Breast cancer is the most common form of cancer in women, affecting one in every eight women in the United States.
The St. Vincent Breast Center, in partnership with Radiology Associates, P.A. believes in the importance of detecting breast cancer early with yearly, quality mammograms, monthly self-breast exams and regular clinical examinations.
To get an accurate mammogram reading, you need high quality images and interpretation of those images. Some factors to consider are the experience of the radiologist reading your mammogram, technologist who performs your exam and whether the facility you choose has the latest technology in breast imaging.
At the St. Vincent Breast Center, we believe annual, quality mammograms are the cornerstone of breast health. We have an impressive staff of board-certified physicians, and technologists who specialize in mammography and combine compassionate care with advanced technology such as digital mammography, dedicated breast ultrasound, breast MRI and computer-aided detection - to provide first class breast imaging services to our patients.
Our staff consists of mammography-certified female technologists, who as women themselves, understand the anxieties, fears and emotions you may experience. And our board-certified physicians work with expert physicians in related fields who work to develop individualized treatment plans for each patient, ensuring you are taken care of from start to finish. Their expertise and skill are crucial in the accurate detection and successful treatment of breast cancer.
Recent Advances in Breast Imaging
The St. Vincent Breast Center is committed to providing our patients with the best diagnostic imaging tools available including digital mammography, dedicated breast ultrasound, breast MRI, and computer-aided detection.
A Digital Mammogram is the same as a traditional mammogram from the patient's perspective. The main benefit is the radiologists' ability to manipulate and enhance the image, much like a digital photo. Additionally, digital mammography delivers lower radiation doses and has better contrast resolution than film mammograms.
Most importantly, studies have shown that digital mammography is more accurate for:
women under 50 years of age
all women with dense breast tissue
Digital mammography is beneficial in these groups of women with dense breast tissue because dense tissue can obscure small lesions. Digital mammography enables our radiologists to better visualize areas of concern on a background of dense tissue.
Dedicated breast ultrasound is an extremely helpful test that complements diagnostic mammograms for evaluation of palpable breast lumps, as well as abnormalities seen on mammograms.
Additionally, the St. Vincent Breast Center offers our patients breast MRI. Breast MRI is superior at demonstrating the size and extent of a breast cancer prior to surgery. In addition, it is beneficial for screening patients at particularly high risk for breast cancer due to genetic predisposition or strong family history, diagnosing breast implant rupture, staging breast cancer and planning treatment. MRI can also play an important role in post-surgical and post-radiation follow-up.
Our radiologists also utilize Computer Aided Detection (CAD) to further enhance review of screening and diagnostic mammograms. Studies show that the use of CAD may increase the detection rate of breast cancer. It works like a second pair of eyes, reviewing a patient's mammogram after the radiologist makes the initial interpretation.
How do I make an appointment?
You may schedule your own screening mammogram by calling us at 501-661-9766.
The St. Vincent Breast Center accepts these insurance plans.
What is Breast Cancer?
Breast cancer is a malignant tumor that starts from cells of the breast. A malignant tumor is a group of cancer cells that may grow into surrounding tissues or spread to distant areas of the body. The disease occurs primarily in women, but some men are affected too.
The key to beating breast cancer is early detection. Women should perform monthly self-breast exams, have regular clinical breast examinations and schedule a yearly mammogram. Numerous studies have demonstrated that early detection is the most vital component in successful treatment of breast cancer. Annual screening mammograms starting at age 40 play a central part in early detection because they can detect subtle changes in the breast before they can be felt.
Signs and symptoms of breast cancer may include:
A breast lump or thickening that feels different from the surrounding tissue
Spontaneous; bloody or clear discharge from the nipple
Changes to the skin over the breast, such as dimpling
Peeling or flaking of the nipple skin
Redness or pitting of the skin over your breast, like the skin of an orange
If you find a lump or other change in your breast even if a recent mammogram was normal make an appointment with your doctor as soon as possible.
