Could City Lights Raise Breast Cancer Risk?

Study found link between ambient light and higher odds in young, smoking females, but more research needed

By Randy Dotinga

HealthDay Reporter

THURSDAY, Aug. 17, 2017 (HealthDay News) — New research reveals an unexpected potential risk factor for breast cancer: city lights.

The Harvard Medical School study found an association between living in areas with high amounts of ambient nighttime light and slightly increased odds for breast cancer in younger women who smoke.

“In our modern industrialized society, artificial lighting is nearly ubiquitous. Our results suggest that this widespread exposure to outdoor lights during nighttime hours could represent a novel risk factor for breast cancer,” study author Peter James said in a Harvard news release. He’s assistant professor of population medicine at Harvard’s Pilgrim Health Care Institute.

As the investigators explained, earlier research had suggested that high levels of exposure to light at night disrupts the body’s internal clock. In turn, that might lower levels of a hormone called melanin which, in turn, might boost the risk of breast cancer.

Testing the theory further, James’ group tracked almost 110,000 U.S. women, followed as part of a long-term study of nurses from 1989-2013.

The researchers used nighttime satellite images and records of night shift work to help figure out the amount of nighttime light each woman might have been exposed to.

The study wasn’t designed to prove cause and effect. However, the Harvard group found that breast cancer levels in premenopausal women who currently smoked or had smoked in the past grew by 14 percent if they were in the 20 percent deemed to have had the most exposure to outdoor light at night.

Furthermore, as levels of outdoor nighttime light went up, so did the likelihood of breast cancer for this subgroup of women, James’ team said.

Older women, and women who’d never smoked, did not seem affected, the researchers said.

The study also found evidence that working night shifts might boost the breast cancer risk.

Given that millions of younger women have little control over the amount of nighttime ambient light they’re exposed to, what, if anything, should be done?

One expert in breast cancer care said it’s just too soon to take anything concrete from this research.

“The findings in this study have to be taken with caution,” said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. “Although circadian rhythm disruption may be a factor in increasing the risk of cancer, it could be other factors related to working at night as well.”

For example, she said, “women who work night shifts may not eat well or exercise, both of which affect breast cancer risk. Also, the study found the risk greatest in smokers — which leads one to believe these women might not be living as healthy a lifestyle as the group that was sleeping at night.”

Overall, Bernik said, “more insight as to the root cause of the increased rate of cancer in night owls is needed.”

The study was published Aug. 17 in the journal Environmental Health Perspectives.

WebMD News from HealthDay
SOURCES: Stephanie Bernik, M.D., chief, surgical oncology, Lenox Hill Hospital, New York City; Harvard T.H. Chan School Of Public Health, news release, Aug. 17, 2017

Hampstead teenagers form business to help people with breast cancer

HAMPSTEAD — “The Pink” comes from the color that represents the fight against breast cancer. “Bowz” comes from the teens’ experience with cheerleading.

Alleigh Wiggs, Kayleigh Riker and Anna Williams were all on the Topsail High School cheerleading team at the time they began The Pink Bowz.

It started when Wiggs and Riker heard one of their friend’s mother was diagnosed with breast cancer in June 2015. A few weeks prior, Riker said Wiggs had sent her a text saying, “Hey, we should do something charity-wise for people.” After learning of their friend’s mother, Wiggs and Riker saw this as their opportunity and teamed up with Williams to start brainstorming ideas on how to raise money.

“We were getting to talking one night before the fundraiser, and were like, ‘You know, we should really continue this — do something more with it,’” Riker said.

And “something more” they did. On Aug. 3, 2015, Riker, Wiggs and Williams filed The Pink Bowz as a business.

Aug. 15, 2015, The Pink Bowz completed its first fundraiser at the Hwy 55 in Hampstead, raising $670 to donate to their friend’s mother.

Local impact

“It’s our community,” Riker said. “We want to give back to the community that’s given so much to us.”

The American Cancer Society estimated that for 2017, there will be 8,580 new cases of female breast cancer in North Carolina alone. Nationally, they estimated 255,180 cases of breast cancer will arise in 2017.

In the 2016 Cancer Annual report, New Hanover Regional Medical Center reports that in 2015, there were 421 total cases of breast cancer, while 418 of those were female breast cancer.

In two years, The Pink Bowz has donated $6,000 to seven women in the Hampstead and Wilmington area. Their goal is to donate $10,000 before they graduate from Topsail High School in June 2018.

