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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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Get Early Cancer Screening Programs for Prevention

Most cancers start with abnormal cells growing out of control. Sometimes you will experience symptoms, but often you will not. That is why regular early cancer screening programs and self-examinations are so important. Finding and treating cancer in its earlier stages is much easier, and potentially life-saving, than waiting until the cancer has spread to other parts of the body.

In 2017, there were an estimated 1,688,780 new cancer cases diagnosed and 600,920 cancer deaths in the U.S. Cancer remains the second most common cause of death in the U.S., accounting for nearly 1 of every 4 deaths. Screening tests are available for many forms of cancer, including colorectal, breast, cervical and prostate.

Early Cancer Screening Programs for Men and Women

Both men and women are encouraged to undergo colorectal cancer tests beginning at age 50 (or earlier if they have risk factors for developing the disease). Screening tests for colorectal cancer include:

  • Stool tests, which tests for blood in the stool
  • Flexible sigmoidoscopy, which allows the doctor to check the rectum and lower part of the colon
  • CT Colonography (Virtual Colonoscopy), which uses an X-ray to find abnormal spots
  • Colonoscopy, which allows the doctor to examine the entire colon

Screening for Women

 There is a current debate in the United States over the best time to begin screening mammograms for breast cancer. The U.S. Preventive Services (USPTF) has recommended that the biennial screening mammography for women should be done between the ages of 50 to 74 years. The recommendation among other health experts has not changed, including the American Cancer Society and the American College of Surgeons.

They continue to recommend that women should begin having annual mammograms at age 40, or earlier if they are at higher risk. The decision about when to start regular, biennial screening mammography should be a result of your individual discussion with your physician. Monthly self exams help women know the normal state of their breasts.

Another screening recommended for women is a Pap test to detect pre-cancerous cells in the cervix or cervical cancer. The test should be done at least every three years between ages 21 and 29, and at least every five years from age 30 to 65. After age 65, women who have had normal results in the past may no longer need screenings. Treatment is available to prevent cervical cancer from developing or when it is found early.

Cancer Screening for Men

Men can be screened for prostate cancer as early as age 40 if they are at high risk for developing the disease. Having a first-degree relative with prostate cancer or being African-American may increase a man’s chances of having prostate cancer. Screening for the condition may include a digital rectal exam or a prostate-specific antigen blood test. Men also are encouraged to examine their testicles on a routine basis to check for testicular cancer. Any lump or swelling should be reported to a physician as soon as possible. Testicular cancer is not common, but it is one of the most treatable forms of cancer.

Screening recommendations can vary for different cancers and depend on the patient’s medical history, family history and lifestyle. Doctors may advise patients to be screened regularly or at a younger age if they are inactive, use tobacco products, drink alcohol or eat a high-fat diet. For more information about cancer screenings, talk with your doctor.

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