Risk Factors & Prevention
A risk factor is anything that makes it more likely you'll get a particular disease. But having one or even several risk factors doesn't necessarily mean you'll develop cancer. In fact, most people with risk factors will not develop breast cancer. And three fourths of all women with breast cancer have no known risk factors other than simply being women.
Things that may increase your risk of breast cancer include:
Being female. Women are much more likely than men are to develop breast cancer.
Increasing age. Your risk of breast cancer increases as you age.
A family history of breast cancer. If you have a mother, sister or daughter with breast cancer, you have a greater chance of being diagnosed with breast cancer. Still, the majority of people diagnosed with breast cancer have no family history of the disease.
Inherited genes that increase cancer risk. Certain gene mutations such as BRCA1 and BRCA2 greatly increase the risk of breast cancer. Doctors estimate this accounts for 5-7% of all breast cancer.
Radiation exposure. If you received radiation treatments to your chest as a child or young adult, you're more likely to develop breast cancer later in life.
A personal history of breast cancer. If you've had breast cancer in one breast, you have an increased risk of developing a second cancer.
There are a number of additional minor risk factors.
Unfortunately, breast cancer cannot be prevented. But there are things all women can do that might reduce their risk and help increase the odds that if cancer does occur, it is found at an early, more treatable stage. First, follow the American Cancer Society guidelines for early detection by getting an annual mammogram, beginning at age 40. Additionally, if you exercise regularly, drink alcohol in moderation if you drink alcohol, and maintain a healthy body weight you may also decrease your risk for breast cancer.
If you have a strong family history or personal history of breast cancer, speak to your physician about when to start mammograms. If you have a first degree relative (mother, sister, or daughter), you should consider starting annual mammograms 10 years younger than their age of diagnosis, or at age 40, whichever is younger. The National Cancer Institute offers a tool to assess risk online Click Here. The St. Vincent Breast Center offers a complementary risk assessment for our patients with strong family history of breast or ovarian cancer. For patients at high risk, annual screening breast MR in addition to mammograms has been found to increase cancer detection.
What is Mammography?
A mammogram is special low-dose x-ray of the breast. A radiologist physician uses the images to detect breast cancer. With screening mammograms, it is possible to find a cancer, sometimes years before a lump can be felt.
Current guidelines from the American Cancer Society (ACS), the American College of Obstetrics and Gynecology (ACOG) and the American College of Radiology (ACR) recommend screening mammography every year for women of average risk, beginning at age 40.
Mammography is the only screening method that is consistently proven to reduce breast cancer deaths. In fact, it is the major reason breast cancer deaths have declined by 30% since 1990. In addition, early detection through mammography often gives women more treatment options such as reduced surgery, better cosmetic outcomes, and may decrease the need for harsh therapies. And since breast cancer found in women under age 50 may be more aggressive, its important to schedule your mammogram every year.
If performed annually as recommended, screening mammography is the key to detecting breast cancer early and saving lives. Women 40 years of age and older with no symptoms of breast disease, should schedule their screening mammogram appointments annually. A physician referral is not required for this exam. However we must have the name of your physician to send your results.
Why annually? Compared to annual exams, if women get their mammograms every other year, 30% of breast cancers will go undetected. One third fewer women will die from breast cancer if they get annual mammograms. Additional information can be found Here on the Mammography Saves Lives website.
Your screening mammogram consists of routine views that will be reviewed after you leave the St. Vincent Breast Center. If your screening mammogram shows a possible abnormality, you will be called back for a diagnostic mammogram (see below). Most of these will turn out fine, often due to overlapping tissue looking like a possible abnormality.
How do I make an appointment?
You may schedule your own screening mammogram by calling us at 501-661-9766.
While a screening mammogram is encouraged each year for women who do not have significant breast symptoms, your doctor may order a diagnostic mammogram if you are experiencing a problem. A diagnostic mammogram should be ordered by your doctor for any worrisome lump, changes in the breast skin, focal pain, spontaneous nipple discharge (clear or bloody), or if you have a personal history of breast cancer. It is also recommended for your first mammogram after a biopsy or procedure. Diagnostic mammography may also be performed if your screening mammogram demonstrates a possible abnormality. Patients with a benign appearing finding on their mammogram may be asked to return in 6 months for a diagnostic mammogram to assess stability.