The fundraisers

As cheerleaders, Wiggs said they wore and made many bows for cheerleading alone, so they started making bows to sell to raise money for their business.

However, after participating in Hampstead’s annual Spot Festival, Wiggs said they realized the amount of work that goes into making so many bows, so they switched their emphasis from bows to bigger fundraisers.

“We found a niche to where it worked out a lot better to do these bigger fundraisers rather than try and sell bows because the market around here is a lot smaller, so we do it sometimes, but we definitely found greater success with other stuff,” Wiggs said.

The Pink Bowz has grown into a club at Topsail High School as well, allowing more students and the community to be involved in the fundraising events.

Molly Johnson was one of the students who joined the club.

She said one of her favorite fundraisers The Pink Bowz has done is the Krispy Kreme doughnut fundraiser because she is “not afraid to go door-to-door with some doughnuts.”

In addition to the pancake breakfasts and Krispy Kreme fundraisers, The Pink Bowz has had penny wars between grade levels at school; “pink-out” games for volleyball, football and basketball; a bowling night; an ice skating night; and putt-putt. They are currently planning a 5K, which they are hoping will happen within the next year.


The four girls do not only focus on one person at a time, but they also share other stories about people with breast cancer in the area.

“We like to hear people’s stories,” Riker said. “We like it if they have a GoFundMe because we can repost it to our Facebook, our Twitter, Instagram, and get the word out because not only can our followers help other people, but it’s getting shared then and going around social media.”

But it’s not just the story — it’s the personal touch the girls find most beneficial in receiving donations.

“Knowing the story behind who you’re donating to makes it a more personal experience because you’ll scroll through Facebook any day and see GoFundMes everywhere, but if you actually see a face with a name and a story … it definitely pulls at your heartstrings more,” Johnson said.

Wiggs said they try to give each person $1,000.

“You know, even if these people are financially stable, this money does help them in some way take care of their costs,” she said. “Because you know they’re having to give up their paycheck to having cancer.”

Where is The Pink Bowz going?

The business is in transition.

Riker, who graduated from Topsail High School earlier this year, is now beginning her freshman year at the University of North Carolina – Greensboro. She plans to spend her weekends home doing fundraising events with The Pink Bowz.

“I’m not done. There’s no way I’m done,” she said.

Johnson, Wiggs and Williams are finishing their time at Topsail High School.

But even though they all plan to leave the Hampstead area for college, they hope to bring The Pink Bowz with them wherever they go.

“I think if everything works out well, I want to keep it going while I’m in college,” Wiggs said. “Hopefully it’ll see even better days than it has already.”


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4 Things Everyone With Boobs Should Know About Breast Cancer Detection

AUGUST 9, 2017

Breast cancer is one of the most “visible” cancers in our society, with organizations and events devoted to finding a cure and advancing treatments being extremely prevalent. And it’s no surprise: According to the Centers for Disease Control and Prevention (CDC), not counting some forms of skin cancer, breast cancer is the most common cancer in women in the United States. And according to estimates from the American Cancer Society, nearly 253,000 new cases of invasive breast cancer will be diagnosed in women in 2017.

The good news? Survival rates continue to rise in breast cancer patients (there are currently more than 3.1 million survivors in the U.S.) And a huge part of continuing that trend is early detection. “Finding breast cancer early and starting treatment as soon as possible is key to a patient’s overall success and health,” says Lydia Liao, a radiologist and director of the Breast Imaging Center at Mount Sinai Radiology Associates West in New York City.

In fact, according to the American Cancer Society, while the five-year relative survival rate for women with metastatic, or stage four breast cancer is 22 percent, that number jumps to nearly 100 percent for women with stage 0 or stage 1 breast cancer. (Worth noting: The American Cancer Society points out that, because treatments are constantly improving, it’s possible the prognoses are even better than those statistics — which are necessarily based on patients who were treated at least five years ago — indicate.)

Here’s what you should know about breast cancer detection, screenings, and signs.

1. It may be worthwhile to start self-exams in your 20s.

Though there are some conflicting views on whether or not people should perform self exams, and the American Cancer Society states that research hasn’t shown “a clear benefit,” Liao still recommends doing them, starting when you’re 20 years old. “I think if breast self examination (BSE) is performed properly, it has value for early breast cancer detection,” she says.

