Many Shades of Pink

Breast cancer is a disease in which cells in the breast tissue grow out of control. There are different kinds of breast cancer. The kind of cancer depends on which cells in the breast turn into cancer. Breast cancer can begin in different parts of the breast. Your breast is made up of 3 main parts, lobules, ducts and connective tissue. The lobules are the glands that produce milk. Ducts are tubes that carry milk to the nipples. Connecitive tissue (fibrous and fatty tissue) forms the breast, surounding and holding everything together. Most breast cancers begin in the ducts or lobules. Breast cancer cells can spread outside the breast through blood vessels and lymphatic vessels. When breast cancer moves to other parts of the body, it is called metastatized. Normal cells vs. Cancer cells In general, regardless of where cancerous cells attack the body, they present a disruption to the lifecycle of cells. Normal human cells grow and divide as the body needs them. When they become old, or damaged the body will either repair them or they die and the body discards them. When cancer arises this orderly process fails. As cells become more and more abnormal, these old or damaged cells stop following the pattern of healthy instructions. Cells fail to die when they should and new cells form when they are not needed causing overgrowth. The extra cells may form growths called tumors. Tumors can be benign or malignant. Benign tumors are usually not life threatening depending on where they are located in body. They tend not to spread into nearby tissue. Unlike malignant tumors which can spread, invading close by tissue and break off traveling to other areas of the body forming new tumors. Cancer cells are different from normal cell in several ways. In addition to ignoring signals to die, cancer cells can influence normal cells, molecules and blood vessels to feed tumors. Cancer cells are also able to avoid or hide from the immune system, your body's protective network of organs and specialized cells whose sole purpose is fighting infection and foreign conditions in the body. Tumors can also use the immune system to stay alive grow enlisting the help of immune cells that usually prevent an abnormal immune response.

Studies show a combination of factors influence breast cancer risk. The main risk factors are being a woman and getting older. When you think about it, two things you'd never change:-) Most breast cancers are found in women 50 years old and older. Some women will get breast cancer without any other known risk factors. Having a risk factor does not mean you will get the disease, and risk factors effects vary. Although, most women have some risk factors, it's also true most women will not get breast cancer. If you have breast cancer risk factors talk with your doctor about ways you can lower your risk and get screened. Risks You Can't Control, But You Can Monitor Getting Older - your risk of breast cancer increases with age. Most breast cancer is diagnosed after the age of 50. Genetic Mutations - inheirited changes (mutations) to certain genes, such as BRCA1 and BRCA 2. Women who have these inheirited changes have a higher risk for breast and ovarian cancer. If you've already been diagnosed with breast cancer, it's important to talk with your doctor about genetic testing as a part of your treatment plan. Reproductive History - starting menstral periods before the age of 12 and beginning menopause after the age of 55 raise your risk of breast cancer because of longer exposure to hormones. Dense Breasts - women with dense breast are more likely to get breast cancer because they have more connective tissue than fatty tissue, making it harder to see tumors on mammogram. Personal History of Cancer or Non-Cancerous Breast Diseases - women who have had breast cancer before are more likely to get it again. Non-cancerous breast disease such as atypical hyperplasia and lobular carcinoma in situ are at higher risk of getting breast cancer. Family History of Breast Cancer - there is a higher risk of breast cancer if a woman's first degree family member (mother, sister or daughter) or multiple relatives on either her mother's or father's side of the family have previously had breast cancer. Young Black Women - tend to be diagnosed with breat cancer ___% more than other ethnic groups of women. Having breast cancer early in life also raises the risk of recurrence. Also, triple negative breast cancer is more likely to be diagnosed in women under 50 years of age. Triple Negative Breast Cancer - Only about 10-20% of all women will be diagnosed with this type of breast cancer. But researchers have found Black and Latino women are more likely to be diagnosed with triple negative breast cancer (estrogen receptor negative, progesterone negative and HER2 protein negative). About 70% of breast cancer with the BRCA 1 gene mutation are triple negative. Previous Radiation Therapy Treatment - women that have had radiation treatment to the chest or breasts (like for Hodgkins Lymphoma) before the age of 30 have an increased risk of breast cancer later in life. Risks You Can Control Being Physically Active - A physically active lifestyle, inclusive of regular exercise lowers your risk of breast cancer. Managing Your Weight After Menopause - taking steps to maintain a healthy weight reduces your risk of breast cancer. Taking Hormones - Some forms of hormone replacement therapy (those that include estrogen and progesterone) taken during menopause can increase your risk of breast cancer when taken for more than 5 years. Additionally, birth control pills have been known to raise your risk of breast cancer. Reproductive History - Having your first pregnancy after the age of 30, not breast feeding and never having a full-term pregnancy can raise your risk of breast cancer. Drinking Alcohol - Studies show an increased risk of breast cancer the more a woman drinks. Research also shows an increased risk of breast cancer with smoking, exposure to cancer causing agents and certain changes in hormones due to night shift working. Many Shades of Pink can help you understand your risk and connect you with free screening resources if needed, contact us!

