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Few conditions create more anxiety and fear for a woman than finding a breast lump. This fear is fueled by the common misconception that lumps are usually cancer and that a breast cancer diagnosis is an automatic death sentence. Fortunately, these fears are not supported by the facts: 80 percent of breast biopsies for lumps are benign, and those that are cancerous are usually found early and have excellent prognoses.
Beginning at age 20, a woman should begin performing monthly selfexaminations to familiarize herself with her breasts, so she may more easily recognize a change. The cause of many lumps is fibrocystic change, a benign condition affecting most women, characterized by areas of dense rubbery breast tissue and/or tenderness that often change with the menstrual cycle. Lumps that are discrete, hard, persistent or enlarging should raise suspicion.
Additionally, bloody nipple discharge, a newly inverted nipple, skin dimpling or skin ulceration can be signs of breast cancer. Any new breast change should be brought to the attention of a physician. This should prompt a clinical examination and, for almost all situations, a mammogram and/or ultrasound. Mammography uses X-ray to visualize the breast tissues. The images of the “abnormal” breast are compared to those of the other “normal” breast and to any previous mammograms to assess for changes. If an abnormality or change is found, attempts to further define it may be done by taking additional close up (magnification view) mammograms. Ultrasound also is particularly useful in determining if a finding is solid or cystic. This is an important distinction since cysts are fairly common but rarely associated with cancer.
Occasionally mammograms are not able to detect a lump or to discern if a finding is cancer. Dense breasts, implants, or a history of previous surgery or radiation are some of the factors that limit mammography’s sensitivity. Ultrasound and MRI may be especially helpful in these situations. Because the breasts of younger patients tend to be denser, an ultrasound may even be obtained before a mammogram.
The exam and any imaging studies are used to decide if a finding is suspicious enough to warrant a biopsy — a sampling of the tissue for evaluation for the presence of cancer cells. The majority of biopsies can be performed in an outpatient setting using minimally invasive techniques.
Article provided by the Hilton Head Regional Medical Center.
