Postoperative Breast Cancer Cares

What is cancer?

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems. Here we intend to present preliminary information for you and your family. This information helps you to choose best decision in order to control your disease.

Breast Cancer

Breast cancer is uncontrolled growth of abnormal cells which creates in different parts of breast. Breast cancer, after skin cancer is second common cancer between women. High epidemiology of breast cancer shows that we must increase women’s knowledge and attitudes about this cancer.
Breast cancer risk factors are:

  • Age: the older a woman gets, the higher is her risk of developing breast cancer
  • Family history of breast cancer, colorectal cancer, ovarian cancer, uterus cancers in close relative (mother or sister)
  • Factors related to hormones: use female hormones especially after menopause, Menopause after 55 years, first pregnancy after 35 years, first menstruation before 12 years
  • Obesity: a high fat diet especially in postmenopausal women increase breast cancer risks. Consumption of vegetables, fruits and exercise is effective role in preventing breast cancer.
  • Smoking and exposure to X-rays: undergoing X-rays and CT scans especially in young women may raise risk of developing breast cancer. Smoking is causes of some cancers as breast cancer in people who are long-term smokers.

Do you know possible symptoms of breast cancer?

The most common symptom of breast cancer is a new lump or mass. A lump that is painless, hard, and has uneven edges is more likely to be cancer. Other symptoms of breast cancer include the following:

  • Swelling of all or part of the breast
  • Skin irritation or dimpling
  • Breast pain
  • Nipple pain or the nipple turning inward
  • Redness, scaliness, or thickening of the nipple or breast skin
  • A nipple discharge other than breast milk

Although these symptoms can be caused by things other than breast cancer, it is important to have them checked out by your doctor.

Screening for breast cancer

The term screening refers to tests and exams used to find a disease like cancer in people who do not have any symptoms. The goal is to find cancers before they start to cause symptoms. Breast cancers screening tests include:

Breast Self-Exam (BSE)

self-examination should be performed every month from the age of 20. Best time for examination is first week of menstruation. BSE is done through observation and palpation. BSE methods include:

  1. Stand in front of mirror and place your hands on your waist and press inward. By tightening these muscles, changes may be easier to see. Look for any changes.
  2. Placing your hands behind your head and pressing forward. Once again, look for changes.
  3. Any nipple discharge could be a sign of a breast problem. To check for nipple discharge, firmly squeeze the breast tissue around the nipple using your thumb and middle finger.
  4. You should lie down in bed to complete the breast exam. Take a pillow and place it under your left shoulder and put your left hand behind your head. This spreads the breast tissue out, making it easier to examine and find changes. Use your right hand to examine your left breast. Many women find it easier to feel changes by putting lotion on their fingers. Hold the fingers of your right hand together, keeping them flat, and use firm pressure to move in circles around your breast. Move your fingers in smaller circles until you have felt the entire breast.
  5. Stand up or sit and raise your right hand and then check for any changes or lumps in the armpit and vice versa.

If you touch any mass or observed any morphological changes, call your doctor as soon as possible.


Clinical Breast Exam (CBE)

advised every year after 35 years by doctor.


Mammography

Women age 45 and older should have a screening mammogram every year. Best time for mammography is first week of menstruation.


Other methods

CT scan, MRI, Ultrasound and biopsy for decisive diagnose


Therapeutic approaches

Understanding the reasons different therapeutic approaches will help you to choose the best approach with your doctor. Your doctor will choose approach based on factors such as age, size, degree of tumor invasiveness, the area where the cancer has spread, Response or lack of response to estrogen or progestron in tumor growth, cancer recurrence, life Expectancy and etc. will propose some approaches include:

Surgery

is the main method and is done in order to remove partial or whole mass and some tissues around it. This approach includes mastectomy (remove all breast) and lumpectomy (remove tumor with tissues around it). It is noteworthy that the most breast masses aren’t cancerous and mastectomy isn’t always the only approach. The chance of recovery will increase if it diagnose in primary stages.


