Breast cancer (female)

such as viruses and bacteria. The trastuzumab antibody targets and destroys cancer cells that are HER2-positive. Trastuzumab is usually given intravenously	 through a drip. Its also sometimes available as an injection under the skin (a subcutaneous injection). You will have the treatment in hospital. Each treatment session takes up to one hour and the number of sessions you need will depend on whether you have early or more advanced breast cancer. On average	 youll need a session once every three weeks for early breast cancer	 and weekly sessions if your cancer is more advanced. Trastuzumab can cause side effects	 including heart problems. This means that its not suitable if you have a heart problem	 such as angina 	 uncontrolled high blood pressure (hypertension) or heart valve disease. If you need to take trastuzumab	 youll haveregular tests on your heart to make sure its not causing any problems. Other side effects of trastuzumab may include: an initial allergic reaction to the medication	 whichcan cause nausea	 wheezing	 chills and fever diarrhoea tiredness aches and pains Clinical trials A great deal of progress has been made in breast cancer treatment	 and more women now live longer and have fewer side effects from treatment. These advances were discovered in clinical trials 	 where new treatments and treatment combinations are compared with standard ones. All cancer trials in the UK are carefully overseen to ensure theyre worthwhile and safely conducted. In fact	 participants in clinical trials can do better overall than thosein routine care. If youre asked to take part in a trial	 youll be given an information sheet and	 if you want to take part	 youll be asked to sign aconsent form. You can refuse or withdraw from a clinical trial without it affecting your care. Read further information: Breast Cancer Now: Clinical trials Against Breast Cancer:Our research Psychological help Dealing with cancer can be a huge challenge	 for both patients and their families. It can cause emotional and practical difficulties. Many women have to cope with the removal of part or all of a breast	 which can be very upsetting. It often helps to talk about your feelings or other difficulties with a trained counsellor or therapist. You can ask for this kind of help at any stage of your illness. There are various ways to find help and support. Your hospital doctor	 specialist nurse or GP can refer you to a counsellor. If youre feeling depressed	 talk to your GP. A course of antidepressant drugs may help	 or your GP can arrange for you to see a counsellor or psychotherapist. It can help to talk to someone whos been through the same thing as you. Many organisations have helplines and online forums. They can also put you in touch with other people whove had cancer treatment. Read further information: Breast Cancer Now: Support for you Macmillan Cancer Support:Online community Complementary therapies Complementary therapies are holistic therapies that can promote physical and emotional wellbeing. Theyre given alongside conventional treatments and include relaxation techniques	 massage	 aromatherapy and acupuncture. Complementary therapycan help some women cope with diagnosis and treatment	 and providea breakfrom the treatment plan. Your hospital or breast unit may be able to provide access to complementary therapies or suggest where you canget them. Its important to speak to your breast cancer specialist nurse about any complementary therapy you wish to use	 to make sure it doesntinterfere with your conventional treatment. Read further information aboutcomplementary therapies Living with breast cancer Recovery Most women with breast cancer have an operation as part of their treatment. Getting back to normal after surgery can take some time. Its important to take things slowly and give yourself time to recover. During this time	 avoid lifting things  for example	 children or heavy shopping bags  and avoid heavy housework. You may also be advised not to drive. Read more about recovering from an operation Some other treatments	 particularly radiotherapy and chemotherapy 	 can make you very tired. You may need to take a break from some of your normal activities for a while. Dontbe afraid to ask for practical help from family and friends. Follow-up After your treatment has finished	 youll be invited for regular check-ups	 usually every 3 months for the first year. If youve had early breast cancer	 your healthcare team will agree a care plan with you after your treatment has finished. This plan contains the details of your follow-up. You will receive a copy of the plan	 which will also be sent to your GP. During the check-up	 your doctor will examine you and may carry out blood tests or X-rays to see how your cancer is responding to treatment. You should also be offered a mammogram every year for the first 5 years after your treatment. Long-term