Things I never knew about breast cancer

Thank you for sharing that article Traveltext. The research shows promise for the vast majority of breast cancers that are +ER. I hope the progress toward tailored and more effective treatments will continue.

Hello everyone,

I've been reading some of the posting on this board. You definitely learn a lot about this topic. One of the many things that I didn't know is how many people are effected by breast cancer, and before this happened I didn't think anyone in my family had dealt with this. After I started treatment my sister informed me that our father had told her that our grandmother had died from breast cancer. Talk about surprise and not knowing.

Breast cancer can go from non-existent (clear mammogram) to invasive in 3 months!

Muriel I'm in Australia too. NSW. I had a mastectomy (very clean margins), chemo and an AI but no rads. I did consult with a Professor in Radiation Oncology but his recommendation was no radiation even though I had multi focal disease. He said he recommends rads for tumours larger than 5cm and although the combined size of my tumours was over 5cm he said he's not an "adder". Meaning he doesn't believe in adding them together. Individually, all of my tumours were under 5cm; so no rads.

I found out that there is no such thing as "Too young for Breast Cancer" when I was diagnosed at 27 years old. My pathologist was so shocked that he called my surgeon to confirm my date of birth because he thought there was an error.

I have since met women in their teens, 20s, and 30s with breast cancer. Unfortunately, BC in younger women tends to be more aggressive (triple negative) and higher grade. Additionally, because of the whole "you're too young mentality" younger women often experience a delay in diagnosis which leads to a cancer that is more advanced when it IS eventually diagnosed.

NO ONE should brush off breast issues because of their age, you're never too young for this disease

travel text....really interesting study. Aromatase inhibitors tend to increase cholesterol levels so this is pretty significant. I'm going to ask my doc at next visit. Thanks for sharing.

When I went to see my GP my lab results came back that my cholesterol and even my blood pressure had gone done. Dr. did say that possibly the tamoxifen had something to do with at least the cholesterol. I'm also on statin and there is a new study I think it claims that statin drugs will help with the side affects of tamoxifen?

Just a rant, I was diagnosed in 2007 at age 51.  I had been having mammograms since age 30 and had even started digital mammograms.  I even had a biopsy by a very famous breast surgeon 4 years prior.  I continued to see him annually. Mammograms and ultra sounds did not catch my 2.2 cm IDC.  I was so disappointed with my famous breast surgeon who wanted me to have recon but when I decided against it, never saw me or spoke to me again. Now I have an oncologist who did not know that Arimidex can cause higher cholesterol.  He also doesn't even examine me when I see him.  I have no faith in doctors and my motto is "paddle your own canoe."

I love this thread.

MRIs also do not always detect breast cancer.

There's a good reason why your doctor might not have heard of a relationship between AIs and dyslipidemia (higher LDL and lower HDL): the research into it is still in its relative infancy. The universe of patients taking AIs who had their lipids monitored before starting and continue while on AIs is very, very small--most research that finds a connection finds it's “statistically insignificant." Patients were not controlled for preexisting dyslipidema vs. normolipidemia. It's also exceedingly difficult to find enough breast cancer patients willing to risk being randomized to placebo rather than standard-of-care, even though data becomes “unblinded" midway through the study and everyone is offered the conscious choice of AI vs. no AI. The few studies out there for which any conclusions can be drawn, therefore, are not just epidemiological rather than prospective double-blind: almost all of them involve either patients taking letrozole for metastatic breast cancer or those switching from tamoxifen for the remainder of their endocrine therapy. (Tamoxifen, however, has been found not to harmfully impact lipid levels and may in fact improve them. because its mechanism does not result in estrogen deficiency in the body, just impaired access by tumor cells' receptors. But it does significantly increase the risk of blood clots, even more so than oral contraceptives in non-smokers. Basically, how would you prefer your heart attack or stroke--from a thrombosis or from plaques breaking off and blocking an already-narrowed arterial lumen? Trick question, since cardiovascular disease sometimes kills suddenly and painlessly, even occasionally in one's sleep--whereas death from metastatic ER+ breast cancer is never swift and pleasant).

