nodes in the lymphatic chain).
Breast Cancer Treatment Options
There are several breast cancer treatment options to choose from, which could can be confusing and overwhelming. The treatment options can differ from patient to patient, from a breast cancer type to another and from a breast cancer stage to another. To give an example, the treatment goal for breast cancer in stage I, II and III is to cure the cancer and prevent a recurrence either in the original location of the tumor or anywhere else within the body. However, The treatment goal for cancer in stage IV is symptom improvement and prolonged survival. Most breast cancer types in the last stage cannot be cured.
Surgery
Surgery is for the premier local option available in the treatment of local tumors in breast cancer, which include breast-conserving surgery and mastectomy. The type of surgery chosen will depends on the size of the tumour, location of the tumour and risk for recurrence. This treatment option removes the tumour in its entirety.
Radiation Therapy
Radition therapy is a treatment type that uses high-energy rays or particles that destroy the cancer cells. There are two types a radiation therapy: external beam radiation and internal radiation.
Radiation Therapy is usually administered several weeks after a lumpectomy or whenever the surgery has healed after a mastectomy. Treatment can last from three to six weeks. It is administered externally but in some cases treatment can be administered internally.
Systemic Therapy
Systemic therapy treatment is received through oral or IV medication to reach and dismiss the cancer cells that may have spread beyond the breast region. Systemic therapy includes: chemotherapy, hormone therapy and immunotherapy.
The chemotherapy treatment can be taken by mouth, by injection, by intravenous injection or by intravenous pump at set cycles or rounds that are determined by the drugs prescribed. These treatments cause the fast growing cancer cells to stop dividing, stop growing and die. Chemotherapy can be given before surgery to shrink a tumour or after surgery to reduce the chances of recurrence.
Hormone Therapy
About two thirds of breast cancers containing estrogen or progesterone receptors are caused by the hormone called estrogen. Estrogen is produced by the ovaries until menopause. This hormone will continue to be present in a woman's body after menopause because a testosterone-like hormone produced by the adrenal gland is converted into estrogen mostly into the fat tissues of the body. Hormone therapy is trying to block the estrogen effect and to reduce the estrogen level.
There are several hormone therapy options like TAMOXIFEN and ARIMIDEX
Lumpectomy is often a suitable treatment option for patients with the following breast cancers:
- Ductal carcinoma in situ (DCIS)
- Stage 1
- Stage 2
- Stage 3
Stage 2 breast cancers are curable with current multi-modality treatment consisting of surgery, chemotherapy, radiation therapy and hormonal therapy.
Surgery
Surgery is for the premier local option available in the treatment of local tumors in breast cancer, which include breast-conserving surgery and mastectomy. The type of surgery chosen will depends on the size of the tumour, location of the tumour and risk for recurrence. This treatment option removes the tumour in its entirety.
Radiation Therapy
Radition therapy is a treatment type that uses high-energy rays or particles that destroy the cancer cells. There are two types a radiation therapy: external beam radiation and internal radiation.
Radiation Therapy is usually administered several weeks after a lumpectomy or whenever the surgery has healed after a mastectomy. Treatment can last from three to six weeks. It is administered externally but in some cases treatment can be administered internally.
Systemic Therapy
Systemic therapy treatment is received through oral or IV medication to reach and dismiss the cancer cells that may have spread beyond the breast region. Systemic therapy includes: chemotherapy, hormone therapy and immunotherapy.
The chemotherapy treatment can be taken by mouth, by injection, by intravenous injection or by intravenous pump at set cycles or rounds that are determined by the drugs prescribed. These treatments cause the fast growing cancer cells to stop dividing, stop growing and die. Chemotherapy can be given before surgery to shrink a tumour or after surgery to reduce the chances of recurrence.
Hormone Therapy
About two thirds of breast cancers containing estrogen or progesterone receptors are caused by the hormone called estrogen. Estrogen is produced by the ovaries until menopause. This hormone will continue to be present in a woman's body after menopause because a testosterone-like hormone produced by the adrenal gland is converted into estrogen mostly into the fat tissues of the body. Hormone therapy is trying to block the estrogen effect and to reduce the estrogen level.
There are several hormone therapy options like TAMOXIFEN and ARIMIDEX
Lumpectomy is often a suitable treatment option for patients with the following breast cancers:
- Ductal carcinoma in situ (DCIS)
- Stage 1
- Stage 2
- Stage 3
Stage 2 breast cancers are curable with current multi-modality treatment consisting of surgery, chemotherapy, radiation therapy and hormonal therapy.
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