complications Although its rare	 your treatment for breast cancer may cause new problems	 such as: pain and stiffness in your arms and shoulders may occur after surgery	 and the skin in these areas may be tight lymphoedema (a build-up of excess lymph fluid which causes swelling)  this may occurif surgery or radiotherapy damages the lymphatic drainage system in the armpit Talk to your healthcare team if you experience these or any other long-term effects of treatment. Read further information: Breast Cancer Now:Life after treatment Breast Cancer Now: Lymphoedema Cancer Research UK: Follow up after breast cancer treatment Your body and breasts after treatment Dealing with changes to your body A diagnosis of breast cancer may change how you think about your body. All women react differently to the bodily changes that happen as a result of breast cancer treatment. Some women react positively	 but others find it more difficult to cope. Its important to give yourself time to come to terms with any changes to your body. Read further information: Breast Cancer Now: Coping with breast cancer emotionally healthtalk: Body image and breast cancer Macmillan Cancer Support:Changes to your appearance and body image Early menopause Although most cases of breast cancer occur in women over 50 who have experiencedthe menopause 	 some younger women have to cope with early menopause brought on by cancer treatment. Symptoms can include hot flushes	 vaginal dryness and loss of sexual desire . Talk to your healthcare team about any symptoms you have and theyll be able to help. Read further information: Breast Cancer Now: Fertility and breast cancer treatment Cancer Research UK: Breast cancer and menopausal symptoms Macmillan: Menopausal symptoms and cancer treatment Prosthesis A breast prosthesis is an artificial breast	 which can be worn inside your bra to replace the breast thats been removed. Soon after a mastectomy	 youll be given a lightweight foam breast to wear until the area affected by surgery or radiotherapy has healed. After its healed	 youll be offered a silicone prosthesis. Prostheses come in many different shapes and sizes	 and you should be able to find one that suits you. Read further information: Breast Cancer Now: Your body after breast cancer treatment Cancer Research UK: False breast shape (prosthesis) after breast cancer surgery Reconstruction If you didnt have immediate breast reconstruction (carried out at the time of a mastectomy)	 you can have reconstruction later. This iscalled a delayed reconstruction. There are 2 main methods of breast reconstruction  reconstruction using your own tissue and reconstruction using an implant. The type thats most suitable for you will depend on many factors	 including the treatment youve had	 any ongoing treatment and the size of your breasts. Talk to your healthcare team about which reconstruction is suitable for you. Read further information about breast reconstruction Relationships with friends and family Its not always easy to talk about cancer 	 either for you or your family and friends. You may sense that some people feel awkward around you or avoid you. Being open about how you feel and what your family and friends can do to help may put them at ease. However	 dont be afraid to tell them that you need some time to yourself	 if thats what you need. Read further information: Breast Cancer Now: Telling family and friends about your breast cancer Macmillan Cancer Support: Talking about your cancer Healthtalk: How breast cancer affects families Your sex life Breast cancer and its treatment can affect your sex life. Its common for women to lose interest in sex after breast cancer treatment. Your treatment may leave you feeling very tired. You may feel shocked	 confused or depressed about being diagnosed with cancer. You may be upset by the changes to your body or grieve the loss of your breasts or	 in some cases	 your fertility. Its understandable that you may not feel like having sex while coping with all this. Try to share your feelings with your partner. If you have problems with sex that arent getting better with time	 you may want to speak to a counsellor or sex therapist. Read further information: Breast Cancer Now: Sex and breast cancer treatment Cancer Research UK: Life after breast cancer surgery Macmillan Cancer Support: Sex and side effects of cancer treatment Money and financial support If you have to reduce or stop work because of your cancer	 you may find it difficult to cope financially. If you have cancer or youre caring for someone with cancer	 you may be entitled to financial support	 for example: if you have a job but cant work because of your illness	 youre entitled to Statutory Sick Pay from your employer if you dont have a job and cant work because of your illness	 you may be entitled to Employment and Support Allowance if youre caring for someone with cancer	 you may be entitled