The type and number of mammographic views taken will be customized to your situation. Any additional mammographic views and ultrasound will be done at the time of your diagnostic mammogram visit.
How should I prepare?
Please bring a disc or films from any prior mammograms, if done at a facility other than The St. Vincent Breast Center. If you would like St. Vincent Breast Center to request these on your behalf, please fill out our medical records release form (please do so 1 month prior to your appointment - it could take up to 3 weeks to obtain films from out of state).
Bring a list of your medications.
On the day of the examination, do not wear talcum powder, deodorant, lotion or perfume under your arms or on your breasts. These substances can cause artifacts on your mammogram making the images harder to interpret. Deodorant will be available to you after your exam.
Wear two-piece clothing so that you only have to remove your top and bra for the examination.
To help minimize discomfort during your exam, consider scheduling your mammogram during the two weeks following your menstrual cycle (when breasts are often less tender).
If your breasts are especially tender, you may take an over-the-counter analgesic an hour before your appointment time.
Please bring any pertinent history to your appointment: prior surgeries, hormone use, family or personal history of breast cancer.
What should I expect?
Your mammogram will be performed by a mammography-certified female technologist. After you check in, you will be escorted to a private dressing room, where you will be asked to undress from the waist up. You will be given a gown that opens in the front. The technologist will ask you several questions, so she can better understand your history and/or any problems you may be having.
When will I receive results?
Screening mammography results will be sent to you and your physician within two weeks. If you are called back for additional mammographic views, do not be alarmed. More views or ultrasound are sometimes needed in order to make an accurate diagnosis. If this is the case a member of our staff will contact you personally to discuss scheduling a diagnostic mammogram.
Diagnostic mammogram results are provided to you in a summary manner at the time of the mammogram. Your referring physician will receive the official results of your exam within 24-48 hours of your visit.
Mammography Benefits & Risks Accuracy
Mammography is the best screening tool for breast cancer available today. However, mammograms do not detect all breast cancers. A breast finding of concern like a new lump should never be ignored even if you have had a recent normal mammogram. If you notice any new changes in your breast(s) you should bring them to your health care providers attention promptly.
Approximately 15% of women are called back from screening mammograms for additional testing (a diagnostic mammogram and/or breast ultrasound).. Most diagnostic mammograms conclude with good results, but it is necessary in order to complete the mammographic evaluation and make an accurate diagnosis. In some cases a follow-up test in 6 months may be advised. A biopsy is sometimes needed to evaluate the tissue under the microscope.
Strict guidelines ensure that mammogram equipment is safe and uses the lowest dose of radiation possible. Many people are concerned about the exposure to x-rays, but the level of radiation used in modern mammograms is very low and does not significantly increase the risk for breast cancer. The amount of radiation can be compared to an airplane flight of a few hours due to the thinner atmosphere.
What is a Breast MRI?
Breast MRI is a sophisticated technology that uses a computer, magnetic field and radio waves instead of x-rays to produce images of the soft tissues in the body. This non-invasive procedure helps our board-certified physicians to better evaluate the breast in special circumstances. When used in conjunction with screening and diagnostic mammography, it can provide valuable information for the detection and characterization of breast disease.
If MRI is used, it should be in addition to, not instead of, a screening mammogram. While an MRI is more likely to detect cancer than a mammogram, it may still miss some cancers that a mammogram would detect. MRI also has a higher false positive rate (where the test finds things that turn out to not be cancer), which would result in unneeded biopsies and other tests if performed on a large portion of women.
For more information on this and other radiology procedures, please Click here.
Who needs a Breast MRI?
