Category Archives: Cancer

6 Causes of Lumps That Aren’t Breast Cancer

It's probably not cancer–but that doesn't mean you can ignore a lump in your breast. “>
Breast Cancer –

College Student with Breast Cancer Underwent Treatment Without Missing a Single Class

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This article originally appeared on

Colleen Cappon’s senior year of college was different than most. While she lived in an apartment with her friends, stayed up late doing homework and went to parties on campus, the then 21-year-old had another side of her life that made her very different from the average college student.

Every other weekend, she left school to drive two hours from campus to her hometown of Watertown, New York, where she would undergo chemotherapy treatments for breast cancer.

Just weeks before Cappon began her senior year at the State University of New York at Cortland in 2007, she was diagnosed with stage 2B breast cancer. That summer, while she was getting ready for a night out with friends, doing what she calls the “boob scoop” into her bra, she felt a lump in her breast. A bit alarmed but not overly concerned, Cappon thought she should see a doctor just in case. At her subsequent doctor’s appointment, she had an ultrasound done. The doctor told her it was likely just a fibroadenoma — a mass of dense cells. She recommended that when Cappon came back over winter break, she get the mass removed.

But something felt off to Cappon, and she thought, “Why wait until Christmas?” She still had a month to go before heading back to school, so she decided to have it removed. “I can’t really explain it,” she tells PEOPLE of her gut instinct.

The mass was removed and then tested per standard procedure. And as she soon found out, Cappon’s instincts might have saved her life: The test revealed she had breast cancer.

At the time of her diagnosis, Cappon, who is now 31 and living in Albany, New York, was set to start her senior year of college. She had her class schedule, her lease signed on an apartment with friends and she didn’t want to give up that experience.

But she had to start treatment — and the sooner, the better. So Cappon devised a plan with her doctors. Every other Thursday night, she’d drive the two-hour distance from campus to her parents’ house. On Friday, she’d undergo chemotherapy, spending the rest of the weekend at home to recover before heading back to school on Sunday evening.

“I’m a very social person,” she says of her choice to stay in school while undergoing chemotherapy. “I knew if I missed out on this, it was not going to be good for my mental health during my treatments. And they say that’s the half of it, the attitude and positive environment and everything.”

She spoke with each of her professors about the situation, and confirmed with her academic advisor that she’d be able to schedule her classes on Monday through Thursday. Everyone was supportive, she says, and professors told her not to stress about deadlines and assignments — they’d be happy to accommodate any schedule changes she needed. But Cappon didn’t want to be accommodated: She made it through her whole senior year without missing a single class or assignment.

“I’m such a stubborn person, and it kind of pissed me off that this was even happening in the first place, so I made it a point to be like, ‘No, I’m not going to miss any classes. I’m not going to miss any exams, I’m going to do all my homework assignments,'” she said. “And I did.”

Though she was making frequent trips home each month for chemotherapy, Cappon was able to retain much of her “normal life” at school, she says. She even went to parties when she was feeling up to it.

Cappon finished her four months of chemotherapy in December 2007. That same month, she underwent a double mastectomy, an experience that turned more emotional than she was expecting. She went on to have reconstructive surgery in May 2008.

“I almost had been looking forward to [the mastectomy], because after all this treatment, and having cancer, I was like, ‘I can’t wait to get rid of this part of my body that had the cancer in it, and I’m going to feel so much better,’ ” she says. “And a big part of me did feel better after the surgery, but there’s also a big part that feels almost a little resentful. Especially at 21 years old. Let’s be real, your breasts look the best they’re ever going to look, and I’m getting rid of them.”

But for Cappon, the timing of her diagnosis wasn’t the hard part. In fact, she views it as something positive, despite her young age. In college, she had more time to relax and sleep than she would have had she been working a full-time job. And since she was living with her friends, there were constant distractions from the cancer.

“It was a great situation to be in, honestly,” Cappon says. “I was never alone, I didn’t have a job yet, I could nap between classes whenever I felt like it.”

What was difficult, she says, was the uncertainty that came along with getting a diagnosis that so few women her age had received. Not only was it isolating, but it came with medical hurdles, too. She consistently found questions left without an answer: Her doctors couldn’t tell her if she’d suffer common side effects, or if she’d be able to have children after her treatment was over.

