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One in Nine Women Get Breast Cancer

Improve Your Chances

You cannot prevent breast cancer, but you can improve your chances of cure if you do get breast cancer:
  • Check your breasts monthly one week after your period starts. (Your breasts should be the least lumpy and tender then.) If you don't have periods, check your breasts on the first of the month or the day your phone bill arrives.
  • Have a yearly physician breast exam.
  • If you don't have a breast problem and aren't at high risk for breast cancer: Have one mammogram between 35 and 40; have a mammogram every one or two years between 40 and 50, and then have a yearly mammogram after age 50.
  • If you have a breast problem or are at high risk for breast cancer, ask us if you should have mammography more often.

Am I at high risk for breast cancer?

You are at high risk for breast cancer if you:
  • Are age 50 and older
  • Are the daughter or sister of someone with breast cancer
  • Went through menopause at 50 or older
  • Had your first period before age 12
  • Had your first child at or after age 30 or have no children
  • Are a college graduate
  • Use alcohol daily
  • Are Jewish

Why do I need a breast exam and mammogram?

20% of breast cancers do not appear on mammograms, but can be felt on breast exam. Another 30% of breast cancers cannot be felt on breast exam, but do show up on mammograms. Check your breasts each month, and have a doctor's exam and mammogram each year to find breast cancer early. Percentages breast cancer found on exam and mammography

My breasts are lumpy (fibrocystic). How can I tell if the lumps I feel are important?

Use the picture below to draw how your breasts feel. Each month, compare your exam to last month's drawing. If you feel any changes, see your doctor. Breast exam chart

What should I do if I find a new lump or change in my breasts?

See your doctor. One lump in five in women under 50 is cancerous. One in two lumps in women over 50 is cancerous. Your doctor may recommend immediate biopsy, cyst aspiration or observation and recheck in a few months.

What is breast cyst aspiration?

Many round moveable breast lumps are cysts (fluid-filled sacs). We aspirate these (withdraw fluid through a needle). If the cyst contains cloudy green or beige fluid and disappears and doesn't come back, you won't need further treatment. If your cyst comes back or contains bloody or clear fluid, it may be a cancerous cyst. We must, therefore, biopsy it.

What is a breast biopsy?

Will I go to sleep for my breast biopsy?

Most women have intravenous sedation (medicine in their IV to relax them) and local anesthesia (lidocaine injected into the breast) for breast biopsy. You'll be relaxed and the biopsy won't hurt, but you won't be asleep.

My mammogram is abnormal, but I can't feel a lump. How will you biopsy this area?

Using mammography, the radiologist will insert a fine marker wire into the abnormal area. Then, I'll remove the area around the wire. If there are microcalcifications (small calcium specks), we'll X-ray the tissue I removed. Otherwise, you'll have mammograms again in six weeks to be sure the abnormal area is gone.

Alternatively, you may go to Sioux Falls for a stereotactic biopsy.

What happens if my biopsy shows breast cancer?

You have two surgical choices. The first is wide removal of the lump and underarm lymph glands followed by Radiation Therapy. This saves the breast, but requires four to six weeks daily Radiation Therapy in Sioux Falls or Aberdeen. Your second choice is removal of the entire breast and underarm lymph glands. This choice has the advantage of not requiring Radiation Therapy, but has the disadvantage that you must wear a prosthesis or have surgical breast reconstruction. We'll discuss these choices after your biopsy. We also have a videotape and pamphlets to help you decide.

Will I have chemotherapy after my breast surgery?

You'll have chemotherapy unless your cancer is very early (small without spread). You may have chemotherapy pills for two to five years or intravenous injections for six months. Your oncologist will choose your chemotherapy, based on your age, estrogen and progesterone receptors, her-2-neu oncogenes and DNA flow cytometry.

How should I prepare for my mammogram?

  1. Do not wear powder or deodorant. These show up as spots on the mammogram. (Bring deodorant with you to use after your mammogram.)
  2. Wear a comfortable blouse and skirt or pants. You'll remove your top before your mammogram.
  3. Do not consume caffeine for two weeks before exam. (Coffee, tea, chocolate and some carbonated beverages contain caffeine.)
  4. Schedule your mammogram for one to two weeks after your menstrual period starts. Your breasts are the least lumpy then.

What will happen during my mammogram?

The X-ray technician will position your breast, apply brief compression, make brief X-ray exposures, release compression, develop the films and show them to the radiologist. The radiologist will inspect the films and compare them with your previous mammograms.
 
 

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Copyright © 2000 Gail Waldby, MD, General Surgery, Sioux Falls, South Dakota and Livingston, Montana, USA
All rights reserved Last modified April 3, 2005
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