Breast MRI has been proven to be more sensitive than any other modality in detecting invasive breast cancer. MRI is superior at demonstrating the size and extent of a breast tumor prior to surgery. In addition, it is beneficial for screening patients at particularly high risk for breast cancer due to genetic predisposition or strong family history, diagnosing breast implant rupture, staging breast cancer and planning treatment. MRI may also play an important role in post-surgical and post-radiation follow-up.
Breast MRI for Women with an Increased Risk of Breast Cancer
In March 2007, the American Cancer Society (ACS) revised the breast cancer early detection guidelines, recommending annual breast MRI screening for women in the following groups:
have a known BRCA1 or BRCA2 gene mutation
have a first-degree relative (mother, father, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools that are based mainly on a family history that includes both her mother's and father's side
had radiation therapy to the chest when they were between the ages of 10 and 30 years
have a genetic disease such as Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have one of these syndromes in first-degree relatives
Women at moderately increased risk should talk with their physicians about the benefits and limitations of adding MRI screening to their yearly mammogram. These patient groups include:
have a lifetime risk of breast cancer of 15% to 20%, according to risk assessment tools that are based mainly on family history (see below)
have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)
have extremely dense breasts or unevenly dense breasts when viewed by mammograms
Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.
St. Vincent Breast Center offers complementary breast cancer risk assessment for our patients with a strong family history of breast or ovarian cancer. The results should be discussed between a woman and her physician to help determine if they should have annual Breast MRI screening in addition to annual mammograms.
What should I expect?
Prepare to arrive 30 minutes before your appointment time. The entire appointment will take 45 minutes to an hour. This exam should be scheduled 7-10 days after the start of your menstrual cycle. Correct timing is important to minimize false positive findings that can occur due to hormonal influence on the breast tissue. If you suffer from minor claustrophobia or anxiety, you may want to ask your physician for a mild sedative. If you take a sedative, you will need to have a driver to take you home. Do not take the sedative until you have signed your paperwork. A Breast MRI does not require your breasts to be compressed, so you should not experience discomfort. When you arrive you will be asked to complete paperwork regarding your history and symptoms. We will escort you into a private dressing room where you can change into a gown and remove all jewelry, since these items contain metal, which disturbs MRI signals.
A technologist will position you for the scan. During the exam, you will lie on your stomach with your arms up over your head and you will enter the machine head first. Avoid eating a large meal prior to the exam. Most patients receive an injection of contrast material called gadolinium during the exam through an intravenous injection. A small intravenous catheter will be placed in your hand or arm. The injection of contrast material is necessary if the MRI is being performed for the diagnosis of breast cancer. It is sometimes not necessary if the sole intent of the study is to evaluate silicone breast implants. Adverse reactions to gadolinium are rare. You will be asked to lie very still, relax and breathe normally. There are typically no side effects during or after MRI, so you can resume normal activities as soon as your exam is over.
It is very important that any prior breast studies (mammograms, ultrasound or MRI) be made available to the radiologist for comparison during the interpretation of your MRI scan. If you have had these at a facility other than the St. Vincent Breast Center, please bring them with you on the day of your appointment.
If you have any of the items listed below, please call 501-686-2650 so we can make arrangements for you before your appointment. Many of these items are contraindications to having an MRI as they are not compatible with the magnetic field present around all MRI machines.
Artificial heart valve prostheses
Eye implants or metal ear implants or any metal implants activated electronically, magnetically or mechanically.
Copper 7 IUD
Shrapnel or non-removed bullet
Weight over 350 lbs
Any metal puncture(s) or fragment(s) in eye
When will I receive results?
After your exam, a radiologist specialized in MRI will review your images and a report will be faxed directly to your physician.
What is a Needle Biopsy of the Breast?
If imaging studies show an abnormality with suspicious features, a biopsy is the only definitive way to confirm if breast tissue is benign or cancerous. Needle biopsy is a safe, minimally invasive procedure used to get a sample from an abnormal breast lesion. Small amounts of breast tissue are removed through a needle, and the tissue is studied under a microscope by a pathologist, who will then provide a diagnosis.