“There were a lot of unanswered questions,” she says. “There were a lot of questions about the side effects. I was told one time, ‘We’re not sure if your hair is going to fall out, because you’re so young, maybe your body will react differently.’ “

Perhaps the biggest unanswered question was about her fertility. Unlike many young women with breast cancer, Cappon wasn’t able to freeze her eggs before starting treatment because of how aggressive her tumor was.

“You don’t really care or think about having kids when you’re 21, until someone says you might not be able to,” she says. “They just said, ‘We’re going to give you this treatment, and we don’t really know what your future is going to be like. Let’s just concentrate on surviving this first,’ ” she says. “I go off the medicine in January, and it’s really just a toss-up.”

It’s a tough future for a 21-year-old to face. Cappon is now married to her college boyfriend, who she was dating during her cancer treatment. She says that at the time, she was open with him about the possibility that she wouldn’t be able to have children one day, and told him that she’d understand if he ended their relationship. “In the beginning, I said, ‘I don’t know what is going to happen with this kids thing. If you want out, I understand,’ ” she says.

Her boyfriend didn’t want out, and encouraged her to go through with the double mastectomy. His support brought a level of relief to the experience, she says.

“I feel a little guilty about it sometimes, because I had a boyfriend throughout the whole time that was encouraging me to do everything I could to make sure I came alive out on the other side of this,” she says. “Other young women who don’t have a serious boyfriend and are out in the dating world, who’ve had mastectomies, that has to be really tough, and weigh on your decision to get the surgery.”

Almost 10 years later, they’re hoping to start a family in the near future and they’re discussing her going off the drug Tamoxifen, which she has been on for the past decade in hopes of reducing the risk of the cancer coming back. For the first time, having a family is a real possibility within sight. Whether she’ll be able to, however, is unknown. She’s still not sure if she’ll be able to have children once she’s off the medication. She was one of the first women her age to go on the drug for a 10-year period, she says, and was told back in 2007 that they’d simply have to wait and see if it would affect her ability to have children.

“Again, more uncertainty,” she says. “But at least I’m here.”

In the years since her first post-chemo and surgery screening showed no evidence of cancer in May 2008, Cappon has connected with many other young women with breast cancer, something that she says has been “really rewarding.”

“I remember really clearly when I was diagnosed feeling like there was no one I could find at my age who had done this and came out okay on the other side, leading a healthy, normal life,” she says. “You’ve just gotta keep your chin up and remember you’re going to come out on the other side.” “>
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Julia Louis-Dreyfus’ Veep Costars ‘Psyche Her Up’ for Third Round of Chemotherapy

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This article originally appeared on

Julia Louis-Dreyfus has some pretty special “darling bozos” in her life.

The Veep star — who announced her battle with breast cancer in September — went in for her third round of chemotherapy on Thursday, and her costars Matt Walsh and Sam Richardson decided to film a small sketch to motivate her.

“2 of my darling Bozos (love them so much) psyche me up for 3rd chemo today,” Louis-Dreyfus, 56, captioned the video on Twitter. “And guess what? It worked! I’m psyched AF.”

In the clip, Walsh, 53, and Richardson, 33, decided send some “motivational quotes” to “psyche her up” ahead of her treatment. They sit down to Google some ideas, but only seem to be coming up with quotes from less-than-ideal candidates: Joseph Stalin, Kevin Spacey and Harvey Weinstein.

Eventually they give up and decide to sing for her instead, breaking into a rendition of Survivor’s “Eye Of The Tiger.”

“Kick some a— today, Julia!” they cheer.

Louis-Dreyfus revealed her breast cancer battle on social media Sept. 28, writing, “1 in 8 women get breast cancer. Today, I’m the one. The good news is that I have the most glorious group of supportive and caring friends, and fantastic insurance through my union.”

“The bad news is that not all women are so lucky,” she added. “So let’s fight all cancers and make universal health care a reality.”

RELATED: Julia Louis-Dreyfus Calls for Universal Health Care After Breast Cancer Diagnosis — 5 Times She Got Political

The announcement came just days after Louis-Dreyfus won her sixth consecutive outstanding lead actress Emmy for her role as Selina Meyer on Veep, setting the record for most wins for a performance in the same role for the same series.

HBO told PEOPLE that Louis-Dreyfus learned of her diagnosis one day after the Sept. 17 award show, noting that “it in no way impacted the decision to make this the final season” and that the production schedule will be adjusted as needed.

