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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White Blood Cell Count: What You Need to Know

White blood cells, also known as leukocytes, help protect the body against infections, bacteria, viruses and diseases. These essential part of the immune system are produced in the bone marrow and are present in the blood and lymph tissue. White blood cells (WBC) come in different types, and the blood normally contains a certain percentage for each type. This is what doctors check when they request tests that measure a person’s WBC count.

Why Do Doctors Check Your WBC Count?

The WBC count is usually included in a test that measures your complete blood count (CBC). A low white blood cell count or a high blood cell count may indicate an infection or an undiagnosed condition such as a blood disorder, an autoimmune diseases or an immune deficiency. The WBC count can help doctors detect and provide treatment for these potential conditions as well as help monitor the effectiveness of radiation treatment or chemotherapy for cancer patients.

What Is the Normal WBC Count?

People’s WBC count may vary depending on their age. Infants usually have a higher WBC count which gradually decreases as they get older. The table below shows the normal WBC ranges per microliter of blood (mcL).

Age range	WBC count (per mcL of blood)
Newborns	9,000 to 30,000
Children below 2 years old	6,200 to 17,000
Children over 2 years old and adults	5,000 to 10,000

Symptoms of an Abnormal WBC Count

An abnormal WBC count may either be lower or higher than the normal range. The common symptoms of a low WBC, also known as leukopenia, include body aches, chills, fever and headaches. If you have these symptoms, please schedule an appointment with your doctor and he/she may recommend a WBC count.

On the other hand, a high WBC count, also known as leukocytosis, usually doesn’t cause symptoms, although the underlying condition that’s causing it may show its own signs.

Risk Factors of an Abnormal WBC Count

A low WBC count may be triggered by the following factors or conditions:

Autoimmune disorders
Bone marrow damage or disorder
Certain medications (i.e., antibiotics)
Human immunodeficiency virus (HIV)
Liver and spleen diseases
Lupus
Lymphoma
Radiation therapy
Severe infections

Meanwhile, a high WBC count may be triggered by the following factors or conditions:

Asthma
Certain allergies
Certain infections (i.e., tuberculosis)
Certain medications (i.e., corticosteroids)
Exercise
Inflammatory conditions (i.e., arthritis and bowel disease)
Leukemia
Pregnancy
Smoking
Stress
Tissue damage
Tumors in the bone marrow

How to Prepare for a WBC Count

First, you have to schedule an appointment with your doctor to get a test request and then schedule an appointment with the laboratory for blood extraction. Certain medications may either lower or increase your WBC count, so please let your physician know if you’re under medication. Some of the drugs that may interfere with your WBC count results are as follows:

Antibiotics
Anticonvulsants
Antihistamines
Chemotherapy medication
Clozapine
Corticosteroids
Diuretics
Heparin
Quinidine
Sulfonamides

Final Thoughts

If your laboratory test results show that you either have a low or high WBC count, your doctor may recommend a treatment plan and may also recheck your WBCs from time to time. But if your WBCs are within the normal range, great. Just keep doing things that can help boost your immune system and keep you healthy, such as eating fruits and vegetables, getting enough sleep, limiting your sugar intake, exercising regularly, managing your stress levels and staying hydrated. Have a great day ahead!

Sources:
National Cancer Institute
Healthline