laparoscopic appendectomy

What is the Appendix?

 

The appendix is a long narrow tube (a few inches in length) that attaches to the first part of the colon. It is usually located in the lower right quadrant of the abdominal cavity. The appendix produces a bacteria destroying protein called immunoglobulins, which help fight infection in the body. Its function, however, is not essential. People who have had appendectomies do not have an increased risk toward infection. Other organs in the body take over this function once the appendix has been removed.

What is a Laparoscopic Appendectomy?

 

Appendicitis is one of the most common surgical problems. One out of every 2,000 people has an appendectomy sometime during their lifetime. Treatment requires an operation to remove the infected appendix. Traditionally, the appendix is removed through an incision in the right lower abdominal wall.

 

In most laparoscopic appendectomies, surgeons operate through 3 small incisions (each ¼ to ½ inch) while watching an enlarged image of the patient’s internal organs on a television monitor. In some cases, one of the small openings may be lengthened to complete the procedure.

Advantages of Laparoscopic Appendectomy

 

Results may vary depending upon the type of procedure and patient’s overall condition. Common advantages are:

 

   Less postoperative pain

   May shorten hospital stay

   May result in a quicker return to bowel function

   Quicker return to normal activity

Society of American Gastrointestinal and Endoscopic Surgeons

   Better cosmetic results

 

Are You a Candidate for Laparoscopic Appendectomy?

 

Although laparoscopic appendectomy has many benefits, it may not be appropriate for some patients. Early, non-ruptured appendicitis usually can be removed laparoscopically. Laparoscopic appendectomy is more difficult to perform if there is advanced infection or the appendix has ruptured. A traditional, open procedure using a larger incision may be required to safely remove the infected appendix in these patients

How is a Laparoscopic Appendectomy Performed?

 

The words “laparoscopic” and “open” appendectomy describes the techniques a surgeon uses to gain access to the internal surgery site. Most laparoscopic appendectomies start the same way. Using a cannula (a narrow tube-like instrument), the surgeon enters the abdomen. A laparoscope (a tiny telescope connected to a video camera) is inserted through a cannula, giving the surgeon a magnified view of the patient’s internal organs on a television monitor. Several other cannulas are inserted to allow the surgeon to work inside and remove the appendix. The entire procedure may be completed through the cannulas or by lengthening one of the small cannula incisions. A drain may be placed during the procedure. This will be removed later by your surgeon.

What Happens if the Operation Cannot Be Performed or Completed by the Laparoscopic Method?

 

In a small number of patients the laparoscopic method is not feasible because of the inability to visualize or handle the organs effectively. If your surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather sound surgical judgment. Factors that may increase the possibility of converting to the “open” procedure may include:

 

   Extensive infection and/or abscess

   A perforated appendix

   Obesity

   A history of prior abdominal surgery causing dense scar tissue

   Inability to visualize organs

   Bleeding problems during the operation

 

What Should I Expect after Surgery?

 

After the operation, it is important to follow your doctor’s instructions. Although many people feel better in just a few days, remember that your body needs time to heal.

 

   You are encouraged to be out of bed the day after surgery and to walk. This will help diminish the risk of blood clots in your legs and of soreness in your muscles.

   You will probably be able to get back to most of your normal activities in one to two weeks time. These activities include showering, driving, walking up stairs, working and engaging in sexual intercourse.

   If you have prolonged soreness or are getting no relief from the prescribed pain medication, you should notify your surgeon.

   You should call your surgeon and schedule a follow up appointment for about 1-2 weeks following your operation.

 

What Complications Can Occur?

 

As with any operation, there are risks of complications. However, the risk of one of these complications occurring is no higher than if the operation was done with the open technique.

 

   Bleeding

   Infection

   A leak at the edge of the colon where the appendix was removed

   Injury to adjacent organs such as the small intestine, ureter, or bladder.

   Blood clots the deep veins in your legs that may travel to your lungs

 

It is important for you to recognize the early signs of possible complications. Contact your surgeon if you have severe abdominal pain, fever, chills or rectal bleeding.

