Living with Breast Cancer

Breast cancer is a disease that affects both the body and mind. Beyond the obvious stress of being diagnosed and needing various treatments, you may experience physical changes you weren’t expecting. Here’s more about how breast cancer affects the body and how to deal with those changes.

What Are the Symptoms of Breast Cancer?

You may not experience any symptoms or show any signs during the earliest stages of breast cancer. As the cancer progresses, you may notice some physical changes, including:

  • a lump in your breast or a thickening of the breast tissue
  • unusual or bloody discharge from your nipples
  • newly inverted nipples
  • skin changes on or around your breasts
  • size or shape changes in your breasts

Early detection is key for early treatment and better survival rates. It’s recommended that women over age 50 have mammograms every other year. In addition, it’s a good idea to routinely check your breasts for any of the above changes.

You can perform a simple checkup by following these steps:

  1. Stand without your top or bra on in front of a mirror, first with your arms at your side and then with your arms above your head.
  2. Look for changes in the shape, size, or skin texture of your breasts.
  3. Then, lie down and use the pad (not the tips) of your fingers to feel your breasts for lumps.
  4. Repeat this step again while you’re in the shower. The soap and water will help you feel more detail.
  5. Lightly squeeze your nipples to check for any discharge or blood.

Risk Factors

The exact cause of breast cancer isn’t entirely clear. There are biological and environmental factors that increase a person’s chance of developing breast cancer. Often, it’s a mix between these two things that puts someone at greater risk.

Biological risk factors include:

  • being a woman
  • being over age 55
  • being Caucasian
  • having a family history of breast cancer
  • having your period before age 12 or menopause after age 55
  • carrying certain gene mutations
  • having dense breast tissue

Environmental risk factors include:

  • engaging in a sedentary lifestyle
  • having a poor diet
  • being overweight or obese
  • frequently consuming alcoholic beverages
  • regularly smoking tobacco
  • having radiation therapy to your chest, especially before age 30
  • taking certain hormones for menopause

Unfortunately, 60 to 70 percent of people diagnosed with breast cancer have none of these known risk factors. On the flip side, if you any of these risk factors apply to you, it doesn’t necessarily mean you’ll develop breast cancer.

How Does the Body Change During Overall Treatment?

During treatment, you’re likely to experience changes ranging from hair loss to weight gain.

Hair Loss

Chemotherapy can cause hair loss by attacking hair follicle cells. Hair loss during cancer treatment is almost always a temporary issue and usually starts a couple of weeks into your treatment. Your hair should regrow once you finish your treatment. Sometimes, it may start to grow before you finish.

Menstrual Changes

Breast cancer treatments can disrupt normal hormone production and lead to interruption of your regular menstrual cycles. This means you may experience:

  • night sweats
  • hot flashes
  • joint paint
  • weight gain
  • a loss of sex drive
  • vaginal dryness
  • infertility

In some cases, you may resume regular periods after treatment. Other women will never regain normal hormone production and will enter menopause. This is most likely to occur in women over 40.

Swelling

Lymphedema is a condition in which fluid collects in different parts of the body and causes swelling. Having breast cancer surgery or radiation puts you at risk for developing lymphedema in the breasts, arms, and hands. You should be referred to a lymphedema specialist after your surgery to reduce your risk or reduce symptoms if you already have them. You may be given specific exercises or a special compression sleeve to help prevent or reduce your symptoms.

Skin Changes

If you have radiation for breast cancer, you may experience a red rash that looks similar to sunburn in the affected area. In some cases, this can be severe. Your breast tissue may also feel firm or swollen. Radiation affects the body in many more ways. It can cause:

  • underarm hair loss
  • fatigue
  • nerve and heart damage
  • arm swelling or lymphedema
  • cardiac damage

Weight Gain

Many women gain weight during breast cancer treatment. Significant weight gain during treatment is linked to the risk of developing obesity-related diseases, such as high blood pressure and diabetes. The weight gain may result from chemotherapy, different steroidal medications, or hormone therapies.

Patient Stories: How I Survived Chemotherapy

How Does the Body Change After Specific Procedures?