Symptoms of breast cancer are not the same for everyone. Quite a few people do not have any symptoms at all. Some signs of breast cancer are: New lump in your breast or underarm (lump will have more obvious edges) Thickening or swelling in part of your breast Any change in size or shape of your breast Irritation or dimpling of your breast skin Unusual redness or flaky skin in your nipple area or breast skin Nipple discharge other than breast milk; including blood Nipple turned inward Pain in any area of the breast These symptoms can happen with other conditions that are not cancer. Remember, some breast cancer symptoms are invisible or go unnoticed without medical screening. To be proactive and give yourself the best chance of catching it early, check your breasts monthly for signs and symptoms with self-breast exams. If you are worried about any signs or symptoms, please see your doctor right away. Keep in mind that breast changes throughout your lifetime are normal. All breasts are unique. So, what is normal for you may not be normal for others. Most women will say their breasts are lumpy or uneven. Breast tend to change as you age. Also, the way your breast look and feel can be affected by the following: getting your period having children losing or gaining weight taking certain medications Many Shades of Pink is here for you, if you have more questions or concerns, contact us!

Breast cancer screening is a way of checking your breasts for cancer before there are any signs or symptoms of disease. Screening helps find breast cancer early when it is easier to treat and lowers your risk of dying from breast cancer. Getting screened for breast cancer will take place at a clinic, hospital or doctor's office. You should talk with your doctor about the best screening options for you. Breast Cancer Screening Tests: Mammogram - an X-ray of the breasts is the best and most used way to find cancer early before it is large enough to cause symptoms and is easier to treat successfully. Regular mammograms lowers the risk of dying from breast cancer and is the best way to find breast cancer for most women.Most health insurance plans are required to cover the costs of mammograms for women over 40 every one to two years with no out-of-pocket fees, such as co-pay, deductible or co-insurance. Magnetic Resonance Imaging (MRI) - uses magnets and radio waves to take pictures of the breasts. MRI is used along with a mammogram for screening women at high risk of breast cancer. MRI is not used for women of average risk because the MRI may show abnormal results even when there is no cancer. MRI reveals more detail and is considered to be more accurate. Clinical Breast Exams - are given by a doctor or nurse who uses their hands to feel for lumps and changes in your breasts and underarm area. Breast Self Exams - monthly checking of your own breasts for lumps and changes to the look or feel of your breasts. Knowing your breasts well and keeping track of how they change over the course of your life, makes it easier to notice any signs and symptoms to report to your doctor. The American Cancer Society and the American College of Obstetrics and Gynecology recommend breast cancer screening with mammography and clinical breast exams yearly beginning at age 40. To learn more about breast cancer screening recommendations, see CDC references. If you have any questions or concerns, contact us!