“Our love and support go out to Julia and her family at this time,” said the network in statement. “We have every confidence she will get through this with her usual tenacity and undaunted spirit, and look forward to her return to health and to HBO for the final season of Veep.”

A premiere date for Veep season 7 has not yet been announced. “>
Breast Cancer –

What Are Lymph Nodes?

Lymph nodes play a role in cancer diagnoses, as well as trapping bacteria and viruses. “>
Breast Cancer –

All the Ways Your Boobs Can Change as You Age

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When it comes to breast cancer screening, there's one piece of advice that's pretty much universal: know your breasts. The idea is that the more familiar you are with your girls, the more likely you are to notice any potential signs of cancer, such as lumps, dimpled skin, or swelling on one side. But as you keep tabs on your boobs, it may be helpful to know there are a host of other breast developments that are completely normal. Here's a look at the many ways your boobs can change throughout different phases of your life.

RELATED: 9 Breast Cancer Symptoms That Aren’t Lumps


Everyone’s born with some breast tissue and nipples; but it isn’t until puberty that our boobs as we know and love them start to show up. When a young woman's body prepares to ovulate and menstruate, “estrogen and progesterone kick it into gear,” says Christine Greves, MD, an ob-gyn at Orlando Health Hospital. “Our mature mammary glands start to develop, and by the time of our adult life, we have what you and I know as breast tissue.” This process even has a fancy medical name: thelarche. And it’s usually complete by the time you turn 20, Dr. Greves adds.

In addition to breasts, you might have also gained some stretch marks during puberty. When breasts grow quickly, “the skin cannot keep up," says Dr. Greves. “There’s nothing to really do about stretch marks if you’re destined to get them.”

RELATED: 20 Things You Need to Know About Your Nipples

Your 20s

By now your boobs are fully formed, and with any luck, your menstrual cycle has settled into a regular routine. It’s common to notice breast changes before or during your period, thanks to fluctuating hormone levels. “Around our period, just like we feel bloated, fluid increase applies to the breast tissue too,” Dr. Greves says. You might notice you're more voluptuous than usual–or possibly in a bit of discomfort. “The swelling can make breasts more tender during that time,” she says.

In some people, that extra fluid can also cause lumpiness, according to the National Cancer Institute (NCI). Talk to your doctor if these lumps concern you; he or she may want to do an exam and see you again at a different point in your cycle.

At this time in your life, your breasts are at their firmest and perkiest. They're also at their densest—which means they contain more fibrous tissue (think glands and ducts) and less fatty tissue. (For more, check out this explainer on what it means to have dense breasts.)

RELATED: The 5 Ways Your Boobs Change Throughout the Month

Your 30s and 40s

Many women have children during these decades, and pregnancy and breastfeeding can usher in more breast changes. When you're pregnant, more milk-producing lobules develop and the milk ducts start working, Dr. Greves says. These gland changes can sometimes feel like lumps. (You should still mention any lumps you detect to your doctor.)

You may also notice that your areolas get darker during pregnancy. “We don’t really know why, but some say it’s because babies’ vision is only good at telling the difference between light and dark,” Dr. Greves says. If the area right around the nipple is easier to distinguish from the rest of your breast, the theory goes, your baby might have an easier time breastfeeding.

Both pregnancy and breastfeeding can add some heft to your chest. “Just like puberty, pregnancy or breastfeeding causes breasts to enlarge very quickly over a short period of time,” Dr. Greves says, which can result in more stretch marks.

Breastfeeding can also cause some lumpiness to develop. If this lumpiness is accompanied by soreness, warmth, or a reddish hue in your skin, you could have an infected or blocked milk duct, called mastitis, which is treatable with antibiotics.

Whether or not you get pregnant in your 30s or 40s, “gravity takes effect” during these decades, Dr. Greves says. Some amount of breast sagging is pretty much unavoidable. The ligaments in your breasts simply stretch out over time.

RELATED: 6 Weird Ways Pregnancy Changes Your Breasts

Your 50s

“I see a lot of patients with complaints like, ‘My breasts were so nice and supple before, and now they hang down!’” says Dr. Greves. Some of that sagging may be the result of prior pregnancies and breastfeeding; but some is caused by the hormonal shifts of menopause.

