Oncology office: Questions and answers about breast cancer

A few weeks ago at Hola.com we opened an oncology clinic for our readers to send their questions and queries about this disease. And, today October 19, on the occasion of the world day against breast cancer, Dr. Javier Cortés, head of the Breast Cancer and Gynecological Tumors Unit of the Oncology Service of the Ramón y Cajal Hospital, in Madrid, Head of the Clinical Research in Breast Cancer at the Vall d'Hebron Cancer Institute in Barcelona and collaborator of the Intheos Foundation, has answered a selection of these questions.

My mother died a year ago of breast cancer, which was a bit strange for all of us because, as far as we know, that disease doesn't really run in my family, either on the maternal or paternal lines, but it did happen. My doubts are the following: can I, as a daughter, necessarily inherit my mother's illness? What preventative measures can I take about it? Thank you so much.

First of all, I am so sorry to hear about the passing of your mother. Breast cancer is a very common disease, so it is common for a sister, daughter or mother to have it despite the fact that it has not appeared before in other relatives. When a person has breast cancer, the chances that a close family member will also have it are very slightly higher than in the general population (approximately 1-2% more), so there is nothing special to do; of course periodic check-ups and mammograms. Regarding preventive measures, I would recommend leading a healthy life; that is, regular exercise, a balanced diet, not smoking and drinking alcohol in moderation (a glass of wine with food is great).

First of all, I would like to thank HOLA and you for the brilliant idea of ​​opening this 'consultation'. My question is the following: In March of this year I did the usual breast examination. A few days after doing it, they call me to say that it is better that I do the test again, this time with an ultrasound. The result is a larger than normal gland that extends into part of the armpit. The fact is that for a couple of months I have been noticing a lot of discomfort in my armpit and as if that gland had hardened. I do self-examinations and notice the irregular area, especially in the area that joins the chest with the armpit. Consulted with my family doctor, he tells me not to worry, that said discomfort can even be of muscular origin and that, since I recently had the revision done, it is not necessary to repeat it. What would be your advice? As important information to tell you that I have recently turned 50, that 6 years ago I went through Pancytopenia (already completely disappeared) and a conization of the cervix 13 years ago. In my family there is a history of various types of cancer (including breast cancer, suffered by my grandmother and great-grandmother). Thank you very much for your time and attention.

Thank you for asking us. Although it is very difficult to make an adequate assessment without being able to see her, I would recommend repeating the ultrasound. There is a lot of benign pathology in the breast, but the best way to be sure is by repeating an innocuous test such as ultrasound.

First of all, thank you for this opportunity to consult. I have been undergoing check-ups for six years (I am 44 years old), first they were every six months and then annually. They consist of mammography, ultrasound and sometimes punctures. My history would be that of a paternal grandmother who died from this cause. My discomfort is mainly in bed and in the shower, the pain is very unpleasant, as if it had pins, especially in the left breast. I will continue with my annual checkups, but should I be aware of any symptoms or discomfort? Thank you.

Oncology Clinic: Questions and answers about the breast cancer

There are many reasons why it can bother the breast. It seems that it is being very well followed, so there is almost certainly nothing serious about it. Having said this, the discomfort that you have must be diagnosed, in order to be able to give you the appropriate treatment. Hormonal changes are generally behind breast discomfort. Another of the most frequent reasons for discomfort in the breast that often goes unnoticed is pathology of the cervical spine, generally in older people.

I would like to know if it is possible to have breast cancer without having any apparent symptoms: pain, noticeable lumps in the breast, etc. Thank you

Yes, you can, and this is precisely where early detection tests come into play, especially mammography.

Hello, a month ago a white pimple appeared on my right nipple, I went to the gynecologist and he sent me an ultrasound of the breast and the result was a sebaceous cyst. I would like to know what is the step to follow, is it drained or operated? In the long, medium or short term, does this lead to breast cancer? Thank you so much.

A sebaceous cyst is a completely benign tumor that does not become cancer. The most frequent complication is that they can become infected. The definitive treatment is surgery, which allows the capsule to be removed.

Thank you for the opportunity to inquire. Two questions: 1- Does the size of the breast have any relationship with the possibility of suffering from cancer, that is, large breasts have more risk? 2- Can the changes that occur in the breast during pregnancy lead to the appearance of cancer? Thank you. All the best

It is controversial whether people with very large breasts have an increased risk of breast cancer; but if it existed, this increase would certainly be small, and does not lead to any extraordinary measure. Regarding your second question, these changes are totally physiological and therefore normal. There is no known relationship with breast cancer.

My question is about food. Is there some type of food that should be avoided and some that should be taken more? Thank you.