to Carers Allowance you may be eligible for other benefits if you have children living at home	 or if you have a low household income Find out what help is available to you as soon as possible. The social worker at your hospital will be able to give you the information you need. Talk to other people Your GP or nurse may be able to answer any questions you have about your cancer or treatment. You may find it helpful to talk to a trained counsellor or psychologist	 or to someone at a specialist helpline. Your GP surgery will have information on these. Some people find it helpful to talk to other people who havebreast cancer	 either at a local support group or in an internet chatroom. Read further information: Breast Cancer Now: Support for you Macmillan Cancer Support: Online community Preventing breast cancer As the causes of breast cancer arent fully understood	 its not known if it can be prevented altogether. Some treatments are available to reduce the risk in women who have a higher risk of developing the condition than the general population. Diet and lifestyle Regular exercise and a healthy	 balanceddiet are recommended for all women because they can help prevent many conditions	 including heart disease 	 diabetes and many forms of cancer . Regular exercise can reduce your risk of developing breast cancer. If you have been through the menopause 	 its particularly important that youre not overweight or obese . This is because these conditions cause more oestrogen to be produced	 which can increase the risk of breast cancer. Breastfeeding Studies have shown that women who breastfeed are statistically less likely to develop breast cancer than those who dont. The reasons arent fully understood	 but it could be because women dont ovulate as regularly while theyre breastfeeding and oestrogen levels remain stable. Treatments to reduce your risk If you have an increased risk of developing breast cancer	 treatment is available to reduce your risk. Your level of riskis determined by factors such as your age	 your familys medical history and the results of genetic tests. You will usually be referred to a specialist genetics service if its thought you have an increased risk of breast cancer.Healthcare professionals working at these servicesshould discuss treatment options with you. The 2 main treatments are surgery to remove the breasts (mastectomy) or medication. Mastectomy A mastectomy is surgery to remove the breasts. It can be usedto treat breast cancer and reduce the chances of developing the condition in the small number of women from high-risk families. By removing as much breast tissue as possible	 a mastectomy canreduceyour risk of breast cancer by up to 90%. However	 like all operations	 theres a risk of complications	 and having your breasts removed can have a significant effect on your body image and sexual relationships. If you want to	 you can usually chooseto have breast reconstruction either during the mastectomy operation	 or at a later date. During breast reconstruction surgery	 your original breast shape is recreated using eitherbreast implants or tissue from elsewhere in your body. An alternative is to usebreast prostheses. These areartificial breaststhat can be worn inside your bra. Read more about your body and your breasts after treatment Medication In 2013	 the National Institute for Health and Care Excellence (NICE) announced that 2 medications	 called tamoxifen and raloxifene	 would be available on the NHSfor women who have an increased risk of developing breast cancer. Eithertamoxifen or raloxifene can be used in women whove been through the menopause	 but only tamoxifen should be used in women who havent. Thesemedications may not be suitable if in the past youve had blood clots or womb cancer 	 or if you have an increased risk of developing these problems in the future. Women whove already had a mastectomy to remove both breastswont be offered these medications	 because their risk of developing breast cancer is very small. Acourse of treatment with tamoxifen or raloxifene will usually involve taking a tablet every day for 5 years. Raloxifene can cause side effects including flu-like symptoms 	 hot flushes and leg cramps. Side effects of tamoxifen can include hot flushes and sweats	 changes to yourperiods	 and nausea and vomiting. Your chances of giving birth to a child with birth defects increase while youre taking tamoxifen	 soyoull be advised to stop taking it at least 2 months before trying for a baby. The medication can also increase your risk of blood clots	 so you should stop taking it 6 weeks before having any planned surgery. Tamoxifen and raloxifene arent currently licensed for the purpose of reducing the risk of breast cancer in women with an increasedrisk of developing the condition. However	 they can still be used if you understand the benefits and risks	 and your doctor believes the treatment will be helpful.