Breast Cancer: Key Q&A
Reviewed By:
Martin E. Liebling, M.D., FACP
When should I have a mammogram?
The American Cancer Society (ACS) recommends that all women age 40
and older have a screening mammogram every year. These mammograms
should continue as long as you are in good health.
If you are at high risk for breast cancer, your physician may
recommend that you have a mammogram at an earlier age or more
frequently.
What other tests should be used for breast cancer
detection?
If you are in your 20s or 30s, you should have a clinical breast
exam (CBE) by a health professional as part of your regular
physical examination. A CBE should be conducted at least every
three years. Once you have reached age 40, a CBE should be
conducted by a health professional every year.
A breast self-examination (BSE) should be considered by all women
in their 20s and above. BSEs are not a substitute for clinical
breast examinations or mammograms, but they can help you learn the
normal feel of your breasts. In turn, this may help you detect
changes and seek immediate attention for them.
What signs might indicate breast cancer?
For many women, the first indication of breast cancer may come from
an abnormal mammogram. The early stages of breast cancer may not
have any signs or symptoms. For this reason, it is important to
follow the recommended screening guidelines. When a tumor grows and
breast cancer progresses, you may have a number of symptoms,
including a lump or thickening in your breast or underarm, a change
in the shape of your breast, or ridges and pitting in your skin.
You may notice redness or scaling of the skin or discharge from
your nipple as well.
What steps will be taken if I have an abnormal
mammogram?
There are several options that may follow an abnormal mammogram. In
some cases, your physician may recommend a repeat mammogram in a
few months. Or, you may receive another mammogram that takes more
specific images of the area of concern. An ultrasound may be used
to help determine if the abnormality is solid (possible cancer) or
fluid filled (such as a benign cyst). You may be referred to a
physician for a needle biopsy if a lump can be felt in addition to
the abnormality on the mammogram.
How is breast cancer diagnosed?
A biopsy is the only definitive way to know if you have cancer. It
allows your physician to obtain cells from the suspicious tissue
for examination under a microscope. There are different types of
biopsies, and your doctor can determine the best kind depending on
your particular mass.
Breast tissue is removed during the biopsy and is examined by a
pathologist to determine if it is cancer. If it is, the pathologist
can obtain a great deal of information from the sample, including
the type of cancer, the level of abnormality and whether it has
spread to surrounding tissues. Additional tests may be performed on
the tissue to help plan treatment and gain information for your
prognosis.
What are the treatment options?
Your treatment will depend on a number of factors such as the size,
location and type of the cancer. The stage of the cancer, your age
and general health will also affect your treatment options.
Surgical treatment possibilities include lumpectomy and various
types of mastectomy. Chemotherapy and radiation therapy may be used
before or after surgery depending on your individual case.
Depending on certain tumor characteristics, you also may receive
hormone therapy or some form of biological therapy. Most patients
receive a combination of these treatments.
What are the risk factors?
Many risk factors for breast cancer cannot be controlled. Just
being female and over the age of 50 increases your chance of
developing breast cancer. A family history of the disease and
certain genetic mutations also raise your risk. However, risk
factors such as weight, diet and physical activity, can be
controlled. Maintaining a healthy weight, eating a balanced diet
and exercising can help reduce your risk of breast cancer. In
addition, limiting alcohol use and not using tobacco improve your
chances of living a life without breast cancer.
Can breast cancer be prevented?
There is no sure way to prevent breast cancer. The most important
action you can take is to follow recommended detection guidelines.
Receive regular mammograms and clinical breast examinations to
increase your odds of detecting cancer at its earliest stage. If
you notice any changes in your breast or in your armpits,
immediately consult a physician. You may not be able to prevent
breast cancer, but you can improve your chance of successful
treatment and survival with early detection.
Where can I go for information and support?
There are many organizations that offer information and support for
breast cancer patients and their families. Your physicians can
refer you to local organizations that provide support and
counseling. You can also obtain information from the:
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