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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Symptoms and Early Signs of Breast Cancer

What Is Breast Cancer?

Breast cancer is the second most common cancer among American women according to the Centers for Disease Control and Prevention. It can begin in any of the three main parts of a breast—the lobules, ducts or connective tissue. The lobules are the milk-producing gland in the breast while the ducts are the pathways that help carry milk to the nipple. The connective tissue is a fibrous and fatty tissue that holds everything together. It is said to have metastasized when breast cancer spreads to other parts of the body through blood vessels and lymph vessels.

Women over 50 are at a higher risk of developing breast cancer, but it can affect younger women as well. Although men can develop breast cancer too, it’s much rarer but is just as serious as the breast cancer women are diagnosed with.

What Are the Signs and Symptoms of Breast Cancer?

Breast cancer may not cause any symptoms in its early stages. Some breast changes can be felt, but most can be detected only with the use of imaging procedures, such as a mammogram, MRI or ultrasound. That’s why it’s important to do breast-self exams to help you learn how your breasts normally feel. This way it would be easier for you to notice and find changes. However, breast self-exams are not a substitute for mammograms.

If you have any of the following symptoms, see your doctor right away:

New lump in the breast or underarm
Thickening or swelling of part of the breast
Irritation, itching or dimpling of breast skin
Redness or flaky skin in the nipple area or the breast
Pulling in of the nipple or pain in the nipple area
Nipple discharge other than breast milk, including blood
Any change in the size of the shape of the breast
Pain in any area of the breast

What Do Lumps in My Breast Mean?

Lumps come in different shapes and sizes. Although lumps may point to cancer, many other conditions can cause lumps in the breast. Note that normal breast tissue can sometimes feel lumpy too. Some of the conditions that cause breast lumps are fibrocystic breasts and cysts.

How Can I Reduce My Risk?

While there are risk factors you can’t control, such as getting older or genetics, subscribing to a healthy lifestyle and taking preventive measures can help lower your risk of developing breast cancer.

Obesity and alcohol misuse increase your risk for developing breast cancer. Go for a nutrient-dense diet, exercise as often as possible and limit intake of alcoholic drinks.
Regular mammograms may not prevent breast cancer, but early is key in breast cancer detection. Consider having annual screenings by the time you reach the age of 40 or based on the recommendations of your doctor.
If you’re taking hormone replacement therapy or oral contraceptives, ask your doctor about the risks and other possible alternatives.
Breastfeed your children, if possible.
Having a family history of breast cancer or inherited changes in your BRCA1 and BRCA2 genes can significantly raise your risk. Discuss your diagnostic and preventive treatment options with your doctor.

Early detection and treatment of breast cancer can save lives. Don’t delay care. We have precautions in place to ensure your safety so you can stay on top of your breast health. We are here for you.

Sources:
Centers for Disease Control and Prevention
MedlinePlus
Healthline