1. What does it mean if my breast cancer is hormone receptor-positive ?
When breast cancer cells have hormone receptors on them, it means the growth of the cancer cells is affected by female hormones. Breast cancer cell with hormone receptors on them are said to be ‘hormone receptor-positive’. About two-thirds of woman with breast cancer have hormones receptor-positive breast cancer. If your breast cancer is hormone receptor-positive, your doctor may recommend that you have treatment with a hormonal therapy. If your breast cancer is hormone receptor-negative, there are other treatment that are suitable for you.
2. What does it mean if my breast cancer is HER2-positive ?
‘HER2-positive’ means that the breast cancer cells have higher than normal levels of a protein called HER2.The HER2 protein affects how quickly cells divide in response to certain growth factors. Trastuzumab (Herceptin) is a targeted therapy that works by stopping HER2-positive cancer cells from growing and dividing. About one in five patients have HER2-positive, your doctor may recommend that you have treatment with targeted therapy.
3. What if I can’t remember what the doctor says ?
A diagnosis of breast cancer can be overwhelming. You will be given lots of information and you may find it difficult to remember everything. You can ask your doctor to repeat things or write them down for you.
4. How will i know what treatment to choose ?
Your doctor will explain your treatment options. Ask your doctor about the possible benefits and side effects of each treatment. You may need time to read about different treatments or talk to family and friends. After weighing up the benefits and side effects, you may decide not to have a particular treatment.
5. What should I do if I want a second opinion ?
You have the right to have second opinion at any time. If you want a second opinion, you can ask your specialist or your GP to refer you to someone else. You may decide after seeing another doctor that you would prefer the original doctor to manage your treatment. The fact that you have seen someone else should not affect how the first doctor manages your treatment.
6. How soon can i have a shower or bath after breast surgery ?
You should be able to have a shower or bath about 24 hours after breast surgery.
7. Will the radioactive substance make me radioactive ?
The amount of radioactive in the radioactive fluid used to locate the sentinel node is very low. It is similar to the level used in many scans for investigation of other medical conditions. It will not make you radioactive and it is safe for you to have close contact with your family immediately afterwards.
8. Will the surgery to the armpit be painful ?
All surgery result in some pain and different people feel pain at different levels. The pain associated with a sentinel node biopsy is much less than a full axillary dissection and its generally not severe. The armpit will often feel ‘tight’ after surgery.
9. How long does it take the blue dye and radioactive fluid to reach the sentinel node ?
The radioactive fluid can take anywhere between 10 – 20 minutes or up to 4 – 6 hours to travel to the lymph glands. Repeat scans may be taken at various time intervals up to several hours after the injection of the radioactive fluid. You may wish to read a book or magazine or listen to a personal music player to calm you while you are waiting.
The blue dye travels to the lymph nodes more quickly, usually within a few minutes of the injection. Therefore, the blue is best used during the operation after you have been anaesthetised.
10. How soon can i use deodorant after the surgery to the armpit ?
Once the wound has healed, you can use deodorant. It is Possible best to wait for up to a week after the surgery to make sure that the wound is healing well.
11. How soon can I shave my armpit after surgery to the armpit ?
It is important to make sure that the wound is healing well before trying to shave the armpit. It is probably best to wait for 1- 2 weeks after the surgery but you should take extra care when shaving as the skin may be quite numb in the early weeks after the producer. If you usually wax or have laser treatments to your armpit, speak to your doctor before restarting these.
12. How long does a breast prosthesis last ?
A breast prosthesis will usually need to be replace every two year or so.
13. How much does breast reconstruction cost ?
The cost of breast reconstruction will depend on many things. These include the type of reconstruction, whether you are a public or private patient, and the fees charged by the surgeon and other health professionals involved in the operation. If you have private health fund, ask an advisor about whether some or all of the costs can be covered by your health insurance policy.
14. How long does it take to recover from a breast cancer reconstruction ?
The time it takes to recover from a breast reconstruction is different for each woman. It also depends on the type of reconstruction. Usually woman can get back to normal activities 4 – 6 weeks after an implant reconstruction. Recovery after reconstruction using tissue from the back or stomach can take longer.
15. How safe are breast implants ?
The technology and safety of silicone implants has improved greatly in recent years. Using saline are also available but the cosmetic result is usually not as good.