Mammography (ma-MAH-gruh-fee) is a screening tool that uses X-rays to create images of the breast. These images, called mammograms (MAM-o-grams), are used to find early signs of breast cancer such as a dense mass or clusters of calcium (microcalcifications). Overall, mammography is the most effective breast cancer screening tool used today. Mammography can also be used as a follow-up test when something abnormal is found on a screening mammogram or a clinical breast exam. When used as follow-up test (instead of screening), a mammogram may be called a “diagnostic mammogram.” When should you get a mammogram? Women at average risk should get a mammogram once a year starting at age 40. Women at higher risk may need to get screened earlier and more frequently than recommended here. If you are at higher risk of breast cancer, talk with your health care provider about which screening options are right for you. The following items will put you at higher risk for breast cancer: A mutation in the BRCA1 or BRCA2 gene (or a first-degree relative with a mutation) Strong family history of breast cancer, such as mother and/or sister diagnosed at age 45 or younger Personal history of breast cancer, including ductal carcinoma in situ (DCIS) Lobular carcinoma in situ (LCIS) or atypical hyperplasia Radiation treatment to the chest area during childhood or young adulthood A mutation in the p53 or PTEN genes (or a first-degree relative with a mutation). These gene mutations can lead to Li-Fraumeni syndrome Mobile Mammography Sometimes, the reason a woman doesn’t get a mammogram is that she doesn’t have time or can’t get to a clinic because of transportation issues. Many Shades of Pink Foundation works with mobile mammography coaches to provide mammography where women work, live, pray or shop. Diagnostic Mammograms and Other Diagnostic Services When a breast screening tests reveals something abnormal, a follow-up test, known as a “diagnostic service,” Every Woman Counts covers the cost of diagnostic mammograms, surgical consultations, MRIs, breast biopsies, ultrasounds and ancillary services for San Diegans. Can Breast Cancer Be Found Early? Breast cancer is sometimes found after symptoms appear, but many women with breast cancer have no symptoms. Therefore, regular breast cancer screening is so important. Finding breast cancer early and getting state-of-the-art cancer treatment are the most important strategies to prevent deaths from breast cancer. Breast cancer that’s found early, when it’s small and has not spread, is easier to treat successfully. Getting regular screening tests is the most reliable way to find breast cancer early. DEBUNKING MYTHS THAT KEEP WOMEN FROM GETTING SCREENED MYTH: Hair relaxers/perms cause breast cancer in African American women. FACT: A large study funded by the National Cancer Institute found no increase in breast cancer risk due to the use of hair relaxers or perms. Study participants included African American women who had used hair relaxers/perms seven or more times a year for 20 years or longer. MYTH: If I don’t have a family history of breast cancer, I won’t get it. FACT: About 90% of the women who develop breast cancer have no family history of the disease. MYTH: Your father’s family history of breast cancer doesn’t affect your risk as much as your mother’s FACT: Your father's family history of breast cancer is just as important as your mother's in understanding your risk. MYTH: Using underarm antiperspirant can cause breast cancer. FACT: There is no evidence of a connection between underarm antiperspirant and breast cancer. MYTH: Overweight women have the same breast cancer risk as other women. FACT: Being overweight or obese increases your breast cancer risk, especially if you're past menopause and/or you gained weight later in life. MYTH: Men cannot get breast cancer, only women. FACT: About 2,500 men are diagnosed with breast cancer each year in the United States. MYTH: Breast cancer always comes in the form of a lump. FACT: Breast cancer might not cause a lump, especially when it first develops. By the time it does, the cancer might have already moved beyond the breast into the lymph nodes. Although performing breast self-exams, it isn’t a substitute for regular screening with mammography. MYTH: Wearing an underwire bra causes breast cancer FACT: Scientific evidence does not support link between wearing an underwire bra (or any type of bra) and breast cancer risk MYTH: Breast implants can cause breast cancer. FACT: Women with breast implants are at no greater risk of getting breast cancer, according to research. Standard mammograms don't always work as well on these women, however, additional X-rays are sometimes needed to more fully examine breast tissue. MYTH: You can’t get breast cancer after a mastectomy. FACT: Breast cancer can recur at any time or not at all, but most recurrences happen in the first 5 years after breast cancer treatment. Breast cancer can come back as a local recurrence (meaning in the treated breast or near the mastectomy scar) or somewhere else in the body. MYTH: Consuming too much sugar causes breast cancer. FACT: There is no evidence that sugar in the diet causes breast cancer. MYTH: Carrying a cell phone in your bra can cause breast cancer. FACT: There is no evidence of a connection between cell phones and breast cancer.