But preliminary anecdotal data--as my PCP confirms--does indicate that at least letrozole does raise LDL and lower HDL, at least nominally, although it has no effect on triglycerides or VLDLs. And within the past 20 years, research has emerged (I've attended several drug-company dinners on the subject) that it isn't so much the raw LDL and HDL numbers as it is cholesterol particle size. You want to have big fluffy HDL particles that mop up the LDL before it can mess up your arteries. And as to LDLs, bigger is better too, because smaller LDL particles act like buckshot on preexisting arterial-wall plaques that are “friable" (flaky, unstable) due to inflammation. Larger LDL particles can cause atherosclerosis that simply narrows the lumen via stable plaque thickening its interior walls: it will eventually impair blood flow to the point that heart muscle can become starved in spots--but that can be corrected via stenting, which compacts the stable plaque in the narrowed spots, enlarging the lumen (the empty space in the “pipe") so blood flows freely....and in worse cases, CABG (coronary artery bypass grafting--a la Bill Clinton or David Letterman) is performed successfully.

Unfortunately, not many labs yet measure particle size and it's a much more expensive blood test than a simple serum lipid panel, so it isn't yet standard-of-care. So unless you're lucky enough to be in a clinical trial of particle-size testing, better to play it safe and try to lower your LDL count and raise HDLs. (Unfortunately, one of the best ways to accomplish the latter is a no-no for ER+ breast cancer patients: a glass or two of red wine per day. The 3 glasses per week (at most) we're allowed is insufficient to raise HDL). The other part of the equation is the ratio of total cholesterol to HDL. You want it to be less than 5:1. (in other words, you want your total cholesterol to be less than 5x your HDL). Mine's 4.4--which is okay--but before letrozole (at least 3 years ago, my previous lipid panel) it was 3:1. Therefore, after my September Surgi-Fest we'll have the statin discussion. (Bob is gloating, “I told you so;" as a cardiologist he believes statins should practically be in the drinking water). My PCP is thinking perhaps rosuvastatin (generic Crestor, which works better with fewer side effects than atorvastatin--generic Lipitor--or older-generation statins) in a lower or periodic--2-3x/week--dose. I had been on atorvastatin 3 yrs ago but he took me off it when I reported quadriceps aches; however, I notice that if I sit with knees bent for too long, as in an arena or theater seat, or use too much resistance on a stationary bike after not having ridden for a while, I get the same quad aches--and I haven't touched a statin since March 2013. (IIRC, I first noticed that ache back then after a stationary bike ride).

Joan - all I can say is wow - and in a way you take the guilt off people who think something they did caused their cancer..

I agree with the problem of waiting for appointments - the anxiety that causes is something the professionals do not take into consideration.. however, if we have a doctor we really want to have as our doctor, we have to wait.. I know that for me, once the radiologist recommended biopsy, it took almost 5 stressful weeks for my appointment with the breast surgeon... Maybe I could have gotten an appointment with someone else quicker but this BS came with high recommendation and I chose to wait. It was a good choice for me and those 5 weeks were so hard for me ... once the cancer was confirmed though, everything moved quickly.

I hope you don't lose your job - yes, you might miss some time but overall it helps to keep working... and you are right, it is against the law to fire you for having cancer..

i wanted to add something...things I never knew...how you have to be your own advocate, don't expect everyone on your medical team to understand breast cancer from A-Z - I have found most only understand their own discipline (surgical oncologists and surgery, medical oncologists and chemo/hormone therapy etc) we need to be our own advocates. I just had a good friend who is about to have breast surgery have a nurse tell her "you wont get lymphedema, and if you do come to us when you have swelling?????? OH MY. - she was kinda fighting me on it asking if I had more nodes removed etc - I only had 2 - I told her low risk isn't zero risk and once you have swelling it is something to manage forever and the best route is prevention

Frustrating

Hi, dtad! What study are you referring to re: high cholesterol and recurrance? Is there a link to it? Many thanks!-JuniperCat