Surviving Breast Cancer – What Comes Next?

Amammogram is a low-dose x-ray of the breasts to look for changes that are not normal, and which may be cancer. The results are recorded on x-ray film or directly into a computer for a radiologist to review. The mammogram allows the doctor to see changes in breast tissue that cannot be felt during a breast exam.

Every woman should ask her doctor whether current guidelines for when and how often to get a mammogram apply to her. The guidelines take age into consideration, but women who have a family history of breast cancer, or any symptoms of abnormalities, probably will be encouraged to get this test soon.

Other factors that your doctor will review with you when deciding if the time is right for you to get a mammogram include starting menopause at 55+, being younger than 12 at your first menstrual period, never giving birth or giving birth to your first child after age 30, never breastfeeding, being overweight or obese, not getting enough exercise, and drinking alcohol.

Additionally doctors will want to know whether you have had high levels of radiation exposure (x-rays) to the chest early in life, take hormone replacement therapy, or have dense breast tissue.

In New York state, breast cancer is the most common form of cancer among women, according to the NYS Department of Health. Call 1-866-442-CANCER (2262) to find out where you can get breast cancer screening and support in your area. The phone line is open 24/7. Or, text "Get Screened" to 81336 to find the nearest location where you can get breast cancer screening. Also, if you don’t have health insurance, you can ask about free screening programs.

Get more information about the state’s Cancer Services Program at https://www.health.ny.gov/diseases/cancer/ services/.

October is Breast Cancer Awareness Month. In some ways, the month is a celebration of the many advances made toward diagnosing and treating breast cancer at its very earliest stages. With these earlier identifications come the expectations for more favorable treatment and survival outcomes. That said, when a cancer diagnosis is delivered, the individual receiving it often hears nothing but “I have cancer.” Words like these can be overwhelming. It begins a search to gather and develop the most competent team to lead you through this journey. There are many options when considering breast cancer surgery. Those are for you and your surgical team to examine. Perhaps you have chosen to pursue a lumpectomy or a mastectomy. These procedures might include lymph nodes being removed in the axilla (the armpit), to discover if a cancer has spread elsewhere.

But what happens after a tumor has been removed? Surgical intervention can deliver a whole new set of concerns including:

• Tissue adhesions that can lead to postural changes

• Impaired shoulder function

• Pain and subsequent movement compensations

• Seromas

• Hematomas

• Serratus anterior weakness

• Axillary web syndrome/cording (scarring or connective tissue under the arm that can limit range of motion) neuropathy; weakness; and an increased risk of cardiovascular disease.

Regardless of your breast cancer treatment approach, every survivor ’s plan for recovery should include treatment for whatever physical changes you may experience. It is imperative to see a physical therapist and certified lymphedema therapist early on to ensure the best results.

A therapist trained in breast cancer rehabilitation can work with you to:

• Address shoulder, complex movement, and soft tissue disorders

• Improve your comfort and function during and following breast reconstruction

• Address effects of radiation

• Reduce fatigue and weakness

• Develop an individualized home exercise program

St. Peter ’s Health Partners Patient Therapies has a variety of outpatient physical therapists at locations throughout the Capital District, accepting all insurances and providing quality one-on-one treatment. Our staff works closely with your oncology and/or primary care team to help decrease pain, improve flexibility, and reduce effects of scar tissue adhesions/ radiation fibrosis. If you are seeking treatment for lymphedema, our therapists have received specialized training in manual lymph drainage and compression bandaging. We have the longest operating lymphedema management program in the Capital District.

For information, please call 518-268-5749 or visit us at www.sphp.com/patient-therapies

Lymphedema is also a common side effect following breast cancer surgery. It occurs after the lymph nodes have been removed or damaged, impairing normal lymphatic flow in the arm, which causes the arm to swell. Your plan of care might also include radiation or chemotherapy. If radiation is part of your treatment, there can be temporary tissue adesions; reduced shoulder and trunk range of motion; inflammatory edema (swelling caused by excess fluid); and pain. You may also experience permanent changes called radiation fibrosis, which is scar tissue that can occur in the breast and chest wall. If your oncology team decides chemotherapy is warranted, challenges from the treatment can include pain; fatigue; poor tolerance to activity;