It’s widely accepted that early detection of breast cancer can lead to early treatment and save lives. Annual mammograms are recommended for women of average risk beginning at 45 and as early as 40.
In addition to an annual mammogram screening, examining your breasts at least once a month is an important way to notice any changes in your breasts and report them to your doctor. Regular breast self-exams can help health care professionals catch cancer early, and earlier detection often increases the likelihood of successful treatment.
“This means being aware of how your breasts look and feel. You should be aware of any changes in size, shape or color, and check for lumps, changes in the feel of the skin on the breast or nipple and nipple discharge,” says Mary Wilde, MD, a breast surgeon with Scripps MD Anderson Cancer Center and medical director of the Scripps Polster Breast Care Center. “It also means seeing a doctor as soon as possible if you notice changes or abnormalities.”
“If you discover a lump, your first thought might be that you have breast cancer but there is no need to panic,” Dr. Wilde says. “Before you allow anxiety and worry to consume you, remember that many women’s breasts feel lumpy and most breast lumps are not cancerous. In fact, only one of out of every five lumps is cancerous.”
You could have a cyst or tumor that is not cancerous. “There are many benign lumps that we see in breasts,” Dr. Wilde continues. “For example, noncancerous lumps sometimes appear when you’re menstruating and go away when your cycle ends.”
Certain changes, or lumps, are more concerning than others. Be on the lookout for these warning signs of breast cancer:
- Bloody or clear nipple discharge that occurs without squeezing the nipple
- Breast dimpling or puckering
- Swollen, red or warm breasts
- Changes in size or shape
- A hard knot or thickening in the underarm area or inside the breast
- A scaly, itchy rash or sore on the nipple
- Inversion (pulling inward) of the nipple or breast
- Pain in one spot that doesn’t go away in two to three weeks
A lump or breast changes may be nothing to worry about. The only way to know for sure what’s going on is by seeing your health care provider. Your doctor may follow these steps to diagnose or rule out cancer:
Your doctor visually examines your breasts for changes and checks for lumps or thickening by palpating (feeling) the deeper tissue in your breasts and armpits.
If a screening mammogram or physical exam finds something unusual, the next step is usually a diagnostic mammogram. This specialized mammogram provides views of the problem area from several angles and at a higher magnification than standard screenings. This helps pinpoint the lump’s location and size.
Also known as tomosynthesis, 3D mammography creates a three-dimensional image of the breast tissue, enabling the radiologist to examine the breast tissue one layer at a time. It is especially helpful examining dense breast tissue.
Breast MRI (magnetic resonance imaging) is often used in women who’ve already been diagnosed with breast cancer to help determine the extent of their cancer. For certain women at high risk, a MRI is recommended along with a yearly mammogram.
An ultrasound uses sound waves to create images of the inside of your breast. These images show whether a breast lump is solid, or fluid-filled. Solid masses are more likely to be cancerous.
Your doctor may remove a tissue sample of the lump to examine it under a microscope and check for cancerous cells. Only 20 percent of biopsied breast tissue turns out to be cancer.
If test results indicate that your lump isn’t cancerous, your doctor may recommend having another clinical breast exam or diagnostic mammogram in a few months to check for any changes. You may still need surgery to remove a benign, noncancerous lump.
“Should the lump turn out to be cancerous, you and your doctor can work together to develop a treatment plan,” Dr. Wilde says. Treatment options vary depending on the stage and type of breast cancer.
If you have a strong family history of breast cancer, talk to your doctor about genetic tests for breast cancer gene mutations.