The path to a breast cancer diagnosis is as unique as you are. You may have found a breast lump or a change in breast appearance led you to the doctor. Still others discover breast cancer more routinely from their yearly mammogram screening. What's important about your breast cancer diagnosis is learning to understand your pathology report. Your doctor will order various lab tests, begining with the initial biopsy report (small breast tissue sample used to diagnose cancer) which collectively will become your pathology report. The results from these tests give you and your doctor specific features of your breast cancer diagnosis. This personalized information about the type of breast cancer you have will be used to choose important treatment options. To make these decisions you'll need to know: size and appearance how fast it grows signs of spread to close by healthy tissue whether hormones or genetic mutations are impacting the cancer's growth and development These characteristics are used to determine and predict many factors, such as: Types - the most common type of breast cancer will be described as IDC invasive ductal carcinoma, cancer that has broken out of the milk duct starting to "invade" breast tissue beyond the milk duct. DCIS non-invasive ductal carcinoma in situ (cancer has not spread outside the milk duct). DCIS accounts for about 1 out of every 5 new cases in the US. Triple Negative breast cancer is distinguished by its hormone and protein expression. It is estrogen negative, progesterone negative and HER2 negative (cancer cells with low amounts of the HER2 protein that help control cell growth). Stage - is typically expressed as a number on a scale from 0 to 4.The stage is determined by the size of impacted (T)issue; positive or negative lymph(N)ode involvement and (M)etastasis, the spread of breast cancer within the breast and to other areas of the body. New staging guidelines also include hormone receptor status and HER2 protein status. For more information see Understanding Breast Cancer Staging. Phase - measures how much cells look like normal cells. The tumor grading scale is from 1 to 3, the lower your rating the more normal your cells appear. This list of characteristics is an overview and doesn't necessarily include all factors you and your doctor will consider in your treatment plan. However, knowing all the attributes of your "breast cancer profile" from your pathology reports will you research your personal health and empower you to ask questions when making decisions that are right for you.

Breast cancer is complex. Understanding the types of breast cancer can be challenging. You'll learn the language of breast cancer which is full of new words and statistics that you will use to consider healthcare choices to make the best decision for you. Each doctor, healthcare provider and support professionals may use different language to explain and describe cancer and its characteristics. You'll need to ask questions, repeat questions and ask again to be sure to have a clear understanding of what you are being told. Take your time with this information, let it settle in and ask for help in understanding if you need it. Breast cancer may start in different areas of the breast. The most common places for it to begin are in the ducts (tubes that carry breast milk) and lobules (glands that make breast milk). It may also be found in the tissue in between. A key factor in understanding breast cancer types is knowing the difference between non-invasive and invasive cancer. Invasive means "invading" or "infiltrating" abnormal looking cells that have spread to surrounding tissue. Non-invasive means an increase in abnormal looking cells that have NOT spread into surrounding tissue. The different types of breast cancer include non-invasive ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), Triple Negative (TNBC), inflammatory breast cancer (IBC) and metastatic breast cancer (MBC). Breast Cancer Types Ductal Carcinoma In Situ (DCIS) - is non-invasive breast cancer. This type of cancer begins in the "Duct" and has not grown outside the milk duct. "In Situ" means the cancer remains in its original place. Carcinoma means any cancer that begins in any of your body tissue. DCIS is very early cancer, it isn't considered life threatening because there are many treatment options. If DCIS is left undetected or untreated it can spread into surrounding tissue. Having DCIS does increase your risk for developing invasive cancer later on and cancer recurrence. Invasive Ductal Carcinoma (IDC) - is the most common breast cancer, this type of breast cancer is diagnosed in 80% of women. This type of cancer also begins in the milk duct. Invasive means the abnormal cells have spread into the surrounding rounding tissue. Posing a greater risk of having spread to the lymphnodes or other parts of the body. Younger women can be diagnosed with IDC, although it is more common in older women 55 years of age or older. IDC is also the type of cancer most likely to affect men. Invasive Lobular Carcinoma (ILC) - is the second most common breast cancer. Cancer cells that began