Keep in mind, though, that self exams are not substitutes for clinical screenings. But BSEs are a good way to get to know your breasts and be attuned to the (common) changes that occur over the years. “Most women will have some lumps or lumpy breasts, and most of those lumps are not cancer,” Liao says. “Only 20% of those with suspicious lumps turn out to be breast cancer.” She recommends keeping a journal or even drawing a diagram or “map” of your breasts so you can keep track of what you feel each month and can more easily identify new findings.

Liao recommends you perform a self exam once a month, and aim for several days after your period ends, “when the breasts are least likely to be swollen and tender.” (If you don’t get a regular period, she says to set a day to conduct your BSE and do it the same day each month.) Do the exam in front of the mirror and use the opposite hand in circular motions to feel for any abnormalities in the breast itself, as well as your armpit, which is also home to lymph nodes, where breast cancer can spread. Johns Hopkins Medicine Breast Center recommendsdoing the exam standing up and lying down, so you get to know the feeling of your breasts in different positions.

2. It’s important to check for lumps and other abnormalities.

The most common direction we hear for breast self exams is to feel for new lumps which, Liao notes, should be reported to your doctor regardless of size. But lumps aren’t the only thing you should be looking for. Liao points out that breast swelling (even without lumps), skin irritation (like a rash, redness, or scaling) or dimpling, breast or nipple pain, newly inverted nipples, and nipple discharge (other than breast milk) are all possible symptoms of breast cancer as well. If you’re experiencing any of those, make an appointment with your doctor. “[Some of] those are relatively non-specific, but when a patient has new, suddenly-occurring symptoms with no explanation, that needs to be examined,” she says.

3. Mammograms are crucial screenings.

Mammograms, which are X-rays of the breasts, are crucial in diagnosing breast cancer. The process itself involves having your breast compressed between two plates (to get a high-quality image) while the machine takes images from different angles. Today, some patients undergo 3D mammograms, or breast tomosynthesis, which Liao says are becoming increasingly more common and available. “Instead of looking at one [flat] picture, [a 3D mammogram] actually looks into the breast with multiple images of the breast at different angles,” she says. For example, she says breast cancer in a dense breast full of tissue is like an airplane in a sky full of clouds. With a flat picture, you may not be able to see the airplane, but with a 3D image, you can. “[The 3D mammogram] looks through layers of tissue to find something hiding within the breast tissue,” she says. “It does increase the power for detecting breast cancer.”

While self-exams help you get to know your breasts, they’re no substitution for mammograms, which can detect small lumps and abnormalities that you (or your doctor) may not be able to feel manually. “Annual mammograms can detect cancer early…before [breast cancer] can be palpated by the patient [during a] self breast examination,” Liao says.

Though there are varying guidelines as to when women should start getting these screenings, she agrees with those that state you should get your first mammogram by the age of 40. (If you have a family history of breast cancer, though, it’s advised to start getting mammograms even earlier. If you’re in that high-risk group, talk to your doctor about the best course of screening action for you.)

4. Some people undergo additional screenings as well.

When reviewing your mammogram pictures, Liao says the doctor will look for calcifications (calcium deposits), masses, and any sort of distortion. If any of those are found, the doctor will likely follow up with a diagnostic mammogram(using a different technique from a screening mammogram) and breast ultrasound for assessment. If a diagnostic exam confirms the suspicious finding, a needle biopsy can be performed to ensure an accurate diagnosis.

And if the mammogram is inconclusive, Liao says your doctor may follow up with an MRI (magnetic resonance imaging) or an ultrasound as well, which can provide an even clearer image. “[An MRI] has the ability to detect breast cancer at a very early stage, [even] when there is no mammographic finding,” she says. If a patient is at high-risk for breast cancer, an MRI may be used as a regular screening tool, along with the yearly mammogram. And if a patient has dense breasts, a breast ultrasound may be used in regular screening as well — but, as the American Cancer Society points out, ultrasounds can reveal more findings that aren’t cancer and lead to unnecessary testing.

“The most important thing [to remember] is breast cancer detection cannot be done only by one thing, like a self- breast examination,” Liao says. “It has to be combined with screening tools when the patient is at the right age, so the breast cancer can be detected…when it’s small and before it spreads to other parts of the body. The key point is to make sure that cancer is diagnosed at an early stage so it can be treated completely.”

As with any medical concern, it’s important to have an open dialogue with your doctor — whether you simply want more information on preparing for tests like these or feel like you’ve detected something potentially concerning. Rather than fret or fear, make that call, schedule that appointment, and put your health first.


