First, it is important to know that the breast does not have a uniform texture and there are some normal structures, such as a rib, that might feel like a lump. Also, chances are that if you find a lump, it probably is benign.
When you go to your physician, your doctor will examine you clinically and he or she may order a mammogram and/or an ultrasound. After evaluating these results, a biopsy might be necessary so that a pathologist can examine cells or tissue from the lump directly.
You often hear the statistic that one of every eight women will be diagnosed with breast cancer. But this is the cumulative risk for the woman who lives to the age 85. Both age and sex are the strongest risk factors for breast cancer. Other risk factors such as a family history of breast cancer, the start of menses before age 12, menopause after age 50 are pertinent for only a minority of cases. In fact, in 80% of cases, women don’t have these risk factors, and likewise, many women with one or more of these factors don’t get breast cancer. Strong risk factors such as inheriting a mutated gene (BRCA1 or BRCA2) again apply to a small minority of cases. There is currently no definite way to prevent breast cancer, so the best strategy is early detection.
Breast Biopsies
These are types of biopsies that are available:
- Aspiration of A Suspected Cyst
This effectively treats the cyst by reducing it in size. If the fluid looks suspicious, the doctor will send it to a pathologist for examination.
- Fine Needle Aspiration
This sounds similar to the first procedure but is somewhat different. Here, the surgeon uses a fine needle to probe the lump and then aspirate or suck up the free floating cells into the syringe. These cells are examined by a pathologist who is specially trained in cytology to look for cancer.
- Core Biopsy
Here, a larger needle is used to remove several cores of tissue. The advantage here is that the arrangement of cells remains intact and helps with the diagnosis of cancer.
- Incisional Biopsy
This is where the doctor uses a local anesthetic to make an incision and removes part of the lump.
- Excisional Biopsy
This involves removing the entire suspicious lump with some surrounding normal tissue.
- Stereotactic Biopsy Systems
The latest technology available allows the surgeon to locate the breast lesion with 3D imaging and then remove multiple cores of tissue with minimal loss of normal breast tissue.
- Stereotactic Excision Biopsy
This technique of breast biopsy minimizes the surgical trauma. It is associated with conventional wire-guided open breast biopsy for non-palpable breast lesions, like micro- calcifications or soft tissue.
Surgery for Breast Cancer
- Lumpectomy
Lumpectomy is the term used to describe the surgical excision of a breast mass or lump while leaving most of the breast tissue intact. This procedure is performed for women with smaller tumors and for very early cancer. Depending on the size and type of breast mass, a lumpectomy can be performed in combination with hormone treatment, chemotherapy and / or radiation therapy to cure many breast cancers. In most cases there is little change in the shape or size of the breast after surgery.
- Mastectomy
Mastectomy is a surgical procedure that is performed for breast cancer. A simple mastectomy is the removal of the entire breast tissue. It is indicted for certain types of early cancer (ductal carcinoma in situ or DCIS) when there are several areas of DCIS or a very large area of DCIS. It is usually combined with post surgery hormonal treatment and radiation.
- Modified Radical Mastectomy
This kind of procedure combines mastectomy with removal of some or all of the lymph nodes that drain the breast (lymph nodes of the axilla). Modified radical mastectomy is indicated for invasive cancer with the intention of cure. It is usually supplemented with radiation and chemotherapy or hormone treatment.
Sometimes a woman who has not developed breast cancer may decide to undergo prophylactic bilateral mastectomy because she is at very high risk of developing the disease. These are women with very strong family histories of breast cancers or who have genetic markers for the development of the disease.
Certain smaller invasive cancers can be treated with lumpectomy (removal of only part of the breast) and axillary node dissection. This treatment has about the same rate of cure for smaller cancer as modified radical mastectomy.
Breast reconstruction
A mastectomy can be followed by reconstruction of the breast either at the time of the mastectomy or later. There are a number of options in breast reconstruction which include implants or reconstruction with the patient’s own tissue.
Recommendation:
Breast Self-Exam (BSE): BSE should commence after the first period. If the breasts are examined regularly young ladies will become more aware how their breasts feel. Doing that, it is more likely to notice possible changes like masses, lumps or nipple discharge, which could be early signs of cancer. BSE should be done one week after period, when breasts are not swollen or tender. If you mention any change, see your doctor immediately.
General Rules:
- Women should perform breast self-exam every month.
- Breast and armpits should be examined by a doctor at least once a year.
- Starting at age 40, women should have a mammogram every two years.
Breast Ultrasound is in conjunction with a mammogram to determine the nature of abnormal breast tissue seen on a mammogram.