When to Call Your Doctor

 

Be sure to call your physician or surgeon if you develop any of the following:

 

   Persistent fever over 101 degrees F (39 C)

   Bleeding

   Increasing abdominal swelling

   Pain that is not relieved by your medications

   Persistent nausea or vomiting

   Chills

   Persistent cough or shortness of breath

   Purulent drainage (pus) from any incision

   Redness surrounding any of your incisions that is worsening or getting bigger

   You are unable to eat or drink liquids.[...]

thyroid cancer

Thyroid cancer is a disease that you get when abnormal cells begin to grow in your thyroid gland camera.gif. The thyroid gland is shaped like a butterfly and is located in the front of your neck. It makes hormones that regulate the way your body uses energy and that help your body work normally.

Thyroid cancer is an uncommon type of cancer. Most people who have it do very well, because the cancer is usually found early and the treatments work well. After it is treated, thyroid cancer may come back, sometimes many years after treatment.

Experts don't know what causes thyroid cancer. But like other cancers, changes in the DNA of your cells seem to play a role. These DNA changes may include changes that are inherited as well as those that happen as you get older.

People who have been exposed to a lot of radiation have a greater chance of getting thyroid cancer.

A dental X-ray now and then will not increase your chance of getting thyroid cancer. But past radiation treatment of your head, neck, or chest (especially during childhood) can put you at risk of getting thyroid cancer.

Thyroid cancer can cause several symptoms:

    You may get a lump or swelling in your neck. This is the most common symptom.
    You may have pain in your neck and sometimes in your ears.
    You may have trouble swallowing.
    You may have trouble breathing or have constant wheezing.
    Your voice may be hoarse.
    You may have a frequent cough that is not related to a cold.

Some people may not have any symptoms. Their doctors may find a lump or nodule in the neck during a routine physical exam.

If you have a lump in your neck that could be thyroid cancer, your doctor may do a biopsy of your thyroid gland to check for cancer cells. A biopsy is a simple procedure in which a small piece of the thyroid tissue is removed, usually with a needle, and then checked.

Sometimes the results of a biopsy are not clear. In this case, you may need surgery to remove all or part of your thyroid gland before you find out if you have thyroid cancer.
Thyroid cancer is treated with surgery and often with radioactive iodine. It rarely needs radiation therapy or chemotherapy. What treatment you need depends on your age, the type of thyroid cancer you have, and the stage of your disease. Stage refers to how severe the disease is and how far, if at all, the cancer has spread.

Finding out that you have cancer can be overwhelming. It's common to feel scared, sad, or even angry. Talking to others who have had thyroid cancer may help. Ask your doctor about cancer support groups in your area.

Most thyroid cancer cannot be prevented.

One rare type of thyroid cancer, called medullary thyroid cancer (MTC), runs in families. A genetic test can tell you if you have a greater chance of getting MTC. If this test shows that you have an increased risk, you can have your thyroid gland removed to reduce your risk for thyroid cancer later in life
Thyroid cancer can cause many symptoms, including:

    A lump or swelling in your neck. This is the most common symptom.
    Pain in your neck and sometimes in your ears.
    Difficulty swallowing.
    Difficulty breathing or constant wheezing.
    Hoarseness that is not related to a cold.
    A cough that continues and is not related to a cold.

Some people may not have any symptoms. Their doctors may find a lump or nodule in the neck during a routine physical examThyroid cancer is a disease that occurs when abnormal cells begin to grow in the thyroid gland. You may notice a lump in your neck and then go to your doctor. Or your doctor may notice a lump during a routine physical exam or on an imaging test that you are having for another health problem.

Thyroid cancer is usually found before the cancer has spread very far. This means that most people who are treated for thyroid cancer do very well. After it is treated, thyroid cancer may come back, sometimes many years after treatment.

