Breast Cancer

Breast Cancer Symptoms

• A new lump or mass (a lump that is painless, hard, and has uneven edges is more likely to be cancer, but some breast cancers are tender, soft and rounded)
• Swelling of all or part of the breast
• Skin irritation or dimpling
• Breast pain, nipple pain, or nipple turning inward
• Redness, scaling or thickening of the nipple or breast skin
• A nipple discharge other than milk
• A lump or swelling under the arm, which could indicate breast cancer has spread to the lymph nodes, even before the tumor is large enough to be felt in the breast

Many patients find early signs of breast cancer by being proactive and diligent about their clinical breast exams, mammograms, and breast self-exams.

Early signs should NOT be ignored and should be checked by a physician as soon as possible.

Breast Cancer Risk Factors

It’s important to note: Having a risk factor for breast cancer, or even several, doesn’t mean that a person will get breast cancer. Some people who have one or more breast cancer risk factors never get the disease. And many people who do get breast cancer don’t have any risk factors. Some breast cancer risk factors have a greater impact than others, and your risk can change over time because of, for example, aging or lifestyle. The following are risk factors for breast cancer:

• Gender—Being a woman is the main risk for getting breast cancer, though men can get breast cancer as well.
• Age—The chance of getting breast cancer increases with age. Two out of three women with invasive breast cancer are 55 or older when the cancer is found.
• Genetics—About five to 10 percent of breast cancers are possibly connected to inherited changes (mutations) in certain genes.
• Family history—Breast cancer risk is higher among people whose close blood relatives have this disease. The relatives can be from either the maternal or paternal side of the family. Having a mother, sister or daughter with breast cancer about doubles a person’s risk. However, keep in mind that over 85 percent of women who get breast cancer do not have a family history of this disease.
• Personal history of breast cancer—A person with cancer in one breast has a greater chance of getting a new cancer in the other breast or in another part of the same breast. This is different from a return of the first cancer (recurrence).
• Race—Caucasian people are slightly more likely to get breast cancer than African-American women. Asian, Hispanic, and Native American people have a lower risk of getting and dying from breast cancer.
• Dense breast tissue—People with more gland tissue and less fatty tissue have a higher risk for breast cancer because it’s harder for physicians to detect problems on mammograms.
• Combined hormone therapy (HT)—Use of combined hormone therapy (progesterone and estrogen) after menopause increases the risk of getting breast cancer. It also increases the risk of dying from breast cancer. Five years after stopping HT, the breast cancer risk seems to drop back to normal.
• Lifestyle—Poor diet, lack of exercise, being overweight, smoking and alcohol appears to increase risk

Breast Cancer Diagnosis & Staging

If screening tests indicate that you could have cancer, the next step is to have a biopsy. During this test, cells from the area of concern are removed so they can be studied in the lab.

There are several types of biopsies. Your physician will determine which one is best for you. Biopsies are performed at The Star and Barry Tobias Women’s Health Center at CentraState by specially trained radiologists or surgeons.

• Stereotactic Needle Biopsy (STNB): STNB is a core biopsy that uses X-rays and computer coordinates. STNB procedures are performed in an outpatient setting using local anesthesia. During this procedure, small samples of tissue are removed for analysis using a hollow needle. This diagnostic procedure is less invasive, less painful, and less costly than traditional surgical biopsy.
• Breast Needle Localization: Prior to surgery, a radiologist localizes the area in the breast to be biopsied by inserting a guidewire. The guidewire “hooks” around the area to be biopsied. The patient is then immediately transported to the Operating Room, where the surgeon makes an incision following the guidewire and accurately excises (removes) the targeted tissue.
• Ultrasound-Guided Breast Biopsy: This type of biopsy is useful when suspicious changes are detected through mammograms and ultrasounds, but no abnormality can be felt during an exam. The procedure is minimally invasive and involves no exposure to radiation. It is performed in an outpatient setting, and takes less time than a traditional surgical biopsy.
• Sentinel Lymph Node Biopsy: A sentinel lymph node biopsy is a way of pinpointing the first few lymph nodes into which a tumor drains (called the “sentinel” node). This helps doctors remove only those nodes that are most likely to contain cancer cells, since the sentinel nodes are the first place cancer is likely to spread. It also helps to alleviate the need for additional nodes to be removed if the sentinel node is negative.

Lab results are analyzed to determine if the tissue is benign (non-cancerous) or cancerous. If it is cancer, then the biopsy can help define what type of cancer it is and whether or not it is invasive.

Other clinical tests may be needed to determine the stage (extent) of the cancer. For example, is it confined to the breast or has it spread? Once the stage is determined, an appropriate treatment plan can be developed.