Beyond the nonsurgical treatments available to people breast cancer, there are several surgeries that can also affect the body. Although surgery carries the risk of bleeding and infection, it’s usually necessary to remove cancerous tumors and lymph nodes.

Lumpectomy

A lumpectomy is sometimes referred to as “breast-conserving surgery.” This is because it can remove smaller tumors locally without removal of the entire breast. The surgeon removes the tumor, as well as a margin of tissue around the tumor. This may lead to some scarring or other physical changes or breast asymmetry.

Mastectomy

Surgeons often perform a mastectomy on larger tumors. The entire breast is removed in this procedure. This includes the removal of the:

  • lobules
  • ducts
  • tissue
  • skin
  • nipple
  • areola

You may explore a “skin-sparing” mastectomy, which is when doctors attempt to preserve the skin of your breast and sometimes your nipple for later reconstruction.

Some women opt to have both breasts removed, which is called a contralateral prophylactic mastectomy. This may be a good option if you have a strong family history of breast cancer, a known genetic mutation like BRCA, or if you have an increased risk of cancer in the other breast. Many women who have cancer in one breast don’t develop it in the other breast.

Lymph Node Removal

Regardless of the breast cancer surgery you choose, your surgeon will most likely remove one or more lymph nodes found under your arm. If there isn’t any clinical evidence or suspicion that the cancer has already spread to the lymph nodes, you’ll most likely have a sentinel node biopsy. This is where only one or two nodes are removed. If you’ve had a lymph node biopsy that showed cancer before your surgery, you’ll likely need an axillary lymph node dissection. During an axillary dissection, your doctor can remove as many as 15 to 20 nodes in an attempt to remove all cancerous nodes. This will leave a scar at the incision sites in the upper outer part of your breast, near your armpit.

After lymph node dissection many women will have pain and decreased mobility of the affected arm. In some cases, this pain may be permanent.

How to Adjust to the Changes

You may choose to consult with a plastic surgeon before undergoing surgery to discover options available to you. Reconstruction can be done by either salvaging your own breast tissue or using silicone or water-filled implants. These procedures are typically performed in tandem with your surgery or afterward.

Prosthetics are an alternative to reconstruction. If you don’t want breast reconstruction but still want a breast shape, you may choose to use a prosthesis. A prosthesis is also called a breast form. A prosthesis can be slipped into your bra or bathing suit to fill the space where your breast was. These breast forms come in many shapes, sizes, and materials, to suit your needs.

Beyond reconstruction, you can do some things to help yourself adjust to your new body and even combat some of the changes.

  • To ward off weight gain, eat a healthy diet with plenty of fruits, vegetables, and whole grains. Limit your sugar intake, drink lots of water, and get good physical activity.
  • To help with swelling from fluid retention, you can ask your doctor about different diuretic medications that help the body get rid of excess water.
  • To deal with hair loss, you can consider cutting you hair short before starting chemotherapy so the loss will feel less dramatic. You can also look into buying wigs in a variety of shades, lengths, and styles. Wigs made of real hair may cost $800 to $3,000. Alternatively, you may choose to wear a scarf or hat.
  • To ease the discomfort from radiation, wear loose clothing that won’t irritate your skin. Ask your doctor about different creams or ointments that might soothe your skin. Ice packs and heating pads don’t typically help ease symptoms.

Adding various treatments and their associated physical changes to the mix may certainly feel like too much to handle at times. If you’re struggling with body image or depression, reach out to your friends, family, and medical care team.

What Is the Outlook?

In a study published by Psychosomatic Medicine, researchers explored the link between psychological distress and cancer survival. They collected data from over 200 people with cancer at their time of diagnosis and again in four-month intervals for up to 10 years. The researchers found that if symptoms of depression were present, a shorter survival time was predicted overall.

Above all, be kind to yourself. Surround yourself with support and reach out for help if you’re feeling low about your changing body. Call on your support system whenever you need a boost.

The good news is that early diagnosis of breast cancer is leading to better survival rates overall. The American Cancer Society (ACS) reports that the five-year survival rates for stages 0 and 1 are 100 percent. Five-year survival rates for stages 2, 3, and 4 are 93 percent, 72 percent, and 22 percent, respectively. In other words, the majority of people diagnosed with breast cancer will survive it.