Before starting your treatment, your doctor needs to find out which type of thyroid cancer you have. A biopsy can identify your type of cancer. During a biopsy, a small piece of thyroid tissue is removed, usually with a fine needle. The thyroid tissue cells are then examined under a microscope.

It is also important to find out the stage of your cancer. Staging is a way for your doctor to tell how far, if at all, the cancer has spread. It also helps your doctor decide what kind of treatment you need. Staging generally depends on the results of your radioactive iodine scan.

If you have your thyroid gland surgically removed, you will probably need to take thyroid hormone medicine for the rest of your life to replace the hormones that were made by your thyroid. Taking it will help regulate your metabolism and other body functions
. Most people with thyroid cancer have surgery to remove the cancer. You may have part or all of your thyroid removed.

The kind of surgery you have may depend on your age, the type of cancer you have, how much the cancer has spread, and your general health.
Surgery choices

    Thyroid lobectomy removes only one part (lobe) of the thyroid gland. This surgery is an option if your cancer is small and is only in one lobe of your thyroid gland.
    Near-total thyroidectomy removes all but a very small part of the thyroid gland. This is done in special cases with smaller tumors or if an experienced surgeon is not available.
    Total thyroidectomy removes the entire thyroid gland. This is the most common type of surgery. It provides the highest rates of cure and also makes radioactive iodine treatment and thyroid hormone therapy work better.

During surgery, lymph nodes in the neck may also be removed and tested for cancer cells (lymphadenectomy). If thyroid cancer has spread to the lymph nodes, radioactive iodine will be used to destroy the remaining cancer cells.

Most thyroid cancers grow and spread so slowly that you can delay surgery for a short time if you need to. If you choose to postpone surgery, your thyroid cancer should be watched closely by an endocrinologist.

Surgery to remove only the part of the thyroid gland that contains cancer (lobectomy) is less complicated than total thyroidectomy and less likely to lead to hypothyroidism. But thyroid cancer comes back (recurs) after lobectomy more often than it does after total thyroidectomy.

If you and your doctor decide that you need surgery, it is important to have the procedure done by a highly skilled surgeon at a hospital that has a good success rate. There are fewer problems from surgery when a person has a skilled and experienced surgeon.2

This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.
..[...]

laparoscopic cholecystectomy

Laparoscopic Gallbladder Surgery for Gallstones

Laparoscopic gallbladder surgery camera.gif (cholecystectomy) removes the gallbladder camera.gif and gallstones through several small cuts (incisions) in the abdomen. The surgeon inflates your abdomen with air or carbon dioxide in order to see clearly.

The surgeon inserts a lighted scope attached to a video camera (laparoscope) into one incision near the belly button. The surgeon then uses a video monitor as a guide while inserting surgical instruments into the other incisions to remove your gallbladder.

Before the surgeon removes the gallbladder, you may have a special X-ray procedure called intraoperative cholangiography, which shows the anatomy of the bile ducts.

You will need general anesthesia for this surgery, which usually lasts 2 hours or less.

After surgery, bile flows from the liver (where it is made) through the common bile duct and into the small intestine. Because the gallbladder has been removed, the body can no longer store bile between meals. In most people, this has little or no effect on digestion.

In 5 to 10 out of 100 laparoscopic gallbladder surgeries in the United States, the surgeon needs to switch to an open surgical method that requires a larger incision.1 Examples of problems that can require open rather than laparoscopic surgery include unexpected inflammation, scar tissue, injury, and bleeding.
What To Expect After Surgery

You may have gallbladder surgery as an outpatient, or you may stay 1 or 2 days in the hospital.

Most people can return to their normal activities in 7 to 10 days. People who have laparoscopic gallbladder surgery are sore for about a week. But in 2 to 3 weeks they have much less discomfort than people who have open surgery. No special diets or other precautions are needed after surgery.
Why It Is Done

Laparoscopic gallbladder surgery is the best method of treating gallstones that cause symptoms, unless there is a reason that the surgery should not be done.