16. Does having a breast reconstruction affect whether breast cancer will come back ?
There is no evidence that breast reconstruction affects whether breast cancer comes back. There is also no evidence that having a breast reconstruction stops breast cancer being diagnoses if it does come back.
17. Will having radiotherapy make me radioactive ?
18. Can i breastfeed if I have radiotherapy ?
If you have radiotherapy, you will probably not be able to breastfeed from the treated breast because will no longer produce milk. If you are able to breastfeed from the treated breast, there is no evidence that this unsafe for your baby.
19. What can i do to relieve symptoms ?
If your skin becomes red, dry, itchy or develops blisters during or after radiotherapy, ask your treatment team about creams and dressing to help you make more comfortable.
20. Can I wear a bra if I’m having radiotherapy ?
You can continue to wear a bra over the month or so of radiotherapy treatment. If your skin becomes sensitive, you may find it more comfortable to wear a cotton bra with no underwire or seams. Some woman like to wear a cotton t-shirt or handkerchief under their bar to reduce irritation.
21. What should I do if my skin doesn’t get better ?
Sometimes skin reactions get worse in the week or two after radiotherapy ends. If your skins is not healed within about two weeks of completing radiotherapy treatment, contact your radiation therapist.
22. How do I decide whether to have chemotherapy ?
Your doctor will talk to you about whether chemotherapy is recommended for you. Ask your doctor about the possible benefits and side effects of treatment. You might find it helpful to talk to other.
23. How often will I have treatment ?
The frequency of treatment will depend on which chemotherapy drugs are recommended for you.
24. Will chemotherapy make me lose my hair ?
Some women who have chemotherapy lose their hair. The chance of you losing your hair will depend on which drugs you receive. Talk to your doctor or breast care nurse about whether hair loss is a risk with the treatments that are recommended for you.
25. How do I know if I am hormone receptor-positive ?
Your pathology report shows whether there are hormone receptors on your breast cancer cells.
26. How do I choose which hormonal therapy to have ?
The decision about whether to have hormonal therapies and which one is best for you will depend on your individual situation. This includes :
* Whether there are hormone receptors on your breast cancer cells.
* Whether you have reached menopause.
* Whether you have completed your family.
* Your risk of breast cancer coming back.
When recommending which hormonal therapy is best for you, your doctor will consider the likely benefits and possible side effects of the different treatments.
27. How do the risk and benefits of different hormonal therapies compare ?
The long-term benefits and risks of taking tamofixen are well known. Tamofixen reduces the risk of breast cancer coming back and improves survival. Studies have shown that treatment with an aromatase inhibitor reduces the risk of breast cancer coming back more than tamofixen. Studies have not been going long enough to say whether aromatase inhibitors improve survival more than tamofixen. Also, we do not yet know the long term side effects of aromatase inhibitors.
For post-menopausal women with a higher risk of breast cancer coming back, the short-term benefits of aromatase inhibitors outweigh the risks of side effects (both known and unknown).
For post-menopausal woman with a lower risk of breast cancer coming back, it is possible that long-term side effects of aromatase inhibitors (as yet unknown) outweigh the short term benefits of treatment compared with tamofixen.
28. If I have side effects, can I lower my dose of hormonal therapy ?
The recommended doses of hormonal therapies are the only ones that have been tested. Taking lower doses or less frequent doses is not a good idea. If you have side effects, it is important that you discuss them with your oncologist, surgeon or GP.
29. If I change GPs during treatment, what should I do ?
If you change GPs while you are taking hormonal therapies, it is important to let your new GP know what are you taking.
30. If I run out of my script, can my GP renew it ?
Yes. Your GP can renew your script, even if your oncologist first prescribed it.
31. If I am planning to have surgery (including dental surgery), can I continue to take my hormonal therapy ?
Tamofixen increases the risk of blood clots. If you are likely to be confines to bed or if your mobility is likely to be limited for a period of time, your doctor may recommend that you stop taking your hormonal therapy before surgery. If your doctor su
ggests that you stop taking your hormonal therapy, you should not start taking it again until you are fully mobile after surgery. Talk to your doctor about what you should do if you are planning to have surgery.
32. If I miss a dose of my hormonal therapy, should I take a double dose ?
No. Just take the next dose as normal.
33. If I change from tamofixen to an aromatase inhibitor, can I change back later if side effects worry me ?
This may be possible. Talk to your doctor about your options if you ahve side effects that you are finding difficult to manage.