There are various methods by which a needle biopsy can be performed. In each, the basic concept is to use an imaging technique to accurately guide needle placement to obtain samples of the abnormal appearing tissue seen on the mammogram, ultrasound or MR images.
An ultrasound-guided biopsy is a technique most often used to guide a breast biopsy when a breast abnormality is visible on ultrasound.
A stereotactic breast biopsy allows for a needle biopsy to be performed on lesions which are better seen on mammography than on ultrasound. This type of biopsy utilizes x-ray images (mammograms) of the breast tissue to guide the biopsy needle to the area of interest. Stereotactic biopsies are most commonly performed on tiny breast calcifications; but can also be utilized on breast masses in certain situations.
An MR-guided biopsy is guided in real-time by magnetic resonance (MR) imaging and is useful when an abnormality is best seen on MRI.
What should I expect?
We realize a biopsy may be an emotionally distressful experience. However, patient comfort, in addition to an accurate diagnosis, is our priority. Our radiologists and staff are trained to make this procedure as comfortable as possible. A needle biopsy can be performed with local anesthetic and usually with minimal discomfort. With this procedure, no stitches are required; a steri-strip tape will be used where the needle is placed through the skin.
If it makes you feel more comfortable, you may want a relative or friend to join you to lend support and drive you home.
You should not take aspirin, ibuprofen (e.g. Advil), naproxen (e.g. Aleve), Vitamin E or Fish Oil for 3 days prior to biopsy. Prior to your appointment, please let us know if you are taking any blood thinners.
Please wear a supportive bra to help maintain the post-biopsy dressing. It is helpful to wear a two-piece outfit, preferably one that buttons up the front. No change of eating habits is required
Biopsies Ultrasound Guided Biopsy
You will lie on your back or turn slightly to the side. The ultrasound probe is used to locate the lesion. Local anesthetic is injected to ensure that you will be comfortable. The radiologist will then create a small nick in the skin through which the biopsy needle will be inserted, and several samples of tissue will be obtained for evaluation. A tiny metallic marking clip may be left at the biopsy site so that it can be easily relocated for surgery or follow up, if needed. We will provide you with an ice pack and post biopsy care instructions.
Stereotactic Breast Biopsy
This minimally invasive procedure requires you to be positioned lying face down on a specially designed table used specifically for breast biopsies. Your breasts are positioned through an opening in the table and placed in compression (less than we use for a regular mammogram). We will then clean the skin and inject a local anesthetic. A tiny incision less than a quarter of an inch is made to allow insertion of the biopsy needle. The radiologist will remove several samples of tissue through this incision. A tiny metallic marking clip may be left at the biopsy site so that it can be easily relocated for surgery or follow up, if needed. We will provide you with an ice pack and post biopsy care instructions.
You will be positioned face down on your stomach and your breasts will be positioned into a cushioned opening containing a special breast-imaging coil. Using computer software, the radiologist will determine the position and depth of the lesion for biopsy. Local anesthetic will be injected into the breast to numb it and contrast material is given in your vein. When the tissue sampling is complete, a tiny metallic marking clip may be left at the site of biopsy, so it can be easily located for surgery or future follow up, if needed.
If you have minor claustrophobia or anxiety, you may want to ask your physician for a prescription for a mild sedative. DO NOT take this medication prior to your arrival or signing paperwork. If you take a sedative, you need to have a driver. Avoid eating a large meal immediately prior to the exam and plan to arrive about 30 minutes before your appointment time.
When you arrive you will be asked to complete paperwork regarding your history and symptoms. You will be asked to remove all jewelry, since these items disturb MRI signals.
What instructions do I follow after the procedure?
After your biopsy, do not participate in any strenuous activity or take aspirin, ibuprofen (e.g. Advil), naproxen (e.g. Aleve), Vitamin E or Fish Oil for 48-hours. You may take acetaminophen (e.g. Tylenol) if needed for any discomfort. You will be given an ice pack to place inside of your bra which you can use for 15 minutes every hour or two on the day of the biopsy. You are also asked to sleep wearing a support bra the night of the biopsy. The outer dressing may be removed after 24 hours. Do not get the area wet until this is done. The steri-strip may be removed five days after the biopsy. You may bathe carefully with the steri-strip in place.