“As we get older, the levels of estrogen and progesterone decrease,” explains Dr. Greves. Estrogen and progesterone fuel the growth of glands, ducts, and other non-fatty tissue in the breasts; so as those hormones decline, the breasts end up with more fatty tissue. “Breast tissue may not be as round and may sag a little bit more,” she says.

After menopause, the skin on your breasts can change as well. It may become drier and thinner, says Dr. Greves, which may also contribute to a droopier appearance.

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When in doubt, speak up

While many breast changes are normal and nothing to worry about, if you discover anything that concerns you, mention it your primary care physician or ob-gyn, Dr. Greves urges: “Bring it up, and don’t be shy.” It's always best to err on the side of caution. “>
Breast Cancer –

Using a Cold Cap Saved My Hair During Chemo, but It Was One of the Most Painful Things I’ve Ever Done

Breast cancer was never on my radar—I didn’t have a family history of the disease, and I was only 38. But last October I felt a small lump in my right breast, like a pencil eraser, as I was getting out of the shower. Fortunately, I had an appointment with my ob-gyn already coming up, and I asked her to check it out. She felt the lump too and scheduled a mammogram.

One mammogram, ultrasound, and biopsy later, I found out I indeed had breast cancer. I walked around that Halloween, completely stunned. After seeing a genetic counselor, I discovered I also had the BRCA1 gene, which increases the risk of developing both breast and ovarian cancer. I went from thinking I’d get a lumpectomy to deciding to have a preventative double mastectomy with reconstruction and a hysterectomy.

The tumor was removed successfully last December, yet I still had 12 weeks of chemotherapy treatments to get through. While my doctors went over the plans for my chemo with me, one doctor mentioned the possibility of using a cold cap, or cooling cap, to keep my hair. Basically, if a frozen cap sits on your hair, blood flow to the follicles becomes constricted. The chemo drugs can't easily penetrate the follicles, and hair is much less likely to fall out.

RELATED: The Five Breast Cancer Stages, Explained

Knowing that I didn't want to lose my hair, I did some research, and I decided to use Penguin Cold Caps throughout my chemo. But prepping for treatments, and then sitting through them, was not easy. First, you have to pay for cold caps out of pocket. I paid about $ 1,500 for the initial set of caps and a dry ice cooler, and then $ 500 to $ 1,000 for more caps each month. My husband and I also had to get our own dry ice to freeze the caps with every week, which cost about $ 50.

We’d drive to an ice cream shop in Brooklyn, where we live, and load up with 50 pounds of ice, cut into slabs, and that home. In the morning, before chemo, we’d take the caps out of our freezer and place them in between the slabs of dry ice in the cooler. After wheeling it all into the hospital, my husband would wear heavy-duty gloves and help me put on the frozen caps.

I’d wear them during the 30 minutes before my chemo started, which could last up to two hours, and then for an hour after treatment ended. Every 10 to 20 minutes, my husband would have to change the cap I had on because it would get too warm in room temperature. The whole time you're wearing one, you can’t really move or speak, and you’re absolutely freezing. It feels like constant brain freeze.

But I knew I had to get through it—mostly for my kids. That's because when I was growing up, my dad had testicular cancer, and he went through aggressive chemotherapy treatments. I remember how people looked at him when we went out—his skin was green, his hair patchy. To make it easier, we joked that he looked like Beetlejuice. But it was traumatic to see him sick like that. He looked like an entirely different person.

RELATED: 16 Celebrities Who Battled Breast Cancer

I didn't want my children, who were 5 and 10 years old at the time, to experience that. I wanted things to feel the same as they always did, and I didn't want my diagnosis to have more of an impact on their lives than it needed to.

I was lucky: throughout my chemo, I kept my hair. I couldn’t wash it more than once a week, or brush it, or get highlights, so I still didn’t feel like I looked exactly like myself. But because I had hair, strangers had no idea I was sick. It felt better to not have people looking at me with pity. I wanted to feel upbeat and positive, because it’s already hard enough to deal with cancer, let alone the visual aspects of it.

Now that I’m on the other side, I appreciate my hair more than ever. (The tumor is gone, but I won’t be officially declared cancer-free until I hit the five-year mark.) When my eyebrows came back in, I really wanted to show them off. When I could start styling my hair again, I got blowouts. I was proud of the little hairs on my arms that began to sprout all over. 