in the milk producing glands (lobule) have spread into surrounding tissue. There is greater risk of this cancer spreading to the lymphnodes and other parts of the body. ILC accounts for about 10% of all invasive cancers. A woman of any age can be diagnosed with invasive lobular carcinoma, but it typically affects older women even later in life than invasive ductal carcinoma (IDC) at about the age of 60. Triple Negative Breast Cancer (TNBC) - is considered agressive and rare. These breast cancer cells test negative for estrogen receptors, progesterone receptors and excess HER2 protein. Since, TNBC does not feed off of hormones or the HER2 protein it does not respond to hormone therapy medications and targeted HER2 protein medicines. There are successful treatments for triple negative breast cancer. TNBC accounts for about 10 -20% of all breast cancers. Anyone can be diagnosed with this type of breast cancer, yet TNBC is found more often in younger people under 50 years of age, Black and Hispanic women and in those that have the inherited BRCA 1 gene. Inflammatory Breast Cancer (IBC) - is another form of agressive and rare breast cancer. Inflammatory breast cancer is fast growing cancer that invades nearby tissue and lymph vessels. It usually does not form a tumor that can be felt and targeted for treatment. When lymph vessels become blocked visible symptoms begin to appear. Early IBC signs and symptoms may include itching, redness, swelling, irritation or rash on the affected breast. The skin may also appear pitted like an orange with dimpling and nipple flattening or turning inward can happen. IBC is generally classified as stage 3 and should be treated immediately. Women in the US are typically diagnosed with IBC about 5 years early than more common types of breast cancers, at the ages of 52 for Black women and 57 for White women. According to the American Cancer Society IBC is more commonly diagnosed in Black women. IBC is also known to affect men. Metastatic Breast Cancer (MBC) - is breast cancer that is classified as stage 4 and has spread to other parts of the body. This typically includes the lungs, liver, bones or brain. Cancer spreading throughout the body usually happens by cells invading close by healthy tissues, getting into the circulatory or lymph vessel systems and traveling to other parts of the body; and cancer cells forming new tumors at new locations in the body. When breast cancer moves to another part of the body, like the lung the tumor or cells are still breast cancer cells in the lung, not lung cancer cells. MBC isn't considered curable at this time, but it is highly treatable and many people go on to live long full lives. This list gives you a basic overview of the most common breast cancer types and many important factors. If you can't find the breast cancer subtype (intrinsic or molecular) covered here you may find more information at breastcancer.org. Many Shades of Pink is here to help you understand the information and advocate for yourself, contact us!

When you need treatment for cancer you have a lot to learn and think about. It is normal if you feel somewhat overwhelmed. Learning about the different treatment options and talking with your physician will help you feel more in control. Also, Many Shades of Pink is here to assist you in this process. More than ever, there are many different breast cancer treatment options and life saving advances. The types of treatment that will be recommended will depend on the type of breast cancer you have and how advanced it is. Most breast cancer patients will have a combination of treatment options, such as surgery, targeted therapy and hormone therapy. Doctors that treat cancer work in teams and will work together to coordinate your treatment: Breast surgeon or Surgical oncologist - is a doctor that uses surgery to treat cancer. Radiation oncologist - is a doctor that uses radiation therapies to treat cancer. Medical oncologist - is a doctor that uses for chemotherapy and other medicines to treat cancer. Plastic surgeon - is a doctor that specializes in reconstructing or repairing parts of the breast. Breast Cancer Treatments In addition to discusing all of your treatment choices, their goals and possible side effects with your doctors. If time permits, keep in mind you can get a second opinion, to gain more information and confidence about your treatment plan. Surgery - is the most common breast cancer treatment. Your surgeon will remove the cancer from your breast and the some of the surrounding tissue (called margins). A biopsy of the sentinel node lymphnode is taken at the time of surgery. The sentinel node lymphnode is the first lymphnode in a group of sentinel lymph nodes th at is first to receive lymphatic drainage from the primary tumor. There are several surgical procedures: Lumpectomy which usually removes the least amount of breast tissue and is followed by radiation treatment. Sentinel lymphnode biopsy Whole breast and partial masectomy removes the entire breast or a significant portion. These type of surgeries may be a consideration depending on the type of breast cancer you