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Column: Recognize the signs of breast cancer

Dr. C. Victoria Thomas

C. Victoria Thomas, M.D. is an oncologist at Mayo Clinic Health System and sees patients in Red Wing and in Cannon Falls.

October is internationally known as an awareness month to educate people about breast cancer. People may choose to wear pink ribbons and attend special fundraising events to raise awareness about this type of cancer.

Substantial support for breast cancer awareness and research funding has helped create advances in the diagnosis and treatment of breast cancer. Breast cancer survival rates have significantly improved due to advances in treatment.

As survival rates have increased, and the number of deaths associated with this disease is steadily declining, largely due to factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease.

Detection

Signs and symptoms of breast cancer may include:

• A breast lump or thickening that feels different from the surrounding tissue

• Change in the size, shape or appearance of a breast

• Changes to the skin over the breast, such as dimpling

• A newly inverted nipple

• Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin

• Redness or pitting of the skin over your breast, like the skin of an orange

Tests and procedures used to diagnose breast cancer include:

• Breast exam. Your doctor will check both of your breasts and lymph nodes in your armpit, feeling for any lumps or other abnormalities.

• Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.

• Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may be used to determine whether a new breast lump is a solid mass or a fluid-filled cyst.

• Removing a sample of breast cells for testing (biopsy). A biopsy is the only definitive way to make a diagnosis of breast cancer. During a biopsy, your doctor uses a specialized needle device guided by X-ray or another imaging test to extract a core of tissue from the suspicious area. Often, a small metal marker is left at the site within your breast so the area can be easily identified on future imaging tests.

• Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye. Unlike other types of imaging tests, an MRI doesn't use radiation to create the images.

Personalized approach

If your doctor has assessed your family history and determined that you have other factors, such as a precancerous breast condition, that increase your risk of breast cancer, you may discuss options to reduce your risk, such as:

• Preventive medications (chemoprevention). Estrogen-blocking medications, such as selective estrogen receptor modulators and aromatase inhibitors, reduce the risk of breast cancer in women with a high risk of the disease. These medications carry a risk of side effects, so doctors reserve these medications for women who have a very high risk of breast cancer. Discuss the benefits and risks with your doctor.

• Preventive surgery. Women with a very high risk of breast cancer may choose to have their healthy breasts surgically removed (prophylactic mastectomy). They may also choose to have their healthy ovaries removed (prophylactic oophorectomy) to reduce the risk of both breast cancer and ovarian cancer.

Advances in treatment of breast cancer have substantially increased survival rates. Talk to your health care provider if you have questions about breast cancer and discuss your personalized risk factors and options.

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