I’m glad I used the cold caps, but I try to be honest with people about how extremely painful it is. For me, it was worth it. My kids treated me like they always do, teasing me, and I felt like I was still myself during the whole treatment. Dealing with so many other challenges, like surgery and losing both breasts, it felt good to still have something that was mine. My hair made me feel like I was the same person that I was before I was diagnosed, and that’s a powerful feeling. “>
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22-Year-Old Woman Discovers Breast Cancer Lump After Dropping Necklace Down Her Shirt

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This article originally appeared on

When Leslie Almiron discovered a lump in her breast in 2016, it was by accident. The pendant on her necklace had fallen off and landed in her bra. When the then 22-year-old reached in to retrieve it, she felt her hand brush up against something. At first, she didn’t think much of it and hopped in the shower. But while she was showering, she couldn’t shake the feeling that something was off. So she felt around again, and this time, she couldn’t deny that there a lump.

Almiron immediately called her mom and asked her what to do. Her mother wasn’t too concerned — after all, Almiron was only 22 — but she suggested she call her doctor to make sure. The doctor wasn’t very worried either, considering her age and history, but advised her to come in.

That initial doctor’s visit led to an ultrasound and then a recommendation to make an appointment with a breast surgeon. But even then, the idea that it could be cancer didn’t weight too heavily on Almiron’s mind. Her doctor didn’t even mention the word, she says.

“Now that I think about it, it did take a long time,” Almiron, now 24, tells PEOPLE of the ultrasound. “But I was just completely unaware of what was going on. I was just laying on the table, perfectly fine.”

The thought that the lump could be cancerous didn’t occur to Almiron until she was getting it biopsied, and she saw the physician assistant’s face go white as she took a closer look. But they couldn’t tell her if it was cancer until her official test results came back the following week.

“I spent the whole weekend borderline freaking out, and then thinking there was just no way that this could happen,” she says.

The following week, she got the call: It was cancer — stage 3 — and they needed her to come in as soon as possible for more tests. Almiron went on to undergo chemotherapy, radiation and a double mastectomy.

Almiron’s diagnosis at such a young age may be rare, but it’s far from unheard of. Though typically associated with older women, about 70,000 women and men under the age of 40 are diagnosed with breast cancer every year, according to the Young Survival Coalition. And every year, the disease kills 1,000 women in the same age group — a lower survival rate compared to those over 40. Young women generally face more aggressive cancers and lower survival rates, and evidence suggests that breast cancer before age 40 differs biologically from the cancer faced by older women.

With these cases comes unique challenges. Jennifer Merschdorf, the CEO of the Young Survival Coalition (who herself was diagnosed with breast cancer at 36, the same year her mother was diagnosed at 66), says the organization’s goal is to help young women navigate these obstacles.

“Young women are starting or in the full swing of their careers,” Merschdorf tells PEOPLE. “They’re starting families. That’s very different than older women.”

The decision to get a mastectomy at such a young age is all the more difficult, and many women go into early menopause, according to Merschdorf.

For many women, the question of fertility and children is “huge” when they get a breast cancer diagnosis, Merschdorf says. Particularly if a woman hasn’t had children or isn’t even sure if she wants them in the future.

Almiron says she hadn’t given much thought to whether she wanted children prior to her diagnosis. So when her doctor suggested freezing her eggs, she was overwhelmed.

“I’m just freaking out,” she says. “I’m thinking ‘I have cancer, I’m not going to live to have children. Why do you want me to do this?’ “

Almiron had been with her boyfriend for four years, but they had just graduated college and were looking for their first jobs and hadn’t seriously spoken about children.

“I had to call him and say, ‘Hey, I have to freeze my eggs. Do you think you’re going to love me forever? Should we do embryos?’ ” she recalls. “That’s just a conversation I don’t need to be having at 22.”

At her doctor’s encouragement, Almiron ended up going forward with the egg preservation, and within days, she was getting hormone injections. She was able to freeze 26 eggs before she started her treatment.

There may be about 70,000 new cases every year, but finding fellow young people living with breast cancer is tough. Especially for those who live outside of an urban area. And though support groups for breast cancer patients exist all over the country, if they’re filled with older woman, it often can make a young patient feel isolated.

Once, when Almiron was checking into to a support group, the leader told her to wait outside for her mom, assuming she was the daughter of a patient, not a patient herself.

“She eventually stopped going after she says she realized “this just isn’t going to make me feel better.”