have and your preferences. Plastic surgery for breast reconstruction and any cosmetic repairs will be coordinated with your surgery. Common Side Effects: Pain, tenderness, tugging sensation in breast, breast swelling, scarring or dimpling of surgery site and possible change in breast shape. Chemotherapy - is a drug used to stop the growth of cancer cells or prevent them from dividing. Chemotherapy for breast cancer is delivered by intravenous infusion (into the vein). Chemotherapy medication enters the bloodstream, to kill cancer systemically, throughout the entire body and some chemotherapy targets cancer cells specifically. Chemotherapy may be recommended before surgery to remove cancer. If given before surgery, chemotherapy shrinks the tumor in order to eliminate the cancer and/or reduce the amount of tissue to be removed during surgery. When chemotherapy treatment is given before surgery it is called neoadjuvant therapy. Traditionally, chemotheraphy is administered after surgery (adjuvant therapy) and may be followed by radiation therapy, targeted therapy or hormone therapy to be sure to kill any remaining cancer cells and lessen the risk of cancer recurring. Systemic chemotherapy is very toxic and side effects can be severe and difficult endure. You should ask about the risks and benefits and ways to lessen toxicity. Common Side Effects: Diarrhea, low red and white blood cell count, nausea, vomiting, mouth sores. Radiation Therapy - uses high energy x-rays to kill cancer cells. This radiotherapy only affects the part of the body treated with radiation. Radiation treatment is used to destory any invisible leftover breast cancer cells after surgery. People with early stage breast cancer Stage 0 (DCIS) andStage 1 invasive cancer higher. There are two types of radiation therapy: External Radiation - uses a machine outside of the body to carry cancer killing radiation to the whole breast or part of it targeting the cancer. This treatment typically requires daily appointments for up to 3 to 5 weeks in an outpatient radiation treatment center. Sometimes an increased dose, also called a "boost dose" will be included for a short period during the treatment course. Until recently, external radiation was the most common type of treatment for breast cancer. Internal Radiation - is a newer partial breast radiation treatment that is delivered in different ways, radioactive material sealed in either needles, seeds, cathater or wires is placed in the body directly into or near the cancer. Also known as brachytherapy, this radiation treatment may be implanted only once at the time of surgery or shortly after surgery over a 5 to 7 day period in a clinical outpatient radiation setting. Remember, how radiation therapy is given depends on the type and stage of cancer. Your radiation oncologist will lay out and discuss the appropriate treatment options with you. Keep in mind that since breast cancer treatments are usually combined with other treatments, getting the newer more convenient partial breast radiation will also depend on your treatment plan. Make sure to ask your doctor(s) if any of your treatments (surgery, chemotherapy or hormone therapy) will limit your options in other treatment areas such as radiation therapy. Common Side Effects: Sun burning, redness, skin peeling, skin darkening to area treated, swelling of the breast and fatigue. Hormone Therapy - kills breast cancer cells by cutting off their supply of hormones (estrogen and progesterone) fueling cancer growth in the body. Hormone therapy works to either remove hormones or block (inhibit) their activity. Hormones are natural substances released by glands in the body to help control healthy bodily functions, like menstration. The lab pathology report used to diagnose breast cancer will show whether cancer cells are feeding off the estrogen and progesterone in your body. Typically, if you're are pre-menopausal, your doctor will recommend hormone blocking therapy, called Tamoxifen which blocks receptors on your cells to starve estrogen-fueled cancers. Depending on the stage of breast cancer the drug, LH-RH agonist may be recommended to slowly prevent the ovaries from producing estrogen and progesterone or surgery to remove ovaries (hysterectomy). In postmenopausal women, your doctor will usually recommend hormone inhibitors, called aromatase inhibitors which stop the aromatase enzyme from turning androgen into estrogen. Thereby, decreasing your body's hormone production. In women with hormone receptor positive cancer, at least 5 years of post surgery hormone therapy (pill tabliets taken by mouth) reduces the risk by 50% that cancer will recur (come back) Common Side Effects: These treatments cause the common symptoms of menopause to become side effects - bone pain, hot flashes and nausea, night sweats and vaginal dryness. Targeted Therapy Targeted therapy is a newer type of treatment that can detect and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy. Types of targeted therapies used in the treatment of breast cancer: Monoclonal antibodies tyrosine kinase inhibitors cyclin-dependent kinase inhibitors