Laparoscopic surgery is used most commonly when no factors are present that may complicate the surgery.
How Well It Works

Laparoscopic gallbladder surgery is safe and effective. Surgery gets rid of gallstones located in the gallbladder. It does not remove stones in the common bile duct. Gallstones can form in the common bile duct years after the gallbladder is removed, although this is rare.
Risks

The overall risk of laparoscopic gallbladder surgery is very low. The most serious possible complications include:

    Infection of an incision.
    Internal bleeding.
    Injury to the common bile duct.
    Injury to the small intestine by one of the instruments used during surgery.
    Risks of general anesthesia.

Other uncommon complications may include:

    Gallstones that remain in the abdominal cavity.
    Bile that leaks into the abdominal cavity.
    Injury to abdominal blood vessels, such as the major blood vessel carrying blood from the heart to the liver (hepatic artery). This is rare.
    A gallstone being pushed into the common bile duct.
    The liver being cut.

More surgery may be needed to repair these complications.

After gallbladder surgery, some people have ongoing abdominal symptoms, such as pain, bloating, gas, and diarrhea (postcholecystectomy syndrome).
What To Think About

Recovery is much faster and less painful after laparoscopic surgery than after open surgery.

    The hospital stay after laparoscopic surgery is shorter than after open surgery. People generally go home the same day or the next day, compared with 2 to 4 days or longer for open surgery.
    Recovery is faster after laparoscopic surgery.
    You will spend less time away from work and other activities after laparoscopic surgery (about 7 to 10 days compared with 4 to 6 weeks)[...]

breast cancer

Breast cancer is cancer that forms in the cells of the breasts.

After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States.

Breast cancer can occur in both men and women, but it's far more common in women.

Substantial support for breast cancer awareness and research funding has helped improve the screening and diagnosis and advances in the treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths steadily has been declining, which is largely due to a number of factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease
Symptoms
By Mayo Clinic Staff
Multimedia

    Illustration of nipple changes
    Nipple changes

Signs and symptoms of breast cancer may include:

    A breast lump or thickening that feels different from the surrounding tissue
    Bloody discharge from the nipple
    Change in the size, shape or appearance of a breast
    Changes to the skin over the breast, such as dimpling
    A newly inverted nipple
    Peeling, scaling or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
    Redness or pitting of the skin over your breast, like the skin of an orange

When to see a doctor

If you find a lump or other change in your breast — even if a recent mammogram was normal — make an appointment with your doctor for prompt evaluation
Causes
By Mayo Clinic Staff

It's not clear what causes breast cancer.

Doctors know that breast cancer occurs when some breast cells begin growing abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. The cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.

Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast.

Researchers have identified hormonal, lifestyle and environmental factors that may increase your risk of breast cancer. But it's not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It's likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment.
Inherited breast cancer

Doctors estimate that only 5 to 10 percent of breast cancers are linked to gene mutations passed through generations of a family.

A number of inherited mutated genes that can increase the likelihood of breast cancer have been identified. The most common are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2), both of which significantly increase the risk of both breast and ovarian cancer.

If you have a strong family history of breast cancer or other cancers, your doctor may recommend a blood test to help identify specific mutations in BRCA or other genes that are being passed through your family.

Consider asking your doctor for a referral to a genetic counselor, who can review your family health history. A genetic counselor can also discuss the benefits, risks and limitations of genetic testing with you and guide you on appropriate genetic testing
Risk factors
By Mayo Clinic Staff

A breast cancer risk factor is anything that makes it more likely you'll get breast cancer. But having one or even several breast cancer risk factors doesn't necessarily mean you'll develop breast cancer. Many women who develop breast cancer have no known risk factors other than simply being women.