Comfort can be found in organizations that are geared towards those living with cancer who are in their age group. The Young Survival Coalition hosts an annual conference called the National Summit for survivors to come and meet one another. And Almiron met fellow young cancer survivors through a group called Stupid Cancer, where she made immediate connections with survivors her own age.


“We clicked right away, and it’s a friendship that you’d think we would have been friends for years,” she says of one of the friends she made through Stupid Cancer. “It’s like, ‘I know exactly what you’ve been through.’ “

And for young women, financial and logistical problems that come with a cancer diagnosis can be even more pronounced. As Merschdorf says: “It’s not like in your twenties you’ve saved this huge nest egg that you can use to offset these huge medical expenses.”

For Almiron, who is a DACA recipient, the ability to pay her medical bills presented its own problems. Before getting her first job a year before her diagnosis, she didn’t have health insurance. And because she had no way to get insurance without a job, she had to continue working while she was going through treatment. The only time she took off was when she was recovering from her double mastectomy, and was, in her words “flat broke.”

“I couldn’t afford to get kicked off my insurance,” she says. “It was like, ‘Tough luck, you have to deal with it.’ And that was my attitude. I have to go to work bald, sweating and in pain. It sucks.”

She credits DACA for saving her life: “If I had been diagnosed two years before when I didn’t have insurance, I don’t know what I would have done.”

When asked what she would want a young woman who has just been diagnosed with breast cancer to know, Almiron says, “It gets better.”

“The finish line will move, and it’s going to change, and it’s not going to be over when you think it’s over, or when you want it to be over, but there is an end,” Almiron says. “It’s coming. Just hang in there.” “>
Breast Cancer –

5 Things to Know About Tamoxifen, the Breast Cancer Drug Jill Goodacre Has Been Taking Since Her Surgery

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In this week’s issue of People, former Victoria’s Secret model Jill Goodacre opens up about her five-year battle with breast cancer and the medication she’s been on to keep the disease at bay. Goodacre, who’s married to singer and actor Harry Connick Jr., went through surgery and radiation in 2012 after a tumor was detected via sonogram, and has taken the drug tamoxifen ever since.

As she approaches her five-year cancer-free mark, Goodacre says she’s looking forward to stopping tamoxifen. The medication can cause side effects, including weight gain, which Goodacre admits she’s struggled with.

“I’ve always been a pretty fit person, and so to be just rounder and heavier and not to really be able to do much about it—that’s been hard,” she told People. “It’s taken a lot out of my self-confidence.”

That’s a common problem among breast cancer survivors, says Nikita Shah, MD, medical director of the Cancer Risk Evaluation Program at Orlando Health UF Health Cancer Center. (Dr. Shah has not treated Goodacre, but does prescribe tamoxifen to many of her own patients.)

Still, tamoxifen can be lifesaving, says Dr. Shah, and for many women, its benefits outweigh its potential side effects. Here’s what else breast cancer patients and their loved ones should know about the pros and cons of this treatment.

It can be a treatment or a prevention

Tamoxifen is in a class of drugs known as selective estrogen receptor modulators, or SERMs. These drugs work by attaching to estrogen receptors in breast cells, blocking estrogen’s ability to cause cell mutations that lead to cancer.

The drug—taken as a pill or a liquid—is often prescribed to pre-menopausal women after surgery for early-stage breast cancer. Because surgeons can’t always be sure they removed all of the cancer cells, tamoxifen can reduce the risk that those leftover cells will continue to multiply and the cancer will return.

It can also be prescribed to women, pre- or post-menopause who have not been diagnosed with breast cancer, if they have a high risk (1.67% or higher) of developing it over the next five years. These women are usually 35 or older, and have risk factors such as a family history of cancer or a history of abnormal biopsies.

RELATED: The 5 Breast Cancer Stages, Explained

It’s only effective for some types of cancer

Studies have shown that tamoxifen can reduce the risk of cancer in high-risk women by more than 30%. But because the drug affects estrogen receptors in the body, it only works against cancers that are estrogen-receptor-positive or progesterone-receptor positive. Together, these make up about two-thirds of all breast cancers, according to

“The way tamoxifen works is you’re depriving your cancer cells of estrogen, which is their nutrition,” says Dr. Shah. “So that will only work for the cancers that are estrogen-fed or progesterone-fed.”