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First-in-class drug holds promise for therapy-resistant breast cancer

Date: August 8, 2017

Source: UT Southwestern Medical Center

Summary: A first-in-class molecule can prevent breast cancer growth when traditional therapies stop working, new research indicates.

UT Southwestern Simmons Cancer Center researchers have shown that a first-in-class molecule can prevent breast cancer growth when traditional therapies stop working.

First-in-class drugs are drugs that work by a unique mechanism, in this case a molecule that targets a protein on the estrogen receptor of tumor cells. The potential drug offers hope for patients whose breast cancer has become resistant to traditional therapies.

“This is a fundamentally different, new class of agents for estrogen-receptor-positive breast cancer,” said Dr. Ganesh Raj, Professor of Urology and Pharmacology at UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center.”Its unique mechanism of action overcomes the limitations of current therapies.”

All breast cancers are tested to determine if they require estrogen to grow and about 80 percent are found to be estrogen-sensitive. These cancers can often be effectively treated with hormone therapy, such as tamoxifen, but as many as a third of these cancers eventually become resistant. The new compound is a potential highly effective, next-line treatment for these patients, said Dr. Raj, part of UT Southwestern’s Urologic Cancer Team.

Traditional hormonal drugs, such as tamoxifen, work by attaching to a molecule called the estrogen receptor in cancer cells, preventing estrogen from binding to the receptor, a necessary step for cancer cells to multiply. But the estrogen receptor can mutate and change its shape over time so that the treatment drug no longer fits neatly with the receptor. When this happens, the cancer cells start multiplying again.

“There has been intense interest in developing drugs that block the ability of the estrogen receptor — the prime target in most breast cancers — from interacting with the co-regulator proteins that cause a tumor’s growth. Blocking such “protein-protein interactions” has been a dream of cancer researchers for decades. Dr. Raj and his colleagues have done the remarkable by discovering what could be the first in class of a therapeutic that realizes this dream,” said Dr. David Mangelsdorf, Professor and Chairman of the Department of Pharmacology, who holds the Alfred G. Gilman Distinguished Chair in Pharmacology, and the Raymond and Ellen Willie Distinguished Chair in Molecular Neuropharmacology in Honor of Harold B. Crasilneck, Ph.D.

The drug works by blocking other molecules — proteins called co-factors — that also must attach to the estrogen receptor for cancer cells to multiply. The new molecule, dubbed ERX-11, mimics a peptide, or protein building block. So far, it has been tested in mice and in cancer cells removed from patients and works well in both models, and there have been no signs of toxicity in the tests.

If successfully translated to a human therapy, another advantage of ERX-11 is that it could be taken orally by patients, rather than as an infusion. Dr. Raj said the group is hoping to get a clinical trial under way in about a year.

The notion of blocking protein co-factors has implications for treatment of other cancers as well. “This could be a first-line breast cancer therapy down the line. It could even lead to new treatments for other hormone-sensitive cancers. For now, it offers hope for women with estrogen-sensitive breast cancer for whom conventional therapies fail,” Dr. Raj said.

The research appears in the online journal eLife.

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New test could predict whether breast cancer will return

Scientists found that by looking at immune cells, they could find those patients who are more at risk of treatment failing

Scientists have found a way of testing whether a person’s breast cancer is likely to return.

The research could allow for huge changes in the treatment of cancers, and identify those who are at most at risk of their treatment failing.

Looking for immune cell “hotspots” around tumours is a reliable way of telling whether a person is more likely to have their breast cancer relapse, the research found.

The study also concluded that women who have more of those immune cells clustered around tumours are more likely to have their breast cancer return within ten years after it has been treated.

As well as allowing doctors to find the people who are most at risk of having breast cancer return, the findings could help inform what treatment people receive in the future.

The researchers wrote that scientists could exploit the findings to help advance the way that people are treated, and stave off any such relapses.

People who are diagnosed with oestrogen-sensitive breast cancer – which accounts for around 80 per cent of breast cancers, the most common cancer in women – respond well to treatment. But some patients are at particular risk of dying when it returns, especially after about five years.

The new research helps identify people who belong to that sub-group, in a move towards avoiding those relapses. It also means that those who aren’t part of those groups may be able to avoid chemotherapy.

Scientists from the Institute of Cancer Research looked at tissue samples from 1,178 women with the most common form of oestrogen-sensitive breast cancer.

