If you discover a breast lump, or some other change in your breast, you may be concerned about breast cancer. But, keep in mind that breast lumps are common. Usually, they’re noncancerous (benign), especially in younger women. However, regardless of your age, if you feel a distinct lump during your self-examination of your breasts, you should consult your doctor for a breast examination as soon as possible. The information below is to help you know what to expect during your clinical breast exam, and what is recommended when a breast lump needs to be further evaluated.
When You Should See Your Doctor
Being familiar with the way your breasts normally feel can help you detect any changes in your breasts. See your doctor if:
- You feel a new lump in your breast
- A breast lump you’ve had for a long time increases in size or changes in some other way
- You find changes in your breast skin (such as dimpling, wrinkling, redness, or crusting)
- You find changes in your nipple (is turning inward (inversion), or appears flatter)
- You find nipple discharge (It may be clear, brown, yellow, or red)
- You feel breast pain that doesn’t stop after your next period
Procedures to Evaluate Your Breast Lump
During your breast exam, your doctor will examine both of your breasts and your lymph nodes in the armpits, to locate lumps or any other abnormality. If your doctor confirms that you have a breast lump or other concern, she/he might recommend one or more of these procedures for diagnosing breast cancer:
- Mammogram —an X-ray of the breast
- Breast ultrasound —Use of sound waves to create images of internal structures of the breast, often used in addition to a mammogram.
- MRI —Breast magnetic resonance imaging (MRI). Uses a magnet and radio waves to produce detailed images of the interior of your breast. A dye is injected to enhance imaging. The MRI is usually used to confirm a diagnosis that may be in question.
- Ductogram —(Galactogram) Used to determine the cause of nipple discharge. A small bit of dye is injected to help an X-ray reveal a tumor in the breast’s duct.
- Other tests— Additional tests and procedures may be necessary, depending on your personal situation, including having a breast biopsy.
Removing a sample of your breast tissue for examination with a microscope (biopsy) is sometimes the only way to confirm that a breast lump is cancer. There are various types of breast biopsy. Your doctor will determine which kind of biopsy is most appropriate, depending on the location and size of your breast lump.
All biopsies should be expected to cause bleeding, bruising, swelling. A surgical biopsy can also be expected to leave a scar and to potentially change the shape of your breast, depending upon how much tissue must be removed.
What if My Breast Cancer Test Results Are Negative?
If your breast lump is not diagnosed as cancerous, then your doctor may recommend monitoring your breast condition for a brief period, including having a follow-up breast exam by your doctor, or having breast imaging again, after a few months, to reexamine the breast area in question. Contact your doctor again if you find any changes in the lump, or if new changes develop in other areas of your breasts.
If your clinical breast exam and mammogram do indicate areas of concern, but, for example, your pathology report on the biopsy indicates benign tissue, your doctor will refer you to a surgeon or other medical specialist for additional consultation.
What if My Breast Cancer Test Results Are Positive?
If your breast lump is diagnosed as cancerous, then your doctor will work with you to determine the best treatment plan for your needs. The type and current stage of the breast cancer will largely determine your range of treatment options. If you feel uncertain about how you should proceed in making the best decision about treatment, ask your doctor to advise you in this decision process.
Breast Cancer Treatments
After your doctor has diagnosed your breast cancer, he/she will determine the stage (extent) of your cancer. This will allow your doctor to determine your prognosis and to recommend appropriate breast cancer treatment options for you. In some cases, your cancer stage may not be knowable until after you have breast cancer surgery. Tests and procedures your doctor may use to determine the stage of your breast cancer may include:
- Blood tests (such as a blood count)
- Mammogram of your other breast (to search for signs of cancer)
- Breast MRI
- Positron emission tomography (PET) scan
- Computerized tomography (CT) scan
- Bone scan
You may not need all of these tests or procedures. Your doctor will determine which breast cancer treatment options are appropriate for you, based on the type of breast cancer you have, its current stage, size, grade, and your cancer cells’ possible sensitivity to hormones. And, your doctor will factor in your general health condition, and, of course, your treatment preferences.
