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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 Skin Smart: Protect Yourself from the Sun

Whether it’s a brisk walk, taking in an outdoor concert, hosting a cook-out, playing a round of golf, gardening, or building a sandcastle, we all like to spend time outside in warmer months. So how do we protect ourselves and our families from the sun and its harmful UV rays? And is it really necessary?

Skin cancer, which is primarily caused by exposure to ultraviolet (UV) rays, is the most common form of cancer in the U.S. Another key fact, according to the American Cancer Society: more skin cancer cases are diagnosed in the U.S. than all other cancers combined.  Those who spend a lot of time in the sun and are exposed to UV rays are at greatest risk. There is good news, though. Prevention and early detection can help fight skin cancer and minimize the sun’s damaging effects.

Here are some important tips and proactive steps to protect you and your family:

  1. Seek shade - especially between the hours of 10 a.m. and 4 p.m. This is when UV light is the strongest.
  2. Use the “shadow” test to determine if the sun’s rays are strongest. If your shadow is shorter than you are, the rays are at their peak. Take cover!
  3. When outside, wear protective clothing to cover your skin. Keep in mind that if you can see light through it, it isn’t protecting against the UV rays.
  4. Use broad spectrum, water-resistant sunscreen. Broad spectrum means it has been tested to protect against both UVA and UVB rays. Without that label, it cannot claim to protect against skin cancer. Also, read the water-resistant protection time on the label (showing either 40 or 80 minutes) indicating the estimated time between applications.
  5. Apply sunscreen properly and generously to face, ears, neck, arms and any other exposed skin. The recommended amount is about an ounce, which is equal to a palm-full, for each area.
  6. Wear a wide-brim hat (with a 2- to 3-inch brim), preferably with a dark, non-reflective underside of the brim to help against rays reflecting from water and other surfaces.
  7. Wear sunglasses that block UV rays – ideally ones that block 99% or more of UVA and UVB rays. If they are not labeled with the UV protection level, don’t assume there’s any.
  8. Children should wear real, UV protective sunglasses– not toy ones.
  9. Avoid tanning beds and sun lamps – tanning beds give out a UVA and usually UVB rays as well, which may contribute to skin cancer and long-term skin damage. If you like looking tan, you might try a self-tanning product.
  10. Protect children – cover them, use sunscreen on them every time they go outdoors, and limit their exposure to large amounts of sunlight.
  11. Babies younger than 6 months – keep them out of direct sunlight, protect them with hats and clothing, and use sunscreen when shade or protective clothing are not available.

If you’re concerned about previous exposure to the sun, get checked by a doctor who specializes in dermatology and skin cancer. Also, if you notice any moles or skin irritations that have changed in color, size or shape, have it looked at promptly. Early detection is your second best defense against skin cancer and increases your chances for a better outcome.

So as the summer approaches, now is the time to develop good-skin habits by planning ahead, being prepared with protective wear and sunscreen, and seeking shade whenever possible. While you’re at it, to look and feel your best, drink lots of water, limit alcohol intake, get plenty of rest, manage the stress in your life, and don’t use tobacco products. Your radiant skin will thank you.

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