What is ER breast cancer

Breast cancer

What do you feel as a patient?

"How do I recognize signs of breast cancer?" - This question moves many women - maybe you too. This is understandable, because in the early stages of the disease there are often no symptoms or pain. It is therefore essential that you go to your gynecologist's annual screening examination.

But even outside of this examination, you can do something to identify possible signs of breast cancer yourself. Women often discover a lump in their breasts themselves - for example, by chance while showering or during specific palpation. Experts therefore recommend examining the breast yourself once a month. However, this should only complement, not replace, other early detection measures. Please note: lumpy changes in the breast can also be benign. Therefore, clarify your suspicions immediately with your doctor. So don't worry unfounded. In any case, regular self-exams will help you develop a sense of changes in your body.

Symptoms include fever, exhaustion, or diarrhea

If the cancer is more advanced, symptoms can arise. These occur when the tumor has spread to other areas outside the mammary gland (metastases). Breast cancer can develop metastases, especially in the bones, lungs and liver.5 If this is the case, you may experience pain or nausea, for example. Other symptoms such as exhaustion, fever of unknown origin, diarrhea or jaundice are possible.6 If you notice one or more of these signs, you need to act quickly: Contact your doctor immediately.

How is breast cancer diagnosed?

Have you noticed any changes in your breast? Then see your gynecologist as soon as possible. He will do various tests to see if you have breast cancer. First, your doctor will do a palpation of your chest. To get a good overview of the breast tissue, your doctor will use imaging tests, such as an ultrasound or a mammogram.

Recommended exams for diagnosing breast cancer1
  • Medical palpation examination
  • Ultrasound scan including the armpit
  • Mammography
  • Tissue examination (biopsy) to confirm the diagnosis
  • If necessary, magnetic resonance imaging (MRI)
Medical palpation examination

During this examination, your gynecologist will palpate your chest while sitting or standing. In principle, he proceeds in the same way as you do at home for the self-examination. The doctor will check for swelling, redness, inflammation, or changes in the shape of the breast or nipple. He also carefully feels the armpits, breastbone and collarbone.4

Ultrasound examination

The doctor performs the ultrasound examination while lying down and it is completely painless. During the examination, the transducer is moved over the skin of the chest to the armpit. The resulting images are viewed on the monitor. An ultrasound examination is not enough as the sole method for early breast cancer detection.3 However, it can provide information and is recommended as a supplementary examination:

  • when women have a familial, high risk of developing breast cancer.
  • if women show dense glandular tissue in the mammography and if the mammography is abnormal.1,3
Mammography

Mammography Mammography uses X-rays to examine the internal structure of the breast. During the examination, the breast is briefly squeezed between two plastic plates. Some women find this uncomfortable to painful, but not others. Mammography is recommended for the early detection of breast cancer for all women with no symptoms or symptoms between 50 and 69 years of age as a preventive examination every two years.1 It is currently the only method recognized to be effective for the detection of breast cancer precursors or early tumor stages.3,4

Securing the diagnosis and further examinations

If your doctor has found a change in your breast, only the tissue sample - also called a biopsy - can show whether it is malignant. Several small samples of tissue are taken from the breast and examined in the laboratory. Several samples are important to get reliable results. The outpatient procedure takes place under local anesthesia so that it is as painless as possible.

If the tests suggest an aggressive tumor, you will be given more advanced imaging tests. This can be used to check whether the tumor has already spread to other areas, further away from the place of origin. These examinations include computed tomography (CT) of the lungs and upper abdomen and skeletal scintigraphy. CT can detect damage to other organs or lymph nodes caused by the tumor. Skeletal scintigraphy is used to examine whether the tumor has already attacked bones.

What types of breast cancer are there?

Doctors basically divide breast cancer into two different stages:

Early stage: localized breast cancer

In locally limited breast cancer, the malignant cells are restricted to the mammary gland.

Advanced stage: relapsed or metastatic breast cancer

In relapsed breast cancer, the breast cancer has returned to the same place after treatment. This can happen if one or more cancer cells survive the treatment. These can be in "sleep mode" for years and suddenly become active again, so that the cancer returns. In metastatic breast cancer, the cancer has spread throughout the body.

There are treatment options for all stages of breast cancer.

The stages of the disease

Before your therapy can be planned (see table), the tumor stage is determined. Your doctor uses the so-called TNM classification for this. This helps to assess how malignant a tumor is.

The three letters stand for the following features:

T - describes the initial tumor and is derived from "tumor". The digits 0-4 provide further information: 0 means that no initial tumor can be detected. 1-4 describe the increasing size and depth of penetration of the tumor.

N - describes whether the surrounding lymph nodes are affected and is derived from "Nodus", Latin Nodus lymphoideus = lymph nodes. The number 0 following the letter N means that no lymph node involvement can be detected. The numbers 1-3 stand for increasing involvement of lymph nodes in the vicinity of the tumor.

M. - describes whether distant metastases have been found and is derived from "metastases". If no distant metastases can be detected, the number 0 follows. M1 stands for the detection of distant metastases in one or more locations.

Your doctor will speak to you calmly and tell you exactly what stage you are and how best to treat it.

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