Breast Cancer Surgery
The majority of women diagnosed with breast cancer will have breast cancer surgery. Types of breast cancer surgeries include:
- Removal of the breast cancer (lumpectomy). This surgery is usually reserved for smaller tumors.
- Removal of the entire breast (mastectomy). This surgery is to remove all of the breast tissue.
- Removing several of your lymph nodes (axillary lymph node dissection). If cancer is detected in sentinel lymph nodes, then your surgeon will advise you regarding removal of additional lymph nodes in your armpit.
- Removing both breasts (double mastectomy). Some women who have cancer in one breast elect to have their other (healthy) breast removed as well (contralateral prophylactic mastectomy).
Most women with breast cancer in one breast will never develop cancer in the other breast. But, this option may be recommended for women who are at especially high risk of cancer in the other breast due to strong family history of breast cancer or genetic predisposition.
Depending upon the breast cancer surgery you choose, complications may arise. All breast cancer surgeries come with a risk of bleeding, infection, arm swelling (lymphedema), and pain.
NOTE: Some women decide to have breast reconstruction immediately following breast cancer surgery, or at a later date. Discuss your options regarding breast reconstruction, breast forms, and other alternatives with your surgeon.
Other Breast Cancer Treatments
The following treatments for breast cancer may be used instead of surgery or in conjunction with it. Your doctor will discuss with you why one or more of these other breast cancer treatments may be appropriate for you. And, he/she will explain the procedures for these treatments, their liklihood of effectiveness in your case, and any side affects you should expect from the treatments.
- Radiation therapy
- Hormone Therapy
- Targeted Drugs
- Palliative care (for pain)
Support and Coping After Cancer Diagnosis and Treatment
Coping with Cancer Diagnosis and Treatment — Each person finds their own way of coping with a cancer diagnosis. Try talking with other breast cancer survivors, or others with whom you can discuss your feelings. Consider asking your doctor for a referral to see a counselor who works with cancer survivors. Keep friends and family near you. And, maintain intimacy with your spouse or partner.
Coping With Fatigue — Fatigue is common during and after breast cancer treatment, and can continue for years. Ask your doctor about alternative medicine for fatigue and stress management.
Questions to Ask Your Doctor
Basic questions for you to ask your doctor include:
- What kind of breast cancer do I have?
- What is the current stage of my breast cancer?
- Can you explain my diagnostic report to me? May I have a copy for my records?
- Will I need additional tests?
- Which treatment options are most appropriate for me?
- What are the benefits of each treatment you most recommend?
- What are the side effects of the treatments?
- Will these treatments cause early menopause?
- How will treatment impact my daily routine? Will I be able to keep working?
- How soon should I decide about cancer treatment?
- Will my insurance cover all of the treatments you’re recommending for me?
- Are there any printed informational materials that I can take with me? Can you recommend any websites or books to help me educate myself on my condition?
- Are there any current clinical trials or newer treatments that you think I should consider?
- Ask any additional questions that may occur to you during your appointment.
Kristine A. Eule, MD, Denver CO
Dr. Kristine Eule is an OB/GYN physician in Denver Colorado. Dr. Eule’s expert professional team serves her Denver OB/GYN patients at her modern medical office in the Denver Tech Center.
Patient Care — Dr. Eule and her caring medical staff provide compassionate, individualized care for each patient. Her focus is on forming a partnership with each woman, to provide the most effective lifetime care, provide information and education, in addition to women’s health care in a friendly, intimate medical environment.
Office Hours — Office hours are 8:30 am – 5pm, Monday – Thursday, and 8:30 – 3pm on Friday. Dr. Eule can be reached 24/7 through her answering service.
Emergency Care — Cathie is Dr. Eule’s Nurse Practitioner. Cathie sees patients, if Dr. Eule is out delivering a baby or away for any other reason. And, the doctor cross-covers with 3 other Denver women OB/GYNs. So, in case a patient has a medical problem or emergency in her absence, there is a qualified female doctor available at all times to help.
For More Information
For more information about what to do if you find a breast lump, or to make an appointment to see a Denver CO OB/GYN, contact Dr. Kristine A. Eule, MD to speak to one of our friendly, helpful staff members. We serve our patients in Denver, and the greater Denver Colorado metro area.