mammalian target of rapamycin (mTOR) inhibitors PARP inhibitors are Monoclonal antibodies: made in the laboratory, monoclonal antibodies are immune system proteins that treat many diseases, including cancer. As a cancer treatment, these antibodies attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Monoclonal antibodies may be used in combination with chemotherapy an after surgery therapy. Types of monoclonal antibody therapy include the following: Trastuzumab more commonly known as Herception is a monoclonal antibody that blocks the effects of the HER2 growth factor protein, which sends growth signals to breast cancer cells. It may be used with other therapies to treat HER2 positive breast cancer. Trastuzumab deruxtecan also known as Enhertu is an antibody-drug temporarily unites and links trastuzumab to a type of chemotherapy. When this linked therapy binds to HER2 positive breast cancer cells, the chemotherapy enters the cells and kills them. Trastuzumab deruxtecan may be used to treat certain patients with HER2 positive breast cancer that has already been treated and has metastasized (spread to other parts of the body). Pertuzumab also called Perjeta is a monoclonal antibody that may be combined with trastuzumab, Herception and chemotherapy to treat breast cancer. It may be used to treat some HER2 positive breast cancer that has metastasized (spread to other parts of the body). It may also be used as neoadjuvant (before surgery) therapy in locally advanced, inflammatory, or early-stage breast cancer. It may also be used as adjuvant (after surgery) therapy in early-stage HER2 positive breast cancer. Ado-trastuzumab emtansine also known as Kadcyla is a monoclonal antibody linked to an anticancer drug. This is called an antibody-drug conjugate (temporarily united). It is used to treat HER2 positive breast cancer that has spread to other parts of the body or recurred (come back). It is also used as adjuvant (after surgery) therapy to treat HER2 positive breast cancer in those who have residual disease after surgery. Sacituzumab govitecan also called Trodelvy is a monoclonal antibody that carries an anticancer drug to the tumor. This is called an antibody-drug conjugate. It is being studied to treat women with triple-negative breast cancer who have received at least two previous chemotherapy regimens. Common Side Effects: Low blood pressure, fever, chills, weakness, nausea, diarrhea, vomiting Tyrosine kinase inhibitors: This treatment block signals needed for tumors to grow. Tyrosine kinase inhibitors may be used with other anticancer drugs as after surgery therapy. Tyrosine kinase inhibitors include the following: Lapatinib is a tyrosine kinase inhibitor that blocks the effects of the HER2 protein and other proteins inside tumor cells. It may be used with other drugs to treat HER2 positive breast cancer that has progressed after treatment with trastuzumab. Neratinib is a tyrosine kinase inhibitor that blocks the effects of the HER2 protein and other proteins inside tumor cells. It may be used to treat early-stage HER2 positive breast cancer after treatment with trastuzumab. Tucatinib is a tyrosine kinase inhibitor used with trastuzumab and capecitabine to treat HER2 positive breast cancer that is advanced and cannot be removed by surgery or has spread to other parts of the body, including the brain. It is used when cancer has already been treated with at least one other anti-HER2 therapy. Common Side Effects: Nausea, diarrhea, vomiting, rash, headache and low blood cell count. Cyclin-dependent kinase inhibitors: This treatment blocks proteins called cyclin-dependent kinases (CDKs), that cause cancer cell growth. Combining CDK4/6 inhibitors with hormone therapy may be effective in treating advanced hormone receptor–positive HER2 negative breast cancer. Cyclin-dependent kinase inhibitors include the following: Palbociclib also known as Ibrance is a cyclin-dependent kinase inhibitor used with the drug letrozole to treat breast cancer that is estrogen receptor positive and HER2 negative and has spread to other parts of the body. It is used in postmenopausal women whose cancer has not been treated with hormone therapy. Palbociclib may also be used with fulvestrant in women whose disease has gotten worse after treatment with hormone therapy. Ribociclib also known as Kisqali is a cyclin-dependent kinase inhibitor used with letrozole to treat breast cancer that is hormone receptor positive and HER2 negative and has come back or spread to other parts of the body. It is used in postmenopausal women whose cancer has not been treated with hormone therapy. It can also be used with fulvestrant in postmenopausal women with hormone receptor positive and HER2 negative breast cancer that has spread to other parts of the body or has recurred. It is also used in premenopausal women with hormone receptor positive and HER2 negative breast cancer that has spread to other parts of the body or has recurred. Abemaciclib also known as Verzenio is a cyclin-dependent kinase inhibitor used to treat hormone receptor positive and HER2 negative breast cancer that is advanced or has spread to