How To Offer Services To Breast Cancer History Patients

Spa Services For Breast Cancer

Spa Services and Breast Cancer
by Morag Currin

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How Estheticians Can Help

5 Concerns The Esthetician Should Engage In When Providing Services To a Client With a History of Breast Cancer

1. Be aware of fibrotic tissue around the breast area after radiation therapy and be aware of any future secondary cancers in areas where radiation has occurred.

2. Know if lymph nodes have been removed and/or radiated in the breast/underarm area and be aware of lymphedema risks.

3. Be aware of possible metastasis. 

4. Keep a vigilant eye out for changes in the skin in the face, neck, decollete and underarm area.  When touching the client, you may ‘feel’ changes versus seeing physical changes.

5. Note any changes to the vital organs and modify the requested service accordingly.

With any type of cancer, a person comes to the spa because they want to be in a safe space.  They may seek out services for relaxation; symptom relief; appearance recovery or mental wellness.  Your touch can help activate the brain’s orbitofrontal cortex which links to feelings of reward and compassion. Since the esthetician’s focus is the skin – let’s offer up the right touch on that skin that contains receptors that directly elicit emotional responses and make the visit a memorable one!

Understanding Breast Cancer

For women in the U.S., breast cancer death rates are higher than those for any other cancer, besides lung cancer.  About 1 in 8 U.S. women (about 13%) will develop invasive breast cancer over the course of her lifetime.

In women under 45, breast cancer is more common in Black women than White women. Overall, Black women are more likely to die of breast cancer. For Asian, Hispanic, and Native-American women, the risk of developing and dying from breast cancer is lower. Ashkenazi Jewish women have a higher risk of breast cancer because of a higher rate of BRCA mutations.

Fewer women are dying from breast cancer today than in the past. Breast cancer deaths have decreased due to earlier detection and breast cancer awareness. This awareness is imperative, and all estheticians need to be educated about the signs and symptoms of breast cancer, so that the esthetician may recognize their client may have breast cancer.  It is not our role to suggest or diagnosis, but simply to make the client aware of changes in their breasts and their skin around the breasts.  These changes can be noticed during spa services, such as underarm waxing, body wraps or other skin care services. By being aware, you can help save a life!

Because a large percentage of women of all ages—and more and more men—visit spas, estheticians cannot shy away from breast cancer statistics. In this article, we address some of the different types of breast cancer—including noninvasive, invasive, recurrent and metastatic breast cancers—as well as breast cancer in men.

When it comes to both sexes, both women and men have breasts; women just have more breast tissue. Each breast lies over the pectoral muscle. The female breast extends from just below the clavicle, to the axilla and across to the sternum.

The breast is a mass of glandular, fatty and connective tissue made up of:

•   Lobules—glands that produce milk;
•   Ducts—tubes that carry milk from the lobules to the nipple;
•   Fatty and connective tissue—surrounds and protects the ducts and lobules, and gives shape to the breast;
•   Areola—the pink or brown circular area around the nipple; and
•   Nipple—the area at the center of the areola that dispenses milk.

Ligaments support the breast. They run from the skin through the breast and attach to muscles on the chest. Breast cancer can begin in different areas of the breast: the ducts, the lobules or, in some cases, the tissue in between. There are several types of breast cancer, but some of them are quite rare. In some cases, a single breast tumor can be a combination of types, or be a mixture of invasive and in situ cancer.

Common Types of Breast Cancer

Ductal carcinoma in situ (DCIS)

DCIS is the most common type of noninvasive breast cancer. DCIS is called “noninvasive” because it doesn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having it can increase the risk of developing an invasive breast cancer later on in life. A client who has had DCIS is at higher risk for the cancer coming back or for developing a new breast cancer than a client who has never had breast cancer before. Most recurrences happen within 5–10 years after initial diagnosis.

•   Signs and symptoms. DCIS generally has no signs or symptoms. A small number of people may have a lump in the breast or some discharge from the nipple.

Lobular carcinoma in situ (LCIS)

LCIS is an area of abnormal cell growth that increases a person’s risk of developing invasive breast cancer later on in life. “Lobular” means that the abnormal cells start growing in the lobules, the milk-producing glands at the end of the breast ducts. People diagnosed with LCIS tend to have more than one lobule affected. Despite the fact that its name includes the term “carcinoma,” LCIS is not a true breast cancer. It is an indication that a client is at higher-than-average risk for getting breast cancer at some point in the future.

• Signs and symptoms. LCIS usually does not cause any signs or symptoms, such as a lump or other visible changes to the breast.

Invasive ductal carcinoma (IDC)

This is the most common type of breast cancer. IDC starts in a milk duct of the breast, breaks through the wall of the duct and grows into the fatty tissue of the breast. If it gets to this fatty tissue, it may metastasize to other parts of the body through the lymphatic system and bloodstream.

•   Signs and symptoms. Sometimes, the first sign of IDC is a new lump or mass in the breast that can be felt. (See Chart on Signs and Symptoms of IDC and ILC.)

Invasive lobular carcinoma (ILC)

This second most common type of invasive breast cancer starts in the milk-producing lobules. Like IDC, it can metastasize to other parts of the body. Some research has suggested that the use of hormone replacement therapy during and after menopause can increase the risk of ILC.

•   Signs and symptoms. In the beginning, ILC may not cause any symptoms. The first sign is a thickening or hardening in the breast that can be felt, rather than a distinct lump. (See Chart Signs and Symptoms of IDC and ILC

Less Common Types of Breast Cancer

Inflammatory breast cancer (IBC)

This is a rare and aggressive form of breast cancer; however, it needs to be known about due to its aggressive nature.

