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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Is It Breast Cancer? Maybe Not.

As women grow and shift into different seasons of womanhood, their breasts do too. Over a woman’s lifetime, her breasts may change in look and feel for many reasons, including, but not limited to:

Hormones
Aging
Breastfeeding
Injury

Waking up to sharp pain, spotting nipple discharge on your clothes or noticing a new lump within your breast can be alarming. However, it is important to remember that many non-cancerous conditions may cause these symptoms.

Eight Breast Conditions That Are Not Cancer

When visiting a provider about breast changes, he/she may perform a breast exam and request imaging to screen for a variety of breast conditions, including:

Mastitis- Mastitis occurs when there is swelling in the breast. While mastitis is most common in women who are breastfeeding, it can occur at other points in a woman’s life. It is sometimes accompanied by fever and headaches. A doctor may prescribe antibiotics to treat the conditions.
Fibroadenomas- Fibroadenomas are the most common breast lumps in younger women with periods. This type of breast lump often causes no pain. A fibroadenoma may feel like a firm, rubbery marble within the breast. Most fibroadenomas grow slowly. If you are diagnosed with fibroadenomas, your physician will want to monitor any changes through regular breast exams.
Calcification- This occurs when calcium collects in the breast. You may not know you have breast calcification, but your doctor may see calcification as a bright white speck or dot in your breast tissues on a mammogram. These are common after menopause and are generally connected to benign cell changes.
Fat Necrosis- Fat necrosis develops when breast tissue is injured. Fat necrosis may form an oil cyst, making the skin around the affected area thicker, bruised or red. Usually, fat necrosis does not need treatment, but if it becomes painful, a doctor may recommend surgical removal.
Nipple Discharge- In many cases, nipple discharge is normal and results from fluctuating hormones. Discharge from a normal, healthy breast is called physiological discharge. During some parts of a woman’s life, like breastfeeding, nipple discharge may be expected and welcomed!
Lobular carcinoma in situ (LCIS)- This condition is uncommon but occurs when abnormal cells form in milk glands in the breast. While LCIS is not cancer, it may increase your risk for cancer. This condition is most often diagnosed during breast biopsies performed for other reasons.
Duct Ectasia- Duct ectasia occurs when a milk duct widens and thickens. Sometimes this can cause the milk duct to become blocked. While duct ectasia is more common for women close to menopause, it can occur at other ages.
Fibrocystic Breast Changes- Fibrocystic breast changes happen when the tissue thickens. The affected breast tissue may feel firm or rubbery underneath the skin. This change in women is very common; almost one-half of women will experience a fibrocystic breast change. Hormonal changes are the main culprit.

Make Time for a Mammogram

What is the best thing you can do for your breast health? Schedule regular breast screenings, like mammograms, and perform monthly self-breast exams. Knowing what your breasts feel like typically can help you identify changes and know when to bring any concerns to your provider.

If you notice something new or experience unexpected pain, do not hesitate to contact your provider. Our care teams are here to walk you through every step of your healthcare journey.

Sources:

American Cancer Society
Breast Cancer Now
Cancer Research UK
National Institutes of Health