other parts of the body. It can be used alone or with other drugs. Alpelisib also known as Piqay is a cylin-dependent kinase inhibitor used with the drug fulvestrant to treat hormone receptor positive and HER2 negative breast cancer that has a certain gene change and is advanced or has spread to other parts of the body. Used in postmenopausal women whose breast cancer has gotten worse during or after treatment with hormone therapy. Common Side Effects: Low blood cell count, nausea and fatigue. Mammalian target of rapamycin (mTOR) inhibitors: This treatment blocks a protein called mTOR, which may keep cancer cells from growing and prevent the growth of new blood vessels that tumors need to grow. mTOR inhibitors include the following: Used in postmenopausal women, Everolimus is an mTOR inhibitor for advanced hormone receptor positive breast cancer that is also HER2 negative and has not gotten better with other treatment. Common Side Effects: Mouth sores, rash, low blood cell count, nausea, diarrhea, fatigue. PARP inhibitors: This treatment blocks DNA repair in order to cause cancer cells to die. PARP inhibitors include the following: Olaparib is a PARP inhibitor used to treat patients with mutations in the BRCA1 or BRCA2 gene and HER2 negative breast cancer that has spread to other parts of the body. PARP inhibitor therapy is being studied for the treatment of patients with triple-negative breast cancer. Talazoparib is a PARP inhibitor used to treat patients with mutations in the BRCA1 or BRCA2 genes and HER2 negative breast cancer that is advanced without spreading or has spread to other parts of the body. Common Side Effects: Nausea, fatigue, stomach upset and low blood count. Although, breast cancer treatment is complex. There are multiple options for treatment that lead to living and even thriving after a diagnosis. Breakthroughs in improved medications and personalized genetic treatment innovations are making treatment less toxic and more effective. Keep in mind clinical trials are also an option that may be of great benefit in treating breast cancer. Remember, detecting breast cancer as early as possible will impact treatment options giving you the best chance of a full recovery. If you need help getting screened, Many Shades of Pink can help, contact us.

When you first learn you have cancer, everything seems to change in an instant. You may feel like your life has been turned upside down. Once the shock wears off, the process of making changes begins. You may have to rearrange tasks and routines in your life as you start treatment. The symptoms and side effects may take a toll on both your body and your emotions. You may have to learn new ways of talking to your loved ones and to your health care team. And you probably have a lot of questions to ask about adjusting to all the new issues that cancer brings. It can seem overwhelming at first, but knowing what to expect may help you feel more at ease. Many Shades of Pink is a great resource and can assist you with information and connections to other survivors in your cultural community with similar experiences you can learn from. Contact us!

There are millions of women and men in the United States living as breast cancer survivors. Many say that they felt they had lots of support during their treatment, but once it ended it was hard to make a transition to a new way of life. It was like entering a whole new world where they had to adjust to new feelings, new problems, and different ways of looking at the world. Knowing what to expect and the kinds of support you should ask for will give you a sense of stability to create an empowering reality moving forward. A New Normal Adjusting to physical and emotional changes after cancer treatment and tips on coping with fear of recurrence. Follow-Up Medical Care Information about follow-up medical care for patients who have completed cancer treatment. Discusses your follow-up care plan, getting a wellness plan, and guidelines for a healthy lifestyle. Late Side Effects of Cancer Treatment Breast cancer treatment can cause late side effects that may not show up for months or years after treatment. These late effects may include heart and lung problems, bone loss, eye and hearing changes, lymphedema, and other problems. Family Issues after Treatment Discusses common family problems and issues that often occur after treatment and ways to cope. Care for Childhood Cancer Survivors Survivorship care for children who have been treated for cancer is important. Get your child's treatment summary, survivorship plan, and recommendations on follow-up care clinics. Learn about long-term and late effects. Questions to Ask Your Doctor When You Have Finished Treatment Suggested questions for cancer patients to ask their doctors after treatment is finished and they are planning for follow-up care and next steps. As hard as treatment is, many cancer survivors say that the experience led them to make important changes in their lives. It helped them learn the value of being grateful for each day and for the people in their lives.

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