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.
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. Talk to your doctor about the mammogram screening schedule that’s right for you.
You can perform a simple checkup by following these steps:
- 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.
- Look for changes in the shape, size, or skin texture of your breasts.
- Then, lie down and use the pad (not the tips) of your fingers to feel your breasts for lumps.
- Repeat this step again while you’re in the shower. The soap and water will help you feel more detail.
- Lightly squeeze your nipples to check for any discharge or blood.
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
- having a family history or personal history of breast, ovarian, tubal, or peritoneal cancer
- having your period before age 12 or menopause after age 55
- carrying certain gene mutations
- having ancestry (such as Ashkenazi Jewish ancestry) that’s associated with an increased risk of BRCA1 and BRCA2 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
- use of birth control pills
However, 60 to 70 percent of people diagnosed with breast cancer have none of these known risk factors. So if any of these risk factors apply to you, it doesn’t necessarily mean you’ll develop breast cancer.
Breast Cancer Healthline is a free app for people who have faced a breast cancer diagnosis. Download here.
During treatment, you’re likely to experience changes ranging from hair loss to weight gain.
Chemotherapy can cause hair loss by attacking hair follicle cells, which usually starts a couple of weeks into treatment.
Hair loss during cancer treatment is almost always a temporary issue. Your hair should regrow once you finish your treatment. Sometimes it may start to grow before you finish.
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 pain
- weight gain
- a loss of sex drive
- vaginal dryness
Some women resume regular periods after treatment. Others never regain normal hormone production and as a result will enter menopause. This is most likely to occur in women over 40.
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 may 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.
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
- nerve and heart damage
- arm swelling or lymphedema
- cardiac damage
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.
Beyond the nonsurgical treatments available to people with 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.
A lumpectomy is sometimes referred to as breast-conserving surgery. This is because it can remove smaller tumors locally instead 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.
Surgeons often perform a mastectomy on larger tumors. The entire breast is removed in this procedure, which includes all of the following:
You may explore a skin-sparing mastectomy, which is when a surgeon attempts to preserve the skin of your breast for reconstruction immediately after the mastectomy or later. In some cases, the nipple can be preserved. This is called a nipple-sparing or total skin-sparing mastectomy.
Some women opt to have both breasts removed, or double mastectomy. This may be a good option if you have a strong family history of breast cancer, a known genetic mutation like BRCA, or 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 a fraction of the nodes in the underarm are removed. This will leave a scar at the incision sites in the upper outer part of your breast, near your armpit.
If you’ve had a lymph node biopsy that showed cancer before your surgery, you may 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 have pain and decreased mobility of the affected arm. In some cases, this pain may be permanent.
You may choose to consult with a plastic surgeon before undergoing surgery to discover options available to you. Reconstruction can be done by using either your own breast tissue or 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 manage 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.
- For hair loss, 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. Alternatively, you may choose to wear a scarf or hat.
- To ease 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 have concerns about body image or depression, reach out to your friends, family, and medical care team.
In a study published by
The researchers found that if symptoms of depression were present, a shorter survival time was predicted overall.
Above all, be kind to yourself. Make sure you have a support system in place, 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.