•   Signs and symptoms. Inflammatory breast cancer usually starts with a feeling of thickness or heaviness in the breast. It may also have the following symptoms:
  • • Redness of the breast
    • Swelling of the breast
    • Warmth
    • Orange-peel appearance
    • Pink or bruised appearance, or the appearance of ridges, welts or hives
    • Swelling of lymph nodes
    • Flattening or inversion of the nipple
    • Aching or burning

Some of these symptoms are similar to those caused by mastitis, a breast infection that can occur in women who are breastfeeding.  

Paget’s Disease

This type of breast cancer starts in the breast ducts and spreads to the skin of the nipple, then to the areola. It is rare, accounting for only about 1% of all cases of breast cancer. Paget’s is often mistaken for eczema (a severe skin rash and inflammation), an infection or injury, or some other skin condition. For many people, it can take several months to get a correct diagnosis Paget Disease is almost always associated with either DCIS or IDC.

•   Signs and symptoms. Paget’s Disease causes the skin on and around the nipple to become red, sore, flaky or scaly. At first, these symptoms tend to come and go. Over time, symptoms of Paget’s Disease usually worsen and may include:
  • • Itching, tingling and/or a burning sensation;
    • Pain and sensitivity;
    • Scaling and thickening of the skin;
    • Flattening of the nipple; and
    • Yellowish or bloody discharge from the nipple.

Breast Cancer In Men

Although rare, breast cancer in men can occur. Both women and men have breast tissue; hormones in females stimulate breast tissue to grow into full breasts. Males normally don’t make much of the breast-stimulating hormones. As a result, their breast tissue usually stays flat and small.

• Signs and symptoms. These include any persistent changes to the breasts, such as a lump, nipple pain, an inverted nipple, nipple discharge, sores on the nipple and areola, and/or enlarged lymph nodes under the arm. Enlargement of both breasts (not just on one side) is usually not cancer. This is known as gynecomastia. Sometimes, male breasts can become quite large. Noncancer-related enlargement of the breasts can be caused by medications, heavy alcohol use, weight gain or marijuana use.

Metastatic Breast Cancer

Although this cancer is considered incurable, there are many treatment options which can help to control the disease for extended periods of time and allow people to live with a good quality of life.

Metastatic breast cancer (sometimes called advanced or stage 4 breast cancer) is breast cancer that has spread to distant parts of the body, such as the lungs, liver, bones, or brain.

Signs and Symptoms at location of metastasis:

•   Bone: bone pain; bone fracture; high calcium levels resulting in fatigue, nausea, constipation, thirst
•   Lungs: cough, shortness of breath, chest pain
•   Liver: fatigue, loss of appetite, itchy skin, jaundice (eyes and skin), nausea
•   Brain: headaches, pressure, memory and personality changes, nausea and vomiting

Triple-Negative Breast Cancer

Triple-negative breast cancer is a subtype of breast cancer that tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein. This means the growth of the cancer is not fueled by the hormones estrogen and progesterone, or by the HER2 protein. So, triple-negative breast cancer does not respond to hormonal therapy medicines or medicines that target HER2 protein receptors.

This cancer is one of the more aggressive breast cancers and has a poorer prognosis than other types of breast cancer. Studies have shown that triple-negative breast cancer is more likely to spread beyond the breast and more likely to recur (come back) after treatment. It tends to be higher grade (usually grade 3) than other types of breast cancer and is It usually is a cell type called “basal-like.” Basal-like cancers tend to be more aggressive, higher grade cancers.

Anyone can be diagnosed with triple-negative breast cancer, however, it is more common in women younger than 50 and is more likely to be diagnosed in Black and Hispanic women with in women with a BRCA1 mutation.

•   Signs and symptoms. These include lumps in breast, changes in breast size or shape, changes in the feel of the nipple or breast, and yellowish or bloody nipple fluid discharge.

HER2 Status

HER2 (human epidermal growth factor receptor 2) is a gene that can play a role in the development of breast cancer. The HER2 gene makes HER2 proteins. HER2 proteins are receptors on breast cells. Normally, HER2 receptors help control how a healthy breast cell grows, divides, and repairs itself. But in about 25% of breast cancers, the HER2 gene doesn’t work correctly and makes too many copies of itself (known as HER2 gene amplification). All these extra HER2 genes tell breast cells to make too many HER2 receptors (HER2 protein overexpression). This makes breast cells grow and divide in an uncontrolled way.

HER2-positive breast cancers tend to be more aggressive than other types of breast cancer. They’re less likely to be sensitive to hormone therapy, though many people with HER2-positive breast cancer can still benefit from hormone therapy.

• Signs and Symptoms: These include lumps in breast, breast swelling, change in shape, skin irritation or dimpling, pain in breast or nipple, redness or thickness of nipple or breast skin and/or discharge from nipple which is not breast milk.

About Morag

As a leader in our industry, Morag has spent over 27 years in the aesthetic/skin care industry, researching and constantly updating her knowledge on cancer and other diseases and how treatment affects the services we offer; plus she still offers services such as reflexology, aromatherapy and electrodessication. Morag pioneered Oncology Esthetics® training back in 2007. It was her concept that has driven change to our industry that others have followed. She consults globally with industry leaders by educating them how to include the cancer community. Besides making time for written articles and webinars she offers equine facilitated learning and activity sessions for the cancer community and veterans since there is a prevalence of significant psychological distress within these communities.