Radiotherapy

in this method we use waves with high levels of energy in order to destroy cancer cells. Radiotherapy depends on type and stage of cancer. Two major radiotherapy methods are external and brachytherapy. In external method which is more common, our target is tumor. We avoid radiate waves to the healthy tissue surrounding the tumor. In brachytherapy method, thin cosmetic enclosure which contains radioactive material, directly implant in breast.


Chemotherapy

in this method we use cytotoxic drugs in order to stop spreading cancer cells and destroy them. Chemotherapy has important role in therapeutic approaches of breast cancer. Doctor is responsible to choose chemotherapy as a therapeutic approach for breast cancer treatment. This depends on patient’s age, general state of patient’s health, primary tumor size, axillary lymph node involvement, hormone receptor status and etc.


Hormones therapy

some breast cancers need estrogen for their growth. Cancer cells have receptors of estrogen and progestron which called ER+ and PR+, respectively. Women’s with breast cancer which have PR+ receptors can take advantage of treatment that is focused on reducing estrogen.


How can I help myself during treatment?

You must have a patron for yourself. Your family and friends and people how had experience of disease is the best choice. Request them come with you to clinic and help you in difficult decisions. Maintain a healthy diet and do exercise regularly. Pay attention to primary care. Contact with your therapeutic team regularly and ask them about your concerns and questions. If you feel you are depressed, you must contact a counseling psychology which is expert in this field. You should practice to have positive sight to life. Oncologist believes that one of the most important cares is psychiatric care.

Is it possible to repair breast after treatment?

This surgery is used for people who have breast cancer and experienced mastectomy. Surgeon can change size and shape of breast to primary state. This surgery can perform with or after mastectomy. Surgeon can repair breast by using prostheses or other body tissues or combinations of both.

Care instructions after mastectomy at home

Pain management

it is expected you feel burning, pain and discomfort at least the first week after surgery. Sedative drugs such as vicodin and ibuprofen decrease your pain. It is better you consume pills before your pain start. Don’t forget resting especially first week after surgery.


Wound caring

it may your wound appear with redness, bruising and thickening. Don’t worry, because these states are parts of healing process. Ask your doctor about how take a shower and wounds caring. Control your wound regularly, based on trauma, hematoma and infection.


Care of drainage system

it may you discharge from hospital with drainage systems with accordion shape. Before you discharge, ask to learn how you can deplete drains and measure drain amount. If you observe this sign, call your doctor immediately: Sudden color changes of drainage and suddenly stop drainage, signs of infection (Odorous drainage, temperature rise).


Exercise and activity

Exercise reduces inflammation, muscle strengthening and development of circulation. After surgery, physiotherapy program is given with a physiotherapist to the patient in order to practice it at home. Avoid lifting heavy things or heavy exercise after surgery until six to eight week after mastectomy and eight to twelve after breast repairing surgery. Aerobic exercises such as aerobics, ride a fixed bike and walking are effective in decreasing side effects and are useful as an adjuvant therapy. You can see some of suitable exercise after mastectomy:

  • Comb the hair: place your hands on your waist. Comb your hair with that hand was under surgery.
  • Hanging small Purse: hang the purse with your right hand and give it with your left hand at your back and vice versa. Repeat this action five times.
  • Twist the arm: put your healthy arm on chair and then put your forehead on it. Relax another arm and hang it. Then twist your arm with circular movement.
  • Raising hands on wall: While you stand, face a wall, with one hand on the wall. Walk your fingers up the wall until you feel a stretch. Slowly walk your fingers back down to the starting position. Repeat 2 or 3 times.
  • Pulling the rope: Stand facing the door. Hang a rope on an open door and take end of shorter part rope in hand of the operated side. Take end of another part of rope with healthy hand. Turn rope, making as wide swings as possible.
  • Circular movement with rope: Tie the rope to doorknob and take it with hand of the operated side. Draw small and large circle and repeat it five times.

Diet

eat less fatty foods and increase your light meal. Drink at least eight glasses of water every day.


Regular examination

After breast cancer treatment, you must checkup yourself every three month during two years after surgery and every six month during three years after surgery and finally every year.