RELATED: 25 Breast Cancer Myths Busted

Other factors can affect how well it works, too

Some people have an abnormal version of an enzyme called CYP2D6, which may make tamoxifen less effective. (Some research has suggested this, although larger, more recent studies haven’t found a link.) Patients may want to consider being tested for this enzyme abnormality before starting tamoxifen, to make sure they’ll get the full benefit.

Certain medications, including diphenhydramine (Benadryl), cimetidine (Tagamet), and some antidepressants can also block the activity of the CYP2D6 enzyme. "That's why it's very important to make sure your oncologist knows every medication you're taking, including supplements," says Dr. Shah. 

Five years is recommended, but 10 years may be better

After breast cancer treatment, most women who take tamoxifen take it for five years. But recent studies have suggested that it can reduce women’s risk for breast cancer even further if it’s taken for 10 years, says Dr. Shah.

However, tamoxifen is only recommended after breast cancer treatment for women who haven’t gone through menopause yet; after menopause, other drugs—called aromatase inhibitors—are known to work better. “If a woman becomes post-menopausal during those five or 10 years she’s on tamoxifen, we will switch her to this other group of drugs that is 20 to 25% more effective,” says Dr. Shah.

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It does have side effects—but they may be overestimated

Despite its protective effects against cancer, some women stop taking tamoxifen because of side effects like hot flashes, mood swings, nausea, vomiting, or weight gain or loss. The drug can cause menstrual irregularities, and changes in sex drive or sleep patterns as well. (Tamoxifen also raises the risk for more serious health issues, like blood clots and uterine cancer; though for most women, the overall risk for these problems is still small.)

But many women who take tamoxifen are perimenopausal, and a recent study found that some women mistake naturally occurring symptoms of menopause with side effects of tamoxifen. In the study, symptom-related drop-out rates were similar across a nearly five-year period for women who took tamoxifen and for those who took a placebo pill.

“Patients will say I started taking tamoxifen and I gained 40 pounds,” says Dr. Shah. “But that’s probably a combination of hormonal and lifestyle changes they’re going through. Tamoxifen can cause some fluid retention, and it could maybe cause a 2- or 3-pound weight gain, but beyond that there are probably other things going on as well.”

Dr. Shah says it’s important to talk to your doctor if you’re experiencing side effects, rather than stopping a recommended course of tamoxifen. “There are ways to manage the side effects, and most of them are not permanent. They get better with time,” she says. “>
Breast Cancer –

Harry Connick Jr. on Supporting Wife Jill Goodacre Amid Cancer Fight: ‘She’s the Most Beautiful Woman in the World’

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Even after 23 years of marriage, Harry Connick Jr. still gazes at Jill Goodacre like a lovestruck teen.

“She’s my best friend, and I really don’t know what I would do without her,” the actor, multiplatinum recording artist and host of the daytime talk show, Harry, tells PEOPLE in this week’s issue as he and his wife reveal her five-year battle with breast cancer.

“I was scared I was going to lose her, absolutely,” says Connick Jr., 50, whose mother died of ovarian cancer when he was 13. “I wasn’t going to let her see that, but I was. I know from losing my mom that the worst can happen.”

In October 2012 — breast cancer awareness month — Goodacre was diagnosed with Stage 1 invasive ductal carcinoma and immediately underwent a lumpectomy, which didn’t come back with clean margins.

Pathology tests showed she also had extensive ductal carcinoma in situ, a less invasive form of the disease. She went in for a second surgery the next day and has been taking Tamoxifen, an estrogen modulator taken in pill form that helps prevent the development of hormone receptor-positive breast cancers, for the last five years.

“It threw me right into menopause,” Goodacre, 53, says of the medication, which can have difficult side effects. “And then there was the weight gain.”

As someone who once had a career built on posing in lingerie and swimsuits, former Victoria’s Secret model Goodacre has found herself in a size and shape she had never before experienced. (The drug can lead to weight gain, particularly in the midsection, a side effect with the dreaded nickname Tamoxifen Tummy.)

“I’ve always been a pretty fit person, and so to be just rounder and heavier and not to really be able to do much about it — that’s been hard,” she admits. “It’s taken a lot out of my self-confidence.”

Connick Jr. understands her struggles.

“It’s not silly and it’s not vain,” he explains. “It’s a part of how the cancer and the treatment impacted her, and it was a real issue, even though she will always be the most beautiful woman in the world.”