Factors that are associated with an increased risk of breast cancer include:

    Being female. Women are much more likely than men are to develop breast cancer.
    Increasing age. Your risk of breast cancer increases as you age.
    A personal history of breast cancer. If you've had breast cancer in one breast, you have an increased risk of developing cancer in the other breast.
    A family history of breast cancer. If your mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, your risk of breast cancer is increased. Still, the majority of people diagnosed with breast cancer have no family history of the disease.
    Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most common gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don't make cancer inevitable.
    Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased.
    Obesity. Being obese increases your risk of breast cancer.
    Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
    Beginning menopause at an older age. If you began menopause at an older age, you're more likely to develop breast cancer.
    Having your first child at an older age. Women who give birth to their first child after age 35 may have an increased risk of breast cancer.
    Having never been pregnant. Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies.
    Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.
    Drinking alcohol. Drinking alcohol increases the risk of breast cancer

Tests and procedures used to diagnose breast cancer include:

    Breast exam. Your doctor will check both of your breasts and lymph nodes in the armpit, feeling for any lumps or other abnormalities.
    Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.
    Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may help distinguish between a solid mass and a fluid-filled cyst. An ultrasound is often obtained as part of the examination of a new lump.
    Removing a sample of breast cells for testing (biopsy). Biopsy samples are sent to a laboratory for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options.
    Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye.

Other tests and procedures may be used depending on your situation.
Staging breast cancer

Once your doctor has diagnosed your breast cancer, he or she works to establish the extent (stage) of your cancer. Your cancer's stage helps determine your prognosis and the best treatment options.

Complete information about your cancer's stage may not be available until after you undergo breast cancer surgery.

Tests and procedures used to stage breast cancer may include:

    Blood tests, such as a complete blood count
    Mammogram of the other breast to look for signs of cancer
    Breast MRI
    Bone scan
    Computerized tomography (CT) scan
    Positron emission tomography (PET) scan

Not all women will need all of these tests and procedures. Your doctor selects the appropriate tests based on your specific circumstances and taking into account new symptoms you may be experiencing.

Breast cancer stages range from 0 to IV with 0 indicating cancer that is noninvasive or contained within the milk ducts. Stage IV breast cancer, also called metastatic breast cancer, indicates cancer that has spread to other areas of the body....

Your doctor determines your breast cancer treatment options based on your type of breast cancer, its stage and grade, size, and whether the cancer cells are sensitive to hormones. Your doctor also considers your overall health and your own preferences.

Most women undergo surgery for breast cancer and also receive additional treatment before or after surgery, such as chemotherapy, hormone therapy or radiation.

There are many options for breast cancer treatment, and you may feel overwhelmed as you make complex decisions about your treatment. Consider seeking a second opinion from a breast specialist in a breast center or clinic. Talk to other women who have faced the same decision.
Breast cancer surgery

Operations used to treat breast cancer include:

    Removing the breast cancer (lumpectomy). During lumpectomy, which may be referred to as breast-sparing surgery or wide local excision, the surgeon removes the tumor and a small margin of surrounding healthy tissue. Lumpectomy is typically reserved for smaller tumors.

    Removing the entire breast (mastectomy). Mastectomy is surgery to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue — the lobules, ducts, fatty tissue and some skin, including the nipple and areola (simple mastectomy).

    In a skin-sparing mastectomy, the skin over the breast is left intact to improve reconstruction and appearance. Depending on the location and size of the tumor, the nipple may also be spared.

    Removing a limited number of lymph nodes (sentinel node biopsy). To determine whether cancer has spread to your lymph nodes, your surgeon will discuss with you the role of removing the lymph nodes that are the first to receive the lymph drainage from your tumor.

    If no cancer is found in those lymph nodes, the chance of finding cancer in any of the remaining lymph nodes is small and no other nodes need to be removed.
    Removing several lymph nodes (axillary lymph node dissection). If cancer is found in the sentinel node, your surgeon will discuss with you the role of removing additional lymph nodes in your armpit.

    Removing both breasts. Some women with cancer in one breast may choose to have their other (healthy) breast removed (contralateral prophylactic mastectomy) if they have a very increased risk of cancer in the other breast because of a genetic predisposition or strong family history.

    Most women with breast cancer in one breast will never develop cancer in the other breast. Discuss your breast cancer risk with your doctor, along with the benefits and risks of this procedure.

