02 Oct I Discovered a Lump in My Breast – Now What?
According to the American Cancer Society, 1 in 8 women will be diagnosed with breast cancer in their lifetime. It’s easy to panic when you discover a lump in your breast, have unusual pain, or are experiencing any other unusual breast symptoms. While the 1 in 8 statistic can be scary, it also means that 7 in 8 women never have a cancer diagnosis.
When you have an unknown health issue, it’s normal to be worried and to have questions. The best thing that you can do is schedule a visit with your doctor as soon as you can. Early detection is the key to a more favorable outcome if you do, indeed, have cancer. If it’s a benign (non-cancerous) breast issue, your appointment will give you peace of mind.
Many women aren’t sure where to start when they have a breast health issue. Which doctor should they see? What diagnostic and treatment procedures should they expect to undergo?
In this post, we’ll share some guidance about the first steps that you should take, as well as some possible treatment options for various diagnoses. Keep in mind that every patient is unique, so you should always see a doctor for diagnosis and treatment.
Breast Symptoms: When to See Your Doctor
Most women know that if they find a lump, they should schedule an appointment with their doctor. Other unusual symptoms that you should have checked out are:
- Unusual pain in the breast that is different than your typical menstrual pain
- Nipple discharge that is new, bloody, or spontaneous (happens on its own)
- Skin discoloration
- Changes in your nipple, such as retraction, swelling, or puckering
Often, breast cancer does not cause pain in patients. If you have painful lumps in your breast, there’s a chance that the cause is something benign or hormone-related. If you suspect that something has changed in your breasts, you can schedule an initial appointment with your primary care doctor or your OB-GYN, whichever you prefer.
You can also reach out to Breast Care Specialists of Carolina. We may be able to assist you in getting a referral for insurance purposes so that you can begin your breast health journey with us.
Most women do not discover a breast abnormality through the presentation of symptoms or by a self-exam (although self-exams are very important, so don’t skip them!). Most often, a radiologist spots breast abnormalities during a routine screening mammogram.
If your first screening is abnormal, you’ll likely have a second diagnostic mammogram. The compression may be a little tighter than your first mammogram so that the radiologist can closely examine the suspicious spot. The goal of a diagnostic mammogram is to get a clearer view of your breast tissue than your first scan provided.
The American Cancer Society recommends that women begin having yearly mammograms at age 40. Mammograms can detect unusual spots much earlier than a woman would feel a lump. The sooner you and your doctors find something atypical, the better, so don’t neglect your routine mammograms.
Seeing a Breast Care Specialist
If your diagnostic mammogram still leaves questions about the mass in your breast, your next step will likely be to see a breast care specialist. Your family practice doctor or OB-GYN can make a referral for further diagnostic testing.
A breast care specialist will begin with a physical examination and review of your health history and current symptoms. It’s important to assess your historical (older) imaging (mammograms and ultrasounds) and your recent imaging to get a better idea of the changes in your breasts.
Most likely, you’ll have an ultrasound at your appointment to determine whether a biopsy of the area is necessary. If the breast care specialist determines that a biopsy could provide helpful information, they will likely proceed with it at the same appointment.
During the biopsy, you’ll be awake. Your physician will numb the area to be biopsied, and using an ultrasound machine, your doctor will locate the lump for targeted breast biopsy. This method of diagnosis is much less invasive than a surgical biopsy. In most cases, the incision is so small that it doesn’t even require a stitch.
Within a couple of days, the breast specialist will have the results from your needle biopsy. In the vast majority of cases, the biopsy provides a definitive answer about the cause of the pain, lump, etc. If the results are still unclear, you may undergo a second biopsy or an MRI to learn more.
If Your Biopsy Result is Benign
There are several different treatment paths that you could travel if the diagnostic tests come back benign. Since there are many different causes of benign breast issues, you’ll need to work with a doctor to create your treatment plan.
Many women do not experience pain or discomfort from a benign mass. If the lump is not painful and is not a known precursor for cancer, your doctor will monitor it for changes over time (becoming painful, growing larger, etc.). Some women opt to have non-symptomatic benign masses removed for comfort and peace of mind.
If the mass is a precursor for cancer, meaning that it could increase your risk of cancer or turn malignant at a later date, your course of treatment will most likely be to remove the mass.
If Your Biopsy Results Indicate Cancer
The location, type, and size of the cancer are patient-specific, so one woman’s treatment plan will be completely different than another. Some possible treatments that you may undergo after you receive a cancer diagnosis are surgery, chemotherapy, radiation, and breast reconstruction.
The order in which you receive each treatment depends upon your cancer and its progression. Your overall health is also a factor. Not all women receive all of the aforementioned procedures, but some do.
All women with breast cancer will see a breast oncologist, or cancer specialist, following their cancer diagnosis. The oncologist is integral in determining the treatment path and order by consulting with your primary physician or OB-GYN and a breast care specialist.
Some women may also do genetic testing if they qualify for it based on personal and family history and if they have insurance approval. The test examines many genes in the DNA including the BRCA1 and BRCA2 genes for deleterious mutations that increase a person’s risk for cancer. Depending on your test results, your treatment may be more or less aggressive.
Not all women with breast cancer undergo mastectomy surgery. In fact, many do not. Some women only have a partial mastectomy, also called a lumpectomy, to remove the cancerous tissue and preserve the remaining healthy breast tissue.
Women whose genetic testing shows mutations may, in extreme cases, opt to undergo a double mastectomy to attempt to prevent future occurrences of breast cancer. Each woman’s surgery, care, and healing is dependent upon her diagnosis and personal preferences.
If the patient needs breast surgery, her oncologist will determine whether to begin chemotherapy and/or radiation treatment before or after breast surgery. The order of treatment depends upon how aggressive and invasive the cancer is. If the patient would appear to benefit from surgery at a later time, the oncologist will move forward with a referral for chemotherapy and/or radiation prior to surgery.
Chemotherapy is administered to a patient’s bloodstream intravenously. It is a systemic treatment, meaning that the medicine works through the patient’s entire body. Your oncologist may also choose to prescribe endocrine therapy. This treatment is often given as an oral pill and may be used to treat hormonally driven cancers.
Radiation therapy, like chemotherapy, is administered by an oncologist. Unlike chemotherapy, radiation is a local treatment, meaning that it targets only a specific area. The treatment focuses radiation waves at areas of your body with cancer to destroy dangerous, mutated cells.
After a mastectomy, some women may choose to have reconstructive surgery to rebuild their breasts. If your breast specialist feels like they can remove all of the cancerous tissue during the surgery, and you tolerate anesthesia well, both procedures may be done at the same time.
Patients who do not tolerate anesthesia well will not be able to have reconstruction at the same time as the mastectomy. The reconstruction adds considerable time to the surgery, and some women may not do well under anesthesia for such a lengthy procedure.
Other times, there may be unclear margins around the cancerous tissue, or there may be cancer cells in the skin. Sometimes, it’s best to wait to do the reconstruction until you have eliminated all of the cancerous cells.
Don’t Put Off Your Appointment
Each woman is different, so each treatment path is unique. If you discover something unusual in your breasts, don’t panic. Take a deep breath. The best thing that you can do is to schedule an appointment with your preferred physician.
The sooner you begin to learn the cause of your breast changes, the sooner you can develop a treatment plan and conquer your benign breast disease or cancer. If you have questions or concerns about your breast health, call us at (704) 769-3800 or visit us online at bcscarolina.com.