34. How do i know if I am HER2-positive ?
Your pathology report shows whether your breast cancer cells are HER2-positive.
35. How do I know if trastuzumab will be of benefits to me ?
Trastuzumab will only be suitable for you if your breast cancer cells are HER2-positive. About one in five patients with breast cancer have HER2-positive breast cancer.
36. How often will I need to receive treatment ?
Trastuzumab can be given weekly or 3-weekly.Your doctor will decide the best dosage and treatment regimen for you.
37. What happens if I have to stop trastuzumab for any reason before one year of treatment ?
We do not yet know the ideal length of time for which trastuzumab should be given. The current recommendation is to give trastuzumab for one year. One small clinical trial suggested that treatment with nine weeks of trastuzumab may be enough to give benefit to some women with early breast cancer.
38. Will trastuzumab treatment make me lose my hair ?
No, hair loss is not common side effect of trastuzumab. If you are receiving trastuzumab in combination with chemotherapy, you may lose your hair due to the chemotherapy.
39. Can I take complementary therapies at the same time as my conventional treatments ?
Some complementary therapies are encouraged by health professionals. These include relaxation, guided imagery, meditation and gentle exercise. Some complementary therapies may be harmful if taken at the same time as conventional treatments. It is important that you tell your doctor about any treatments you are taking or are involved in.
40. What is the difference between complementary and alternative therapies ?
Complementary therapies are therapies or treatments that are used alongside conventional medicine. Alternative therapies are therapies or treatments that are used instead of conventional medicine.
41. Can complementary therapies be used to treat or prevent breast cancer ?
There is no evidence that complimentary or alternative therapies can remove breast cancer, stop it from coming back or stop it from spreading to other parts of the body.
42. What should I do if I notice a change in my breast ?
If you find a change in your treated breast (or chest wall if you had a mastectomy) or in your other breast between follow-up appointments, see your GP or specialist as soon as possible. It is important that you do not wait until your next appointment.
43. How common is lymphoedema ?
We do not know exactly how many people develop lymphoedema in the arm or breast after treatment for breast cancer. Estimates vary from one in ten people to one in three people treated for breast cancer.
44. Will treatment affect my ability to become pregnant ?
Some treatments for breast cancer can affect your ability to become pregnant (your fertility). Once your treatment has finished there is no reliable test to find out if you can still become pregnant. If you do fall pregnant after treatment for breast cancer, there is no evidence that this will increase your risk of breast cancer coming back.
If your periods stop for a year or more, it is likely that your menopause will be permanent. If your menopause is permanent, you will be unable to have children naturally.
45. Is it safe to use hormone replacement therapy (HRT) after a diagnosis of breast cancer ?
Hormone replacement therapy (HRT) is a very effective treatment for menopausal symptoms. However, it is generally not recommended after breast cancer.
Studies of HRT after breast cancer have shown mixed result. We do not know whether HRT is definitely safe for women who have had breast cancer. The most common forms of HRT are ‘combined HRT’ which contain the hormones oestrogen and progestogen. Some treatments only use progestogen. These treatments are not as effective as those containing oestrogen. We do not yet know whether it is safe to take progestrogen after breast cancer.
Some women’s menopausal symptoms are severe and cannot be controlled with other treatments.HRT may be recommended for these women to relieve severe symptoms and lower the risk of fractures from osteoporosis.
If you have questions, discuss these with your doctor.
46. Who can I talk to for advice about returning to work after breast cancer ?
Some people find that diagnosis of breast cancer makes them rethink their work priorities. You may decide to try a different career path or change to part time work. If you find you are still tired when treatment is over,talk to your employer or organisation about making your hours more flexible for period of time.
A discussion with your personnel manager or supervisor early after your return to work will be useful in clarifying expectations.
47. How do i know if I am anxious ?
Some of the signs of anxiety include constantly feeling agitated or angry. You may have difficulty sleeping or you may have trouble concentrating or making decisions. You may find yourself avoiding distressing situations or you may get sudden feelings of panic or fear.
48. How do I know if I am depressed ?
Some of the signs of depression include feeling low or flat and losing interest in things you used to enjoy. You may feel tearful or find it hard to see the funny side of things. You may have difficulty sleeping or lose your appetite (although bear in mind this can also be a side effect of some treatments).