There has been much talk about diet and breast cancer and continues to be talked about a lot. There is no study that has specifically and correctly assessed this aspect. Recently, the consumption of olive oil has been associated with a decrease in breast cancer; however, it must be remembered that this was not the main objective of this work. My recommendation is to lead a healthy life, which includes a balanced and Mediterranean diet. And also physical exercise.

Good afternoon, I am almost a year away from a right mastectomy. Thanks to the pink campaigns, it was possible to detect a grade 1, with a size 2, in time. At first, they were only going to perform a quadrantectomy, however, for my safety they opted for a mastectomy. The doctor who operated on me – a man with a lot of experience – left me with a lot of skin; he told me it was so plastic surgeons would have something to work with. My question: Is it safe to rebuild me? Will I present problems later because of the implant? What is the convalescence time? Will my breasts look the same? My latent fear is that something will be removed and cells will multiply. I've already had chemotherapy and radiotherapy and I'm on Novaldex) and my last mammogram and ultrasound came out great!

Absolutely. It can be rebuilt without any fear. From the point of view of risk of relapse, it does not increase due to having performed a reconstruction after the mastectomy, and from an oncological point of view it does not present any problem. These can come from surgical and/or aesthetic aspects. As for how the reconstructed breast looks, it depends on many factors, but sometimes it turns out really well. The convalescence time depends a lot on the type of surgery, but in general it is a few days.

Hello doctor, I had an operation in October 2012 and they removed 33 lymph nodes, 32 of which were infected. I would like to know what are the latest treatments for lymphedema. I do the multilayer bandage and wear a sleeve, but really bandaging every night is horrible. Thank you for letting me know as I am anxious and worried about my issue.

It depends a lot on the degree of lymphedema you have. I recommend two things; firstly rehabilitation exercises (with a good rehabilitator) and secondly assessment by a vascular surgeon specializing in lymphedemas. There are some patients who really improve with surgery, but it must be carefully evaluated by experts in this type of procedure.

I would like to know what water cysts are and if they can cause any problems or complications. Thank you for the opportunity to raise a question. All the best.

Water cysts are not so-called simple cysts; that is to say, an absolutely benign pathology that does not increase the chances of cancer. They are very frequent and generally you don't have to do anything. Only if they were large, you could click to reduce their size.

I have had for more than six months a discomfort in the right breast, burning and pain in the upper right part almost attached to the armpit. The doctors say it's hormonal, but I already have pain and swelling all the time. I am 42 years old, I am mixed race, I have no children and I am overweight. Thank you for solving me, since it worries me.

As your doctors have told you, it probably has to do with hormonal changes; However, if it bothers you a lot, gandulitis or mastitis should be ruled out, which could require specific treatment. An ultrasound could help you in the diagnosis. That said, if you can eat a balanced diet and get some exercise, it may help you get better.

Two years ago, I overcame breast cancer in the sentinel lymph node. It is affected. My lymph nodes were emptied and I was given chemo and radiotherapy. Now he has touched me again in the other breast, they have removed the sentinel node for analysis, but now the gynecologist has said that even if it is affected, the nodes should not be removed. The truth is that I don't understand why and I'm worried. Could you help me?

Lately, some studies have appeared that show that, in some cases, despite the fact that some of the sentinel nodes are affected, axillary dissection has no advantage. This has been known since very little. It depends on many factors, so your doctor's indication may be totally correct.

I've had a fibroadenoma removed from my left breast, I'm perimenopausal, what are the chances of it recurring? Is it true that wearing a bra day and night reduces the chances of tumor formation? I say this because it was recommended to me at the hospital.

Fibroadenomas are benign tumors that are in no way related to breast cancer. They are very frequent and it is possible that they may appear or be more. If they are clear, nothing needs to be done, unless they are annoying due to their size (sometimes it is recommended to remove them) or they are not diagnosed with quality, in which case a biopsy is usually obtained to be sure. Although there are few studies in this regard, the most important work carried out in Seattle did not show any relationship between wearing a bra and breast cancer.

I have breast prostheses in front of the muscle, I get mammograms every year, my question is: can any anomalies be detected with the prostheses?

Yeah, don't worry. The follow-up of the breasts can be carried out correctly despite having prostheses.

I am 30 years old and every year I have a check-up at my gynecologist, my mother suffered breast cancer when she was 43 years old. My question is if the review every year through the normal gynecological examination is enough without the need for a mammogram or ultrasound, since my doctor has never done one (she examines me with her hands).

Women in their 30s tend to have very glandular breasts, so mammograms have little sensitivity. With that being said, it would be important to know if she has any further history of breast and/or ovarian cancer in her family. I recommend you discuss these aspects with your doctor and the possibilities of having a specific genetic alteration. Depending on this, the recommendations would be different. That said, an annual ultrasound (especially from the age of 33-35) could be considered.

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