Breast Cancer

WHAT YOU SHOULD KNOW:

No one knows for sure what causes breast cancer. You are at a higher risk for getting this cancer if you started your menstrual periods before age 11, or if your periods ended after age 54. You may also develop the disease if a close family member had breast cancer. Early signs of breast cancer include bleeding or clear discharge from your nipple, breast swelling, or a lump in the breast. A mammogram is a test that can find breast lumps that are too small to feel during a breast self-exam. Breast cancer may spread to the lymph nodes, bone, lungs, and liver. Treatments may include surgery, radiation, and anticancer or hormone medicines. The chances of surviving breast cancer are better when the cancer is found early.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Some treatments for breast cancer cause unpleasant side effects. Signs and symptoms may be different for different people. The most common side effects are nausea (upset stomach) and vomiting (throwing up), and a feeling of tiredness or depression. Anticancer medicines may make you irritable, stop your monthly periods, and cause sexual problems. You may have pain and swelling of your arm after having breast cancer surgery.
  
  
• If you have surgery, you may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• If breast cancer is not treated, it can spread to other parts of your body and you may die. Your cancer may spread even if you are treated. Your chances of stopping the cancer are better with treatment. Call your caregiver if you are worried or have questions about your disease, care, or treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

Blood gases:

For this test, blood is taken from an artery in your wrist, elbow, or groin. The groin is the area where your abdomen (stomach) meets your upper leg. Your blood is tested for the amount of oxygen, acids, and carbon dioxide in your blood. Blood gases may be tested if you have trouble breathing, or have other problems caused by the cancer.

Blood tests:

You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

Chest x-ray:

This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.

Diet:

It is important that you get good nutrition when you have cancer. Eat a variety of healthy foods. Eating healthy foods may help you feel better and have more energy. If you have trouble swallowing, you may be given foods that are soft or in liquid form. Ask your caregiver about any extra nutrition you may need, such as nutrition shakes or vitamins. Tell your caregiver if you have problems eating, or if you are getting sick to your stomach.

Drinking liquids:

Men 19 years old and older should drink about three Liters of liquid each day (about 13 eight-ounce cups). Women 19 years old and older should drink about two Liters of liquid each day (about 9 eight-ounce cups). It is especially important to drink enough liquids if you are vomiting (throwing up) from chemotherapy. Follow your caregiver's advice if you must change the amount of liquids you drink. For most people, healthy liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty. It may be helpful to drink liquids between your meals instead of with your meals.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

Your caregiver may give you one or more of the following medicines:

• Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Tests:

You may need one or more of the following tests to help caregivers plan your treatment:

• Biopsy: Caregivers will clean an area of the breast. You will be given medicine to make you lose feeling in the area. All or part of the tumor will be removed from the breast. After the biopsy, you may need stitches and a bandage to close the wound. The tissue sample is then sent to the lab for tests.
  
  
• Bone scan: This is a test done to look at the bones in your body. The bone scan shows areas where your bone is diseased or damaged. You will get a radioactive liquid, called a tracer, through a vein in your arm. The tracer collects in your bones. Pictures will then be taken to look for problems. Examples of bone problems include fractures (breaks) and infection.
  
  
• MRI: This test is called magnetic resonance imaging. An MRI may be used to look at the brain, muscles, joints, and bones to see if the cancer has spread. You will need to lay still during the test. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

Treatment options:

Breast cancer is treated differently depending upon if it has spread to other parts of your body. You may have one or more of the following treatments:

• Chemotherapy:
  
  
  • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.
    
    
  • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.
  
  
• Hormone therapy: Some hormones (such as estrogen) may cause some cancer cells to grow. Medicine or surgery may be needed to block the estrogen and slow a growing tumor. Sometimes both medicine and surgery are needed. If you need surgery, your ovaries may be removed to stop the estrogen.
  
  
• Radiation: Radiation shrinks tumors and kills cancer cells with x-rays or gamma rays. Radiation may be given after surgery to kill cancer cells that were not removed. It may also be given alone or with chemotherapy to treat cancer.
  
  
• Surgery: You may need surgery depending on the stage of your breast cancer. The lump, part of the breast, or all of the breast may be removed. You may also need to have some lymph nodes removed. The lymph nodes are checked for cancer. This will help tell your caregiver if the cancer has spread outside your breast.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Breast Cancer (Inpatient Care)