They found that those whose immune cells showed the clustering behaviour had a 25 per cent higher chance of having their breast cancer return within 10 years. The chance it would return in five years was also 23 per cent higher.

Lead scientist, Dr Yinyin Yuan, said: “We have developed a new, automated computer tool that makes an assessment of the risk of relapse based on how cells are organised spatially, and whether or not immune cells are clustered together in the tumour.”

“In the most common form of breast cancer, oestrogen receptor positive, the presence of hotspots of immune cells clustered together in the tumour was strongly linked to an increased risk of relapse after hormone treatment.

“Larger studies are needed before an immune hotspot test could come to the clinic, but in future such a test could pick out patients at the highest risk of their cancer returning. It might also be possible to predict which patients would respond to immunotherapy.”

The findings appear in the Journal of the National Cancer Institute.

Researchers said that the study could go on to change the way that people are treated in the future, as well as helping identify the ways that treatment work.

Professor Paul Workman, chief executive of The Institute of Cancer Research, said: “What this study tells us is that the immune system probably has a key role to play in how breast cancer responds to hormone treatment.

“Measuring the immune response to cancer could be important in the future to help identify patients who could benefit from immunotherapy.”

Katherine Woods, from the charity Breast Cancer Now, which co-funded the study, said: “That this exciting immune tool could be added to existing prognostic tests to more accurately identify women at high risk of their breast cancer coming back is very promising.

“Automatically analysing the distribution of immune cells in a tumour is a big achievement, and if this approach is validated it could help doctors guide chemotherapy treatment.”


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New compound boosts treatment for aggressive breast cancer

Although breast cancer survival rates are overall very high, some forms of cancer are more difficult to treat than others. However, a new compound proves highly effective against these types by targeting a protein that makes cancer cells resistant to treatment.
Triple-negative breast cancer is often resistant to treatment. Its name refers to the hormone receptor status that divides breast cancer into different types, and the cells in this type of cancer are called triple-negative because they do not have estrogen receptors, progesterone receptors, or the protein HER2.

Triple-negative breast cancer tumors can be particularly aggressive, and they tend to occur in women with a defective BRCA1 gene.

It is estimated that approximately 12 percent of breast cancers are triple-negative.

New research, which has recently been published in the journal Science Translational Medicine, tests the effect of a novel anticancer agent on treating different types of breast cancer and finds that a new compound – when administered in combination with conventional anticancer drugs – is “highly effective” for treating both triple negative and HER2 positive breast cancers.

As the authors of the new study note, treatment for triple-negative breast cancer has seen little improvement in the past 30 years, so the recent findings are particularly welcome in this context.

The researchers were led by Dr. Delphine Merino, Dr. James Whittle, Dr. François Vaillant, Prof. Jane Visvader, and Prof. Geoff Lindeman, all of whom are from the Walter and Eliza Hall Institute of Medical Research in Melbourne, Australia.

Targeting cancer’s ‘Achilles’ heel’

Dr. Merino and colleagues combined existing anticancer drugs with a new compound called S63845. The uniqueness of the new compound lies in the fact that it targets MCL-1, which is a protein that has previously been shown to be key for the survival of cancer cells.

“MCL-1 gives cancer cells a survival advantage, allowing them to resist chemotherapy or other anti-cancer therapies that would otherwise trigger cancer cell death,” explains Dr. Whittle. This advantage has been referred to by the researchers as “Achilles’ heel.”

As the authors explain in the study, MCL-1 is often overexpressed in breast cancer patients, and high expression usually means poor life expectancy for the patient.

In the new research, Dr. Merino and team tested the effect of the MCL-1 inhibitor in cancer cell cultures, as well as in tissue samples taken from breast cancer patients who had high levels of MCL-1.

Dr. Vaillant explains the methodology used, saying, “With the support of the Victorian Cancer Biobank, and samples donated by breast cancer patients, we have generated a large number of laboratory models that mimic how tumors behave and respond to therapy in the patient, allowing us to test a range of anti-cancer drugs.”

“In addition, we […] performed molecular analysis to anticipate the mechanisms of resistance that may occur,” Drs. Whittle and Merino told Medical News Today.

Fantastic hope’ for triple negative cancer

S63845 worked together with existing drug docetaxel to combat triple-negative breast cancer, and with the drugs trastuzumab or lapatinib to inhibit HER2-positive breast cancer.

“Combining S63845 with standard therapies, such as chemotherapy or targeted drugs such as Herceptin [trastuzumab], proved highly effective in killing these very aggressive tumor types,” says Dr. Merino.