Complications of breast cancer surgery depend on the procedures you choose. Surgery carries a risk of bleeding and infection.

Some women choose to have breast reconstruction after surgery. Discuss your options and preferences with your surgeon.

Consider a referral to a plastic surgeon before your breast cancer surgery. Your options may include reconstruction with a breast implant (silicone or water-filled) or reconstruction using your own tissue. These operations can be performed at the time of your mastectomy or at a later date.
Radiation therapy

Radiation therapy uses high-powered beams of energy, such as X-rays, to kill cancer cells. Radiation therapy is typically done using a large machine that aims the energy beams at your body (external beam radiation). But radiation can also be done by placing radioactive material inside your body (brachytherapy).

External beam radiation is commonly used after lumpectomy for early-stage breast cancer. Doctors may also recommend radiation therapy to the chest wall after mastectomy for larger breast cancers or cancers that have spread to the lymph nodes.

Side effects of radiation therapy include fatigue and a red, sunburn-like rash where the radiation is aimed. Breast tissue may also appear swollen or more firm. Rarely, more-serious problems may occur, such as damage to the heart or lungs or, very rarely, second cancers in the treated area.
Chemotherapy

Chemotherapy uses drugs to destroy cancer cells. If your cancer has a high risk of returning or spreading to another part of your body, your doctor may recommend chemotherapy to decrease the chance that the cancer will recur. This is known as adjuvant systemic chemotherapy.

Chemotherapy is sometimes given before surgery in women with larger breast tumors. The goal is to shrink a tumor to a size that makes it easier to remove with surgery.

Chemotherapy is also used in women whose cancer has already spread to other parts of the body. Chemotherapy may be recommended to try to control the cancer and decrease any symptoms the cancer is causing.

Chemotherapy side effects depend on the drugs you receive. Common side effects include hair loss, nausea, vomiting, fatigue and an increased risk of developing infection. Rare side effects can include premature menopause, infertility (if premenopausal), damage to the heart and kidneys, nerve damage, and, very rarely, blood cell cancer.
Hormone therapy

Hormone therapy — perhaps more properly termed hormone-blocking therapy — is often used to treat breast cancers that are sensitive to hormones. Doctors sometimes refer to these cancers as estrogen receptor positive (ER positive) and progesterone receptor positive (PR positive) cancers.

Hormone therapy can be used after surgery or other treatments to decrease the chance of your cancer returning. If the cancer has already spread, hormone therapy may shrink and control it.

Treatments that can be used in hormone therapy include:

    Medications that block hormones from attaching to cancer cells. Selective estrogen receptor modulator (SERM) medications act by blocking estrogen from attaching to the estrogen receptor on the cancer cells, slowing the growth of tumors and killing tumor cells.

    SERMs include tamoxifen, raloxifene (Evista) and toremifene (Fareston).

    Possible side effects include hot flashes, night sweats and vaginal dryness. More-significant risks include blood clots, stroke, uterine cancer and cataracts.

    Medications that stop the body from making estrogen after menopause. Called aromatase inhibitors, these drugs block the action of an enzyme that converts androgens in the body into estrogen. These drugs are effective only in postmenopausal women.

    Aromatase inhibitors include anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin).

    Side effects include hot flashes, night sweats, vaginal dryness, joint and muscle pain, as well as an increased risk of bone thinning (osteoporosis).
    A drug that targets estrogen receptors for destruction. The drug fulvestrant (Faslodex) blocks estrogen receptors on cancer cells and signals to the cell to destroy the receptors. Fulvestrant is used in postmenopausal women. Side effects that may occur include nausea, hot flashes and joint pain.
    Surgery or medications to stop hormone production in the ovaries. In premenopausal women, surgery to remove the ovaries or medications to stop the ovaries from making estrogen can be an effective hormonal treatment.