Connick Jr. met Goodacre at a party in 1990, at the height of her modeling career, when he was best known as New Orleans-bred big band crooner who repopularized Gershwin on the soundtrack of When Harry Met Sally.

They wed four years later, and today share a cozy, converted barn in a quiet Connecticut town with their daughters Georgia, 21, Sara Kate, 20 (who goes by Kate), and Charlotte, 15.

“I think one of the reasons we’ve lasted this long is that we’re so aligned in every way,” he says. “We have the same morals, the same goals.”

“Everything that he values, I value so much too,” she adds. “And our family has always been the most important.”

Now, as she approaches the five-year mark of remission, Goodacre is looking forward to stopping Tamoxifen soon and preparing to tell the world what few outside her family knew.

On Thursday’s episode of Harry, the couple will candidly discuss her cancer journey and the moment she was diagnosed — “It’s one of the hardest days of my life,” she recalls — in a heart-to-heart discussion.

As for her husband? He still has the same hope he did after their very first encounter.

“I knew as soon as I met her that I wanted to grow old with her,” he says. “I’m so grateful that I still can.”

Harry airs weekdays (check local listings or visit “>
Breast Cancer –

‘I’m Permanently Damaged.’ Woman Sues After She Says Doctors Unnecessarily Removed Her Breasts and Uterus

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Last year, Elisha Cooke-Moore made the hardest decision of her life: After doctors said genetic tests revealed that she was at risk for aggressive breast and ovarian cancers, she says she followed their recommendation and underwent surgery to remove both her breasts and her uterus.

Based on the genetic tests, the Gold Beach, Ore. resident says she had been told she had MLH1 and BRCA1 gene mutations, as well as Lynch syndrome, which together gave her a 50% chance of developing breast cancer and an up to 80% chance of developing uterine cancer. Based on those results, she went through with a double mastectomy and a hysterectomy.

After the surgeries, however, she was unhappy with the results of her mastectomy and reached out to a lawyer, who suggested that she see another doctor about breast reconstruction. After examining her case file, the new doctor informed Cooke-Moore that her genetic test results were actually negative, says Christopher Cauble, Cooke-Moore’s lawyer. She called the lab to confirm, and felt her world crash down when she learned that the doctor was right: The operations that had pushed her into early menopause, forced multiple follow-up surgeries, and left her with post-traumatic stress disorder were likely unnecessary.

“I’m permanently damaged,” she told TIME this week. “No amount of money will ever fix what they’ve done to me. Never.”

Last week, the 36-year-old filed a $ 1.8 million lawsuit in Curry County Circuit Court. The suit names Curry Medical Practice and Curry Medical Center, where the procedures were performed, as well as several health professionals who work there and were involved in Cooke-Moore’s treatment, including her October 2016 double mastectomy.

Curry Medical Network did not immediately respond to requests for comment on behalf of itself and its employees.

Cooke-Moore underwent genetic testing because both her mother and grandmother had cancer. Despite test results that she says clearly show no clinically significant mutations, doctors told her she carried an MLH1 gene mutation and had Lynch syndrome, both of which increase the odds of developing colorectal, uterine and ovarian cancers. (Lynch syndrome does not have a clear bearing on breast cancer, but the lawsuit alleges that members of Cooke-Moore’s care team told her it could raise her risk.) Cooke-Moore says she was also told she had mutations in the BRCA1 gene, which are linked to a higher-than-average risk of breast and ovarian cancer, though the lawsuit claims she did not.

Cauble says it’s still unclear how and why doctors misread the results. His guess, he says, is that doctors misinterpreted a line in the results, which said that there were “variants of uncertain significance” associated with the MLH1 gene. (Variants of uncertain significance is an often-used term in genetic testing that means it is not clear if the variations are or are not associated with cancer.) “The explanation to me is that everyone has some kind of gene mutation, but these gene mutations do not constitute a positive test,” he wrote in an email to TIME.

This kind of genetic testing has become far more common in recent years, though it’s still only recommended for people, like Cooke-Moore, with a strong family history of heritable cancer. Not all doctors recommend it, however, because it does come with the risk of false positives, which may cause people undue emotional stress or unnecessary procedures. Then there’s the risk of the results being misinterpreted altogether, as Cook-Moore says happened in her case.

Cooke-Moore says the pain — both physical and emotional — has been some of the worst of her life, and she wants those responsible to be held accountable. “I will not stand down,” she says. “>
Breast Cancer –