Dr. Whittle also stresses the advantages of combining the new compound with existing treatment.

Importantly, the combination of the MCL-1 inhibitor S63845 with standard therapies was far more effective than either treatment alone. These can be incredibly aggressive tumors, so to see a response to the combined therapy in this tumor type is very exciting.”

Dr. James Whittle

Referring to the compound’s “potent synergistic effect” with chemotherapy, Dr. Whittle and Dr. Merino told Medical News Today that this is “a fantastic hope for patients with triple-negative breast cancer.”

Prof. Lindeman also emphasizes the fact that triple-negative breast cancers urgently need alternative forms of treatment. He says, “Our hope is that it will be possible to combine MCL-1 inhibitors with conventional therapies to more effectively treat certain types of breast cancer and deliver better outcomes for our patients.”

However, the authors also note the limitations of their study. “[T]hese results are an early indication of effectiveness,” said Dr. Whittle and Dr. Merino, “and further work will be required to identify which patients are more likely to respond and what will be the best strategy to adopt in the case of tumor recurrence.”

The researchers hope that their study “will provide the momentum for the development of clinical trials in breast cancer patients.”


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This Woman’s Breast Dimpling Was Her Only Sign of Breast Cancer

Lumps aren’t the only things to watch out for

You’re probably aware that one of the most common signs of breast cancer is a lump. But breast cancer can manifest in a number of ways, and a woman in the U.K. is hoping to raise awareness about one lesser-known symptom: breast dimpling.

Sherrie Rhodes posted a picture and caption on Facebook detailing the dimple on her breast, which was the only breast cancer symptom she had. The post has since been shared over 1,200 times.

“Yesterday I was diagnosed with breast cancer. It came as a total shock as this dimpling (in the pic) is the only symptom I had,” she wrote. Rhodes says she noticed the dimple at the end of June and flagged it for her doctor, who referred her to a breast clinic. She had a scan, which revealed a mass, followed by a mammogram and a few biopsies. “I wasn’t too worried as there was no lump or anything,” she said. “Unfortunately it came back as breast cancer. Please check your breast regularly and don’t ignore anything that is different. If I hadn’t seen a post like this previously I wouldn’t have known that this dimpling was a sign of cancer. Please share and raise awareness.”

The most common symptom of breast cancer is a new lump or mass, according to the American Cancer Society, but breast dimpling can also be a symptom, as well as swelling of all or part of the breast, breast or nipple pain, nipple retraction, redness or thickening of the nipple or breast skin, and nipple discharge other than breast milk.

“That’s very rare as the only sign of breast cancer, but it’s not uncommon to see dimpling associated with other symptoms, like an underlying mass,” Therese Bartholomew Bevers, M.D., F.A.A.F.P., medical director of the Cancer Prevention Center and prevention outreach programs at MD Anderson Cancer Center in Houston, tells SELF. Dimpling can happen when a tumor is growing in the tissue underneath the skin and pulling it inward, she says. Nipple retraction, when a person’s nipple suddenly turns in, is another form of this, she adds.

Dimpling can happen with several forms of breast cancer, but there’s one in particular that it might point to.

That’s known as lobular carcinoma, which is the second most common type of breast cancer, according to the Mayo Clinic. Lobular carcinoma doesn’t usually form a lump—rather, it creates sheets of cancer cells that can cause dimpling, Dr. Bevers says.

Dimpling can also be a sign of a rare form of breast cancer known as inflammatory breast cancer. With this form of breast cancer, tumor cells obstruct or block the lymphatic channels that run through the breast and cause the breast skin to look dimpled, similar to the appearance of the skin of an orange, Susan Hoover, M.D., F.A.C.S., a surgical oncologist in the Breast Oncology Program at Moffitt Cancer Center in Tampa, Florida, tells SELF.

If someone has breast dimpling and it’s not related to inflammatory breast cancer, there is often a mass associated with it that doctors can see on imaging—either a mammogram, ultrasound, or MRI, Dr. Bevers says. In rare cases, doctors may not find anything, but it’s important to continue to monitor the patient to see if anything develops over time. A small percentage of breast cancers are not seen on a mammogram and sometimes they’re too small to feel. So breast dimpling “may be the first sign of something growing in the breast,” Richard J. Bleicher, M.D., F.A.C.S., a professor in the Department of Surgical Oncology at the Fox Chase Cancer Center, tells SELF.