Targeted drugs

Targeted drug treatments attack specific abnormalities within cancer cells. Targeted drugs used to treat breast cancer include:

    Trastuzumab (Herceptin). Some breast cancers make excessive amounts of a protein called human growth factor receptor 2 (HER2), which helps breast cancer cells grow and survive. If your breast cancer cells make too much HER2, trastuzumab may help block that protein and cause the cancer cells to die. Side effects may include headaches, diarrhea and heart problems.
    Pertuzumab (Perjeta). Pertuzumab targets HER2 and is approved for use in metastatic breast cancer in combination with trastuzumab and chemotherapy. This combination of treatments is reserved for women who haven't yet received other drug treatments for their cancer. Side effects of pertuzumab may include diarrhea, hair loss and heart problems.
    Ado-trastuzumab (Kadcyla). This drug combines trastuzumab with a cell-killing drug. When the combination drug enters the body, the trastuzumab helps it find the cancer cells because it is attracted to HER2. The cell-killing drug is then released into the cancer cells. Ado-trastuzumab may be an option for women with metastatic breast cancer who've already tried trastuzumab and chemotherapy.
    Lapatinib (Tykerb). Lapatinib targets HER2 and is approved for use in advanced or metastatic breast cancer. Lapatinib can be used in combination with chemotherapy or hormone therapy. Potential side effects include diarrhea, painful hands and feet, nausea, and heart problems.
    Bevacizumab (Avastin). Bevacizumab is no longer approved for the treatment of breast cancer in the United States. Research suggests that although this medication may help slow the growth of breast cancer, it doesn't appear to increase survival times.
Breast cancer risk reduction for women with an average risk
Multimedia

    Illustration of breast self-exam
    Breast self-exam

Making changes in your daily life may help reduce your risk of breast cancer. Try to:

    Ask your doctor about breast cancer screening. Discuss with your doctor when to begin breast cancer screening exams and tests, such as clinical breast exams and mammograms.

    Talk to your doctor about the benefits and risks of screening. Together, you can decide what breast cancer screening strategies are right for you.

    Become familiar with your breasts through breast self-exam for breast awareness. Women may choose to become familiar with their breasts by occasionally inspecting their breasts during a breast self-exam for breast awareness. If there is a new change, lumps or other unusual signs in your breasts, talk to your doctor promptly.

    Breast awareness can't prevent breast cancer, but it may help you to better understand the normal changes that your breasts undergo and identify any unusual signs and symptoms.
    Drink alcohol in moderation, if at all. Limit the amount of alcohol you drink to less than one drink a day, if you choose to drink.
    Exercise most days of the week. Aim for at least 30 minutes of exercise on most days of the week. If you haven't been active lately, ask your doctor whether it's OK and start slowly.

    Limit postmenopausal hormone therapy. Combination hormone therapy may increase the risk of breast cancer. Talk with your doctor about the benefits and risks of hormone therapy.

    Some women experience bothersome signs and symptoms during menopause and, for these women, the increased risk of breast cancer may be acceptable in order to relieve menopause signs and symptoms.

    To reduce the risk of breast cancer, use the lowest dose of hormone therapy possible for the shortest amount of time.
    Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, ask your doctor about healthy strategies to accomplish this. Reduce the number of calories you eat each day and slowly increase the amount of exercise.

Breast cancer risk reduction for women with a high risk

If your doctor has assessed your family history and other factors and determined that you may have an increased risk of breast cancer, options to reduce your risk include:

    Preventive medications (chemoprevention). Estrogen-blocking medications may help reduce the risk of breast cancer. Options include tamoxifen and raloxifene (Evista). Aromatase inhibitors have shown some promise in reducing the risk of breast cancer in women with a high risk.

    These medications carry a risk of side effects, so doctors reserve these medications for women who have a very high risk of breast cancer. Discuss the benefits and risks with your doctor.
    Preventive surgery. Women with a very high risk of breast cancer may choose to have their healthy breasts surgically removed (prophylactic mastectomy). They may also choose to have their healthy ovaries removed (prophylactic oophorectomy) to reduce the risk of both breast cancer and ovarian cancer.
http://www.mayoclinic.org[...]

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