You may have some discomfort or bruising at the biopsy site. Watch for excessive bleeding, pain, or fever. Should any of these occur, contact our office. If calling between 8 am and 4:30 pm Monday through Friday, the number is 501-661-9766. On weekends during the day, call 552-4648. After 4:30 p.m. Monday through Friday (and after 5:30 p.m. on the weekend) call 686-2660.
When will I receive results?
Biopsy samples are sent to a pathologist, who will provide your physician and St. Vincent Breast Center with a diagnosis. You will be notified of results within several days of your biopsy appointment.
How do I make an appointment?
Your doctor needs to make your appointment. He or she can call our Breast Center at 501-661-9766.
What is a Breast Ultrasound?
Breast ultrasound is a non-invasive tool using high frequency sound energy used to evaluate specific areas of concern - such as a breast lump felt by a patient or physician or an area of concern seen on a mammogram. Breast ultrasound does not replace the need for mammography in women old enough to have mammograms.
What should I expect?
Your exam will be performed by a mammography-certified female technologist or a board-certified radiologist.
An ultrasound is most often performed in conjunction with a diagnostic mammogram. During your ultrasound procedure, the technologist will ask you to lie down on a table and position you appropriately. She will then apply a gel to your breast to allow the ultrasound energy to pass efficiently through your skin. A small probe will be passed over the surface of your breast, causing some pressure on your skin. A picture of the breast tissue will be seen on the ultrasound screen.
A breast ultrasound test usually takes between 15 and 30 minutes. More time may be needed if a physical breast exam is needed. A radiologist will review your images with the technologist and may also want to obtain more ultrasound views of some areas of your breast.
When will I receive results?
At the time of your visit, you will receive a summary of your exam results and recommendations. Your referring physician will receive the results of your exam within 24-48 hours of your visit.
How do I make an appointment?
Your physician should make your appointment by calling 501-661-9766.
Breast Abnormalities What are Breast Calcifications?
Breast calcifications are calcium deposits within the breast. Extremely common in women of all ages, calcifications are typically found during a screening mammogram, appearing as white spots similar to grains of salt. They usually cannot be felt.
Calcifications are very common on mammograms and increase with age. Some type of calcification is seen on about 25% of all mammograms by age 40, and on about 2/3 of all mammograms by age 65.
The vast majority of calcifications are benign. However, the earliest type of non-invasive breast cancer shows up as calcifications on mammograms. Calcifications associated with early cancer often have an abnormal appearance on mammograms.
Certain patterns of calcificationssuch as tight clusters with irregular shapescan indicate a problem, and when they are seen on a screening mammogram, they may need to be analyzed more closely. Your radiologist may suggest a diagnostic mammogram with magnification views. Magnification views allow the radiologist to analyze the shape and distribution of the calcifications within the breast more clearly and often determine whether calcifications appear benign or suspicious.
If the calcifications have benign-appearing features, then routine follow-up mammograms are important to allow continued monitoring of the calcifications over time. Sometimes calcifications appear benign, but represent a change from prior mammograms. In that case, short term follow up, such as a mammogram in 6 months may be recommended. If the radiologist is concerned that the calcifications may be associated with a cancer, a biopsy is necessary to analyze the significance of the calcifications.
Because benign calcifications are so common, they can sometimes mimic the appearance of suspicious calcifications. Of all biopsies done for calcifications, about 3/4 turn out to be benign. However, once calcifications have a suspicious appearance on the mammogram, a biopsy is necessary to determine the cause of the calcifications.
Biopsies can be done as needle biopsies or surgical biopsies. You can talk with our radiologist or your physician about the different types of biopsy.
What is a Breast Lump?