It’s also possible to have breast dimpling and not have have breast cancer.

So, if you develop it, don’t panic and automatically assume you have breast cancer. Breast dimpling can also be caused by a scar that pulls the breast tissue inward or a breast condition known as fat necrosis, which is damaged or dead fatty tissue in the breast, Dr. Bevers says. Fat necrosis is usually caused by some kind of trauma to the breast, like from a seatbelt, she says. Years after the trauma, a person can start to see dimpling. Still, it’s a good idea to get any new breast changes checked out, especially breast dimpling.

If you notice dimpling in your breast, talk to your doctor about getting screened with a mammogram or ultrasound. “This is not something that should be written off,” Richard Reitherman, M.D., Ph.D., medical director of breast imaging at MemorialCare Breast Center at Orange Coast Memorial Medical Center in Fountain Valley, California, tells SELF. If you don’t get any answers from those scans, see a breast specialist and make sure they continue to monitor you. “A patient should not be satisfied until they get a good report or symptoms resolve,” Dr. Reitherman says. “Personal advocacy, iterated as many times as necessary, is empowerment.”


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What Is Stage-Zero Breast Cancer

Earlier this year, days before my parents embarked on a four-week cruise around South America, my mother sent an email to our family that included the line: “By the way, our wills are in the safe. Just in case we don’t make it.”

My parents—retired lawyers—have always been highly pragmatic about their end-of-life planning, so I brushed the comment aside. “Morbid much, Mom?” I wrote back. “Have a great trip!”

Not until after they had returned from their adventure did I realize her pessimistic aside could have meant something other than falling off the Lido deck. Within a few days of my parents’ homecoming, she called me to break the news: She had experienced bleeding from her breast that alarmed her the day before they were scheduled to depart, but had decided to continue with her plans rather than rush to the emergency room. When she returned, she went to the doctor, who sent her in for a biopsy.


The result? Cancer.

Confronted with the dreaded c-word, I immediately went into a tailspin of panic. I hoped and prayed that they had caught it early, but it still shook me to my core. I imagined my mother having to go through months of radiation or chemotherapy, a double mastectomy, and then, well, I didn’t even want to imagine what could happen next. On the other side of the country, she was feeling the same unnerving fears.

The doctors came back later with a complete diagnosis: ductal carcinoma in situ (DCIS), or stage zero—a form of cancer in which the cancerous cells are contained to the breast ducts and have not spread to the surrounding tissue.

I had heard of nascent cancer cells from my many years of pap smears—”changes to the cervix” was a phrase that my gynecologist had always warned me about. Friends had dealt with cancerous cervical cells using cryotherapy, literally freezing the offending cells off one-by-one.

But the fact that it can happen to breast tissue was news to me, despite the fact that it turns out to be quite common—the American Cancer Society expects 63,410 new cases of carcinoma in situ, or stage zero, to be diagnosed this year.

Naturally my mom was bombarded with questions. Mostly from me. What, exactly, is stage-zero cancer? Why had we never heard about it? What is the prognosis? How is it treated? What’s the chance of survival?

Susan Brown, M.S., R.N., senior director of health education at the Susan G. Komen Foundation, helped break it down for me, explaining that cancer equals any cells that are growing without control. In the case of stage zero, the duct tissue of the breast contains the abnormal cells. Once the cancer spreads to other areas, it’s redefined as stages 1 to 4. Only 40 to 50 percent of stage zero cases move on to more advanced stages after being detected. And, Brown says, researchers are developing new ways to detect which cases are most likely to progress into aggressive forms of cancer, and which forms can be treated with less aggressive treatments.


If caught at stage zero, the prognosis is excellent: Roughly 95 percent of patients are still living 10 years after their initial diagnosis. Then again, this form of cancer is typically too localized to generate any symptoms. My mother was alarmed because her main symptom—leakage from her breast—was alarming and hard-to-ignore. But usually stage zero would have to be detected on a routine mammogram.

Because of this, stage zero often goes unnoticed until it has moved into more advanced stages, particularly in younger women for whom mammograms are not generally recommended (their denser breast tissue leads to a higher risk of false positives). Even women in their 40s—who are usually covered for routine mammograms—have a false positive rate of roughly 16 percent, according to the University of California San Francisco. A false positive can lead to unnecessary anxiety or invasive testing procedures—but younger women are, of course, diagnosed with breast cancer every day.

