Diagnosing Breast Cancer

Breast cancer can strike anyone, young or old, male or female, from all ethnic backgrounds and walks of life. Former First Lady Betty Ford, Good Morning America anchor Robin Roberts, singer Olivia Newton-John and actor Richard Roundtree are all breast cancer survivors. Their breast cancer experiences began when the disease was diagnosed because a symptom or screening test suggested breast cancer.

The most common sign of breast cancer is a lump or mass. Other common symptoms include breast swelling, skin irritation, the nipple turning inward, nipple discharge (not breast milk), and breast or nipple pain. These signs may be noticed during a breast self-exam, routine clinical breast exam or screening mammogram. If a suspicious-looking area is detected, additional testing will be used to either confirm a breast cancer diagnosis or identify a benign condition.

Three tests used to diagnose breast conditions are diagnostic mammogram, ultrasound and magnetic resonance imaging (MRI). A diagnostic mammogram, which generates X-ray pictures, focuses on a specific area of the breast and takes more detailed pictures of the areas that look abnormal. An ultrasound, which uses sound waves, can help doctors determine if an abnormality is a benign fluid-filled cyst or a potentially cancerous solid mass. MRI, which uses radio waves and strong magnets, is sometimes used to look for tumors that did not appear on a mammogram.

Imaging tests can help locate a breast mass, but they cannot confirm a breast cancer diagnosis. This is done during a biopsy to remove cells or tissue samples for laboratory testing. There are three main types of biopsies:

Fine needle aspiration biopsy involves inserting a very thin needle into the suspicious area to withdraw cells. Ultrasound may be used to guide the needle if the lump cannot be easily located.
Core needle biopsy uses a slightly larger needle to remove three to five small cylinders of tissue from the breast abnormality. Larger core biopsies can be performed using suction to remove tissue samples.
Surgery may be recommended to remove all or part of a lump for examination. During an incisional biopsy, a sample is removed from the abnormal area. An excisional biopsy involves removing the entire mass as well as a surrounding margin of normal tissue.

If cancer cells are found after a biopsy, test results can determine the cancer type and whether it is invasive (likely to spread) or in situ (localized). Invasive cancers are assigned a grade based on how closely the sample resembles normal tissue and the likelihood the cancer will grow and spread. An estrogen and progesterone receptor test can determine if hormone therapy may help stop the cancer from growing. A human epidermal growth factor receptor-2 test can measure a growth factor protein that may cause cancer cells to spread more aggressively.

For more information about breast cancer, talk with your doctor or visit the American Cancer Society website at www.cancer.org.

For a physician referral, call Palm Beach Health Network at (561) 625-5070.

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Can You Prevent Cancer?

An estimated 1.7 million people received a cancer diagnosis in 2018. And while there are many factors that we can’t control, such as genes, we do have some control over lifestyle and our environment. When someone asks, “Can you prevent cancer?” here are some of the choices and tests that can help avoid cancer or find it soon enough to make a difference.

Lifestyle Choices to Reduce the Risk of Cancer

Protect your skin. Skin cancer is caused by exposure to ultraviolet (UV) rays from the sun and/or tanning beds. When you’re outside, wear a hat, sunglasses, sun-protective clothing and sunscreen. Stay in shade when possible and/or avoid the peak hours of sunlight between 9 a.m. and 3 p.m. standard time.
Maintain a healthy weight. Obesity increases the risk for several types of cancers including uterine, breast, prostate and colorectal. Your weight is directly related to food and activity choices. If you’re not sure how to get started, talk with your doctor.
Avoid tobacco. Lung cancer is the most deadly form of cancer, largely attributed to cigarette smoke. Smoking also causes or contributes to cancer in the mouth, throat, esophagus, trachea, stomach, colon, rectum, liver, pancreas, kidney, urinary bladder and cervix. And, those exposed to secondhand smoke have a 20 to 30 percent higher risk of developing lung cancer than those not exposed.
Limit drinking alcohol. Drinking alcohol may contribute to mouth, voice box, throat, liver and breast cancer. Less alcohol is associated with lower risk.

Prevent Cancer by Finding Cancer Early

With cancer, the sooner the treatment, the better opportunity for a good outcome. Screenings are available and recommended for:

Breast cancer – Women should ask for their doctor’s recommendation about the age to begin and how often to get a mammogram.

Cervical cancer – A pap test identifies abnormal cells in the cervix that could develop into cancer and is recommended for women age 21 to 65.

Colorectal cancer – For most people, colorectal screening begins at age 50. Certain conditions may cause your doctor to recommend earlier screening.

Lung cancer – Candidates for lung cancer screening include people who have a history of heavy smoking or have quit within the last 15 years, and are age 55 to 80 years old.

Warning Signs of Cancer

Different cancers have a variety of symptoms. However, when the goal is to prevent cancer, it’s helpful to know some of the general signs to watch for.

Unexplained weight loss – Losing 10 pounds or more without trying may be a sign of cancer of the pancreas, stomach, esophagus or lung.
Fatigue – Extreme tiredness that doesn’t get better with rest may be a symptom as cancer grows or if the cancer is causing internal bleeding.
Fever – Cancer often has associated fever when it spreads past where it started.
Pain – The location of pain may indicate a type of cancer such as bone or testicular cancer. Headaches that won’t go away may indicate a brain tumor, or back pain may accompany colon, rectum or ovarian cancer.
Skin changes – Noticing changes in moles or skin pigment may indicate skin cancer. Additionally, skin that is darker, redder or yellow-tint, itching or excessive hair growth may be symptoms of cancer.
Lump or thickening in the breast or other parts of the body – Talk with your doctor if you notice any unusual lumps or thickened skin, especially in the breast, testicles, lymph nodes or soft tissues.

Make sure to have regular annual checkups with your primary care doctor, and talk with him or her about any health concerns. (You can find a doctor by completing the form on this page.)

Sources:

National Cancer Institute, https://www.cancer.gov/about-cancer/understanding/statistics

National Cancer Institute, Cancer Prevention Overview, retrieved from https://www.cancer.gov/about-cancer/causes-prevention/patient-prevention-overview-pdq

Centers for Disease Control, Cancer Prevention and Control, retrieved from https://www.cdc.gov/cancer/prevention/healthy-choices.html

Centers for Disease Control, Cancer Screening Tests, retrieved from https://www.cdc.gov/cancer/prevention/screening.html

American Cancer Society, Signs and Symptoms of Cancer, retrieved from https://www.cancer.org/treatment/understanding-your-diagnosis/signs-and-symptoms-of-cancer.html