Breast Cancer Detection
Breast Cancer Detection
Richard E. Gould (Hematologist/Oncologist, Cedars-Sinai Outpatient Cancer Center) gives expert video advice on: How are most cancerous breast lumps found?; Is pain a sign of breast cancer?; How often should I do a breast self-examination? and more...
What are the warning signs of breast cancer?
The things to look for in breast cancer are, number one, the change in the breast. Is there part of the skin which is different than how it used to be? Is it thicker? Is it dimpled? Is there any discharge from the nipple? Is there any blood coming out? Do you feel a new lump, a new bump; something that wasn't there before? Basically, you want to look for any and all of these changes in your breast. If you notice one, to go to your doctor immediately, so that you can get it evaluated. Pain in the breast can also be a sign of cancer, but the majority of breast cancers are not painful, and pain is often times a sign of a benign condition. Having said that, just because you feel a lump and it's painful does not mean that it's not cancer, and you have to get it checked out. In addition to all of those, there may actually be no warning signs, and that's why it's so important to get yearly exams by your physician and to also get screening mammography, because a mammogram can pick up breast cancer lesions that are not palpable and they can pick them up early, when they're curable.
How are most cancerous breast lumps found?
With regards to breast cancer detection, breast lumps are found in different ways. Often, times an individual feels a change in her breast while she's in the shower, while she's dressing, and brings it to the attention of her physician. Then the evaluation is undergone to determine if the breast lump is benign or cancerous; or it can be found on a clinical breast exam. When a woman comes in for her yearly breast exam and mammography, the physician can feel a lump or bump or change in the breast that can necessitate a further evaluation workup.
Is pain a sign of breast cancer?
With regards to breast cancer detection, pain can be a sign of breast cancer. It is not typical of most breast cancers, but certainly if you have pain in your breast, you need to get it checked out by your physician. Pain is a sign that there is something abnormal going on, whether its cancer or a benign condition, it needs to be evaluated. Therefore be sure to see your doctor.
How often should I do a breast self-examination?
Breast self-exams are a controversial topic, and recently the American Cancer Society has recommended not to recommend general breast self-examination, but to recommend a general breast health awareness, so that a woman is aware if there are changes in her breast. The difficult thing is that there have been a number of studies looking at the efficacy of breast self-exam, to pick up breast cancer earlier and to try to improve breast cancer outcomes, and what they found was that breast self-examination actually did not lead to picking up breast cancers earlier and led to more biopsies for benign conditions. And so overall it did not help breast cancer outcomes. Having said that, those are studies done on large groups of individuals and for populations. For any one individual, I can tell you plenty of stories of women who noticed an abnormality in their breast because they were doing a breast self-examination which led to the cancer. So I personally have a hard time saying not to recommend it, but it's a woman's individual choice to decide whether she wants to examine her breasts or not, looking for lumps. If she does not decide to look for lumps, it's important that she is still aware of what her normal breast looks like so that if there are any changes, she picks up on them sooner rather than later.
What happens first if my doctor suspects I have breast cancer?
With breast cancer detection, if your primary doctor thinks that you have breast cancer, the next step will be that the doctor will order a mammogram, and likely to refer you to see a breast surgeon. The breast surgeon may or may not perform an ultrasound, and will likely perform a biopsy to determine if that tissue is indeed cancerous or if it's benign. Based upon the results of that biopsy, you may need further workup, further evaluation, or definitive surgical management if it does come up positive for breast cancer.
Are larger breasted women more likely to develop breast cancer?
It's not clear if women with large breasts have a greater risk. They certainly have more breast tissue in which to develop breast cancer and it can be more difficult to detect a breast cancer in a larger breasted woman because there is more tissue to feel through. In women with large breasts there are some case series which show the breast cancers present at a more advanced stage because of detection difficulties. However, there's no routine recommendation for any different screening for a women with larger breasts than a women with smaller breasts. However, having said that, if a woman has denser breasts and denser breast tissue a mammogram might not pick up breast cancers. Recently the American Cancer Society recommended breast MRI for screening for women at higher risk for breast cancer and this includes women with denser breasts.