Finding a breast lump can be alarming, but it does not necessarily mean you have breast cancer. A breast lump can result from many benign conditions including fibrocystic changes, a cyst or a benign (non-cancerous) tumor called a fibroadenoma. If you feel a breast lump, you should contact your physician promptly for evaluation. Your physician may do a clinical breast exam, and refer you for a diagnostic mammogram and ultrasound. They may do a follow up breast exam one month to see if the lump changes with your menstrual cycle.
Normal breast tissue can sometimes feel lumpy. This usually feels smooth, mobile and soft or slightly firm. Normal lumpiness is common, and is one reason why women should examine themselves monthly. However, if you notice a new lump, you should contact your physician.
Cysts are fluid-filled masses in the breast. Cysts are very common, and are rarely associated with cancer. Ultrasound is the best way to tell a cyst from a solid mass, because sound waves pass right through a liquid-filled cyst. Solid masses, on the other hand, produce echoes that are detected by the ultrasound equipment.
Cysts can make it hard to examine yourself, since it's hard to feel around and behind them. For women with multiple cysts, if a new lump is found, you should contact your physician promptly. Although a new lump may be a new cyst, you cannot assume that. Cysts look like masses on mammograms, and ultrasound is usually needed to determine whether any changes correspond to new cysts.
Sometimes cysts are simple, and clearly represent fluid filled cysts on ultrasound. Sometimes they are not simple (called complex or complicated cysts) and have echoes within them on ultrasound. This can mimic the appearance of a solid mass. Either cyst aspiration using ultrasound guidance or short term follow up ultrasound (for example, in 6 months) may be recommended if there is a possible complex cyst.
Cyst aspirations are sometimes performed under ultrasound guidance, by removing fluid from a lump with a needle and a syringe. This may be done if there is uncertainty as to whether the lesion is cystic or solid. It can also be done to relieve discomfort from a painful cyst. When cysts are drained, the fluid is usually discarded unless it is bloody or looks suspicious. In these cases, it is sent to the lab for analysis.
Fibroadenomas are mobile, solid, rounded lumps made up of normal breast cells. They are the most common kind of benign (non-cancerous) solid breast mass, especially in young women. Depending on the appearance, a solid mass with benign appearing features may be followed with mammogram and/or ultrasound imaging. This is usually done for at least two years, initially in 6 months. If the mass has any suspicious features such a irregularity or lobulation of the wall, a biopsy can be done. A biopsy, if needed, can be done as a needle biopsy or surgical biopsy.
Sometimes a biopsy may be needed to determine whether a breast lump is benign or cancerous. This is often done as a needle biopsy under imaging guidance as an alternative to a surgical biopsy. If a clearly benign result is obtained (which is the case in about 3/4 of cases), the mass does not need to be removed and can be followed with mammograms and/or ultrasound. If cancer is diagnosed on a needle biopsy, the patient is referred to a surgeon for definitive management.
Needle biopsies give definitive results (benign or malignant) about 95% of the time. About 5% of needle biopsies require follow up surgical biopsies to obtain more tissue for more accurate diagnosis. The most common example of this is when a needle biopsy shows atypical cells. Although they are benign, they can indicate a pre-cancerous condition. It has been found that about 10-15% of patients with atypical cells may have cancer cells in the vicinity that were not included in the tissue samples obtained with the needle biopsy. Surgery is recommended in those cases to sample the surrounding tissue more thoroughly.
What is Breast Pain?
Breast pain is the most common breast related complaint among women. Nearly 70% of women experience it at some point in their lives and approximately 15% of women require treatment. Breast pain may occur in one or both breasts or in the underarm region. Usually, breast pain does not indicate breast cancer, though women should discuss the condition with their physician.
Focal breast pain (which you can point to with one finger) is often evaluated with a diagnostic mammogram in a manner similar to a new breast lump.
Regional or diffuse breast pain is rarely associated with cancer.
Breast Cancer Websites
American Cancer Society Click Here
Avon Foundation for Women Breast Cancer Crusade Click Here