Liz Buscema of Kearneysville, West Virginia, was 33 when she was diagnosed with stage zero breast cancer in 2009. She and her husband were trying for a second child when she felt a lump in her breast tissue accompanied by moderate pain. A nurse practitioner at one of her doctors’ offices said she was “too young to worry about it,” recalls Buscema. But months later the symptoms had not disappeared—in fact, they’d gotten worse. She says she still probably would have brushed it aside if not for the fact that her mother had been diagnosed with breast cancer the year before. She consulted a doctor, who sent her off for a mammogram.

“If it hadn’t been for my mom, I never would have thought of cancer at all,” Buscema says. It’s a good thing she did: Even though her cancer was caught at stage zero, tests indicated that the it was aggressive in nature. Due to her family history, Buscema’s doctors recommended a double mastectomy, and Buscema has now been cancer-free since her diagnosis eight years ago.

Doctors are getting better not only at detecting the stage of cancer, but the type, which creates better outcomes for patients. My mother opted for a lumpectomy, since her strain of cancer is non-aggressive. She’s currently recovering from surgery and is expected to continue her trips around the world as a retiree—she already has a vacation to Germany planned before she begins her radiation treatment. And because she was post-menopausal when she developed cancer, her doctors insist that it’s less likely to be due to an inherited pre-disposition, which means my own risk hasn’t risen.

For women under 40, like myself, the key is to not worry but to be vigilant if anything seems amiss. If you feel a bump, lump, or any other unusual changes to your breast, it’s always good to get it checked out. As my mom puts it, “Shit happens when you get to be my age”—and here’s to being more knowledgeable and empowered about our bodies along the way.


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The Art of Camouflage After Breast Cancer Surgery

Recently, while walking through a sporting goods store, I was intrigued by all of the camouflaged garments. I listened as my daughter’s boyfriend explained about the importance of hiding from the deer.

“In order to be in position for a kill,” he said, “you have to hide in plain sight.” He told us about how hunters used camouflaged clothing and blinds to be near the deer without exposing themselves. There was an art to hunting and it took great skill to get close to a wild animal, especially one with a keen sense of smell. I continued listening as he talked, and that’s what got me to thinking about the art of camouflage.

Since having both breasts removed, I was in the minority of the post-breast cancer world. Most of the women I talked to had chosen to go the route of reconstruction. They were young and wanted to keep their breasts. Instead of just having their breasts lopped off and being forever flat, they went through the complicated process of reconstruction. After having breasts removed, tissue expanders were inserted for those choosing to have silicone or saline implants. For those choosing to use their own body fat to make new breasts, the choice between DIEP flap or TRAM flap had to be made. Surgeries were complicated and painful, but each woman chose what worked best for her. My choice was pretty cut and dry. I wanted them taken off and wanted to be done with cancer forever. I wanted a once-and-done kind of surgery.  

How Breast Cancer Can Affect Your Relationship (And How To Get Things Back On Track)

“I feel very uncomfortable with intimacy because I feel like my body isn’t attractive anymore,” says Jane, 48.

“I don’t really feel like a woman anymore, breasts are so much part of being a woman, so that’s had a big impact on me and a big part of our relationship.”

In 2014, Jane became one of the 60,000 people diagnosed with breast cancer in the UK each year.

Although she’s responded well to treatment physically, the disease continues to affect her confidence and her relationship with husband, Tim.

Unfortunately, the pair’s experience is far from unique as many couples affected by breast cancer experience unforeseen changes in their relationship.


Jane was diagnosed with breast cancer when she was 45 years old, which led to her having surgery six times.

At first she had a series of lumpectomies, where doctors removed tumours from her breast area, but eight months into treatment she was forced to have a mastectomy. She’s now in the process of having reconstructive surgery.

“I thought that when you have breast reconstruction it meant they recreate what you had before, but of course it’s nothing like that,” she tells The Huffington Post UK.

“My body is not the body that I had at all. After I had my mastectomy in 2015 I didn’t show Tim. I didn’t feel like a woman anymore. I didn’t feel like me and that’s been really difficult.”

Jane says the intimate side of her relationship with Tim has “just gone”, which is all too common for couples who’ve been affected by breast cancer.

Statistics from Breast Cancer Care show that nearly nine in every 10 (88%) women with breast cancer say they have lost their self-esteem and confidence in their bodies after treatment.

What’s more, nearly two-thirds (68%) say it has affected their sexual and intimate relationships.