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Breast Cancer Resources
Nurse Navigator
Ramona Couteau, RN, BSN, MA
410.414.4516
ramona.couteau@calverthealthmed.org
Learn More about Ramona
Location
Calvert Medical Arts Building
130 Hospital Rd.
Prince Frederick, MD 20678


Phone: 410.414.4516
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Breast Cancer

Breast Cancer

Breast cancer is the most common type of cancer among women. Though rare, breast cancer can also develop in men. Anyone who notices a lump or any unusual change in a breast should see a physician as quickly as possible.

What are the types of breast cancer?
There are several types of breast cancer:

  • Carcinoma in situ refers to abnormal cells that are still in the area where they formed. They may become cancer and spread to other tissues.
  • Lobular carcinoma in situ is an abnormal growth inside the lobules of the breast. The lobules are the part of the breast that produce breastmilk after a baby is born. This abnormal growth is not cancer. However, having had LCIC increases your chances of developing it.
  • Ductal carcinoma in situ is a cancer that has begun growing in the cells of the ducts of the breast but has not spread outside them. Ducts are the part of the breast that carry breast milk from the lobules to the nipple. If DCIS isn’t treated, it may spread to other parts of the body.
  • Paget’s Disease is an exceedingly rare form of cancer that affects the nipple and areola.
What are the symptoms of breast cancer?
Most women will not notice anything unusual, unless they perform a breast self-exam and notice a lump or find it by accident. Such lumps are typically painless. Sometimes, as in Paget's Disease, there will be visible changes to the nipple. If you notice what looks like a new and different skin condition on any part of your breast, see your doctor.

How is breast cancer diagnosed?
When a suspicious breast change is detected through mammography, a self-exam or any other method, a biopsy is usually performed. A biopsy involves removing a small tissue sample for testing, typically with a needle but sometimes with an incision. All biopsied materials will be examined by a pathologist.

What are the stages of breast cancer?
The National Comprehensive Cancer Network describes breast cancer in stages from 0 to IV:

  • Stage I: The tumor is no larger than 2 centimeters in diameter and has not spread elsewhere. The lymph nodes are unaffected.
  • Stage IIA: The breast tumors are no larger than 2 centimeters in diameter or there is no breast tumor, but the cancer has spread to a few axillary lymph nodes, or the tumors are between 2-5 centimeters in diameter but have not spread to any lymph nodes.
  • Stage IIB: Breast tumors are between 2-5 centimeters and the cancer has spread to a few axillary lymph nodes, or the tumors are larger than 5 centimeters with no signs of cancer in lymph nodes.
  • Stage IIIA: The cancer has not spread to the chest wall or breast skin but has spread to nearby lymph nodes. The size of the cancer may vary.
  • Stage IIIB: The cancer affects the chest wall, breast skin or both places. In some cases, the cancer has spread to nearby lymph nodes.
  • Stage IIIC: The cancer has spread widely to nearby lymph nodes.
  • Stage IV: This is metastatic breast cancer, which has spread to distant parts of the body, such as bones, lungs, brain and liver. This can be the stage of cancer when diagnosed, or it may develop after other stages of breast cancer advance and spread.
What are the treatments for breast cancer?
There are numerous treatments, depending on the type and stage of the cancer and your age and health. Often, you'll receive a combination of treatments.

Some of the treatments may include:

  • Hormone therapy: Also known as endocrine therapy, this includes such well-known medications as Tamoxifen, which lowers the levels of female hormones in your body. Some tumors thrive in the presence of higher female sex hormones, so medications may be given to reduce them.
  • Lumpectomy: In this procedure, the surgeon will remove just the lump and a margin of surrounding tissue. Lumpectomies are appropriate for small cancers that have not spread.
  • Chemotherapy: This is a common treatment for both self-contained and metastatic breast cancers (those that have spread beyond the breast). It can be given to shrink a tumor before surgery, to help prevent cancer from spreading to other areas, or, in advanced breast cancers, it may be given in order to prolong life or provide a better quality of life. Different chemotherapy regimens will be given depending on your situation. If you receive chemotherapy, it will likely be delivered via infusion.
  • Radiation: Radiation therapy is very commonly utilized after a lumpectomy or surgical removal of a tumor.
  • Surgery: This can take many forms, from lumpectomy to total double mastectomy. If the lymph nodes are affected, they will be removed as well.
  • HER2 inhibitors: These drugs signal cancer cells to stop growing.
What about breast reconstruction?
If you have a mastectomy or an extensive lumpectomy, you may decide to undergo breast reconstruction, in which implants or your own tissues taken from elsewhere in your body are used. It's important that you talk to your surgeon about your reconstruction options and preferences before your cancer surgery. In some cases, a nipple-sparing mastectomy may be possible, although this is not an option for all women.

What are the risk factors for breast cancer?
There are genetic predispositions to some breast cancers, so if your mother, daughter or sister has had breast cancer, you are considered at higher risk. The risk of breast cancer also rises as you age. Women who have never given birth or who gave birth to their first child later in life have a higher risk than women who gave birth at a younger age. Breastfeeding for at least a year also reduces risk. Many of these factors are out of your control, but others are things you can control: Eat a healthful diet, maintain a healthy weight, quit or don't start smoking, exercise regularly and limit alcohol intake.

What are some additional resources for learning about breast cancer?
If you or your loved one is facing breast cancer, CalvertHealth has a whole range of services designed to help you so you never take this journey alone. Please talk to your CalvertHealth provider, your Nurse Navigator, or check the service pages for information about treatments, services and support groups. Additional patient-friendly information about breast cancer may be found on the breast cancer page of the National Comprehensive Cancer Network site.