Breast Cancer: Development and Early Detection
Breast cancer treatment has changed tremendously over the last decade. Screening is more affordable and widely available than ever before. Minimally invasive diagnostic and biopsy techniques provide quick analysis, helping patients and their doctors form immediate plans of action. October marks Breast Cancer Awareness Month – a time when healthcare providers across the nation reach out to their patients to encourage them to take the time to get a mammogram. A few facts, however, may surprise you and explain why early detection can make the difference.
Where Does Breast Cancer Actually Begin?
Most patients understand that cancer is simply a group of cancer cells that forms a tumor – in this case, in the breast. The breast has three main parts, each a bit different when cancer is involved:
- Lobules, the glands that produce milk.
- Ducts, vessels that let milk flow from the lobules to the nipple.
- Stroma, fatty and connective tissue surrounding the lobules, ducts, and lymph and blood vessels.
While cancers do sometimes begin in the lobules or stroma, those tiny ducts are where cancer cells most often begin their growth. In a study cited in “Hospital Physician,” 80 percent of ductile cancers were not palpable but were detectable through a mammogram. That’s why a mammogram is so important. A manual exam is highly unlikely to be able to pinpoint a tiny group of cells deep within a breast, but in the vast majority of cases, a mammogram, ultrasound or MRI will.
If I Don’t Have a Lump, Why Worry?
The medical community encourages both women and men to examine their breasts regularly. However, an exam is much more than searching for a lump. The real purpose is to ensure individuals are familiar with how their body normally feels and looks so that they can notice even slight changes. Bodies give signs when something is wrong. While a tiny nodule or bump needs prompt medical evaluation, so do a number of other changes in the breast, such as:
- Any change in a breast’s size, shape, or texture.
- Swelling or inflammation, especially under the arm or along the collarbone.
- A change in temperature in the breast or adjacent areas of the body.
- Nipple changes, such as the nipple drawing inward, known as nipple retraction or inversion.
- A flat area, dimpling or indentation in the breast.
- Skin irritation, such as a rash or reddish scales on the breast, particularly around the nipple.
- Discharge other than milk; some patients notice stains on clothing or linens.
- Pain in the nipple or breast.
- No pain; some cancerous growths produce very little or no pain at all.
- A lump in the breast, under the arm or along the collarbone, particularly one that persists well after a menstrual cycle has ended.
What About the Lymphatic System?
Medical professionals are anxious to detect cancerous growths in the breast early particularly because of the body’s lymphatic system. Hundreds of lymph nodes interconnect through vessels that circulate clear lymph fluid throughout the body to attack and filter out infection. The body has lymph nodes and vessels near every area and organ vital to life, including the breast, neck and armpit. Each breast has lymph vessels that empty directly into nodes in the armpit. Nodes also sit beneath the breastbone and deep in the chest cavity. As a cancer grows, it invades or spreads to surrounding tissue. Often cancer cells break or slough off to enter the lymphatic circulatory system. Once cancerous cells enter, they can travel to any area of the body and grow there, complicating treatment options.
Who Should Be Screened?
Current guidelines state, “Women age 40 and older should have a mammogram every year and should continue to do so for as long as they are in good health.” In addition, “Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic (regular) health exam by a health professional preferably every 3 years. Starting at age 40, women should have a CBE by a health professional every year.”
Current guidelines for high-risk patients state, “Women who are at high risk for breast cancer based on certain factors should get a mammogram every year.” The discovery of the BRCA1 and BRCA2 gene mutations has given both patients and their doctors more definitive tools than family history alone for diagnosing risks and deciding on breast cancer treatment, but other factors can qualify patients for high-risk status, too. Patients are considered at high risk if they have even one of these factors:
- The BRCA1 or BRCA2 gene mutation.
- A first-degree relative who has the BRCA1 or BRCA2 gene mutation.
- A family history of breast cancer.
- Prior radiation therapy to the chest between ages 10 and 30.
- Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome.
- A first-degree relative who has one of the above-listed syndromes.
What Are Mammograms and MRIs?
Mammograms are simply X-rays of the breast. Two plates compress the breast while X-rays use minimal levels of radiation to capture black-and-white images, or views. Traditionally, mammograms have been two-dimensional yet offered image quality capable of revealing any anomalies or calcifications within the breast, usually through two views. Three-dimensional – 3D – mammograms are now available that move across the breast and allow even more detailed, computerized views. Remember, however, that while a mammogram can detect breast abnormalities, only a biopsy can confirm or deny the presence of cancerous cells.
MRI – Magnetic Resonance Imaging
For an MRI of the breast, magnets and radio waves photograph cross-sections of the area and then assemble the “slices” to provide a detailed picture of all the vessels and ducts in the breast. A contrast dye often provides the best resolution, and the scan usually takes about an hour. While an MRI image alone cannot confirm or deny the presence of cancerous cells, medical professionals advise selecting a facility that is familiar with the procedure and equipped to perform an immediate follow-up biopsy to complete the diagnosis.
MIIGS Specializes in Minimally Invasive Biopsies
The only way to confirm or deny the presence of cancerous cells is by taking a small sample of the suspicious tissue. MIIGS offers state-of-the-art breast biopsy services that promise little to no pain. During the procedure, X-ray, ultrasound or computerized tomography guidance allows your doctor – one of our board-certified interventional radiologists – to insert a fine needle into the mass. The needle draws a tiny cell sample that a pathologist can use to determine whether the cells need further treatment or are simply benign.
MIIGS Offers Full Suite of Services
When four Louisiana doctors recognized the need for a minimally invasive diagnostic and treatment facility to serve the Alexandria area, they established MIIGS – the region’s only interventional radiology clinic and one of a handful in the state. All of our physicians are board-certified radiologists who specialize in advanced, minimally invasive techniques and medical procedures that use imaging technologies. Unlike surgical procedures, interventional radiology techniques usually:
- Have less risk and little to no pain.
- Allow outpatient treatment or only a short hospital stay.
- Involve only tiny, entry-point incisions that heal quickly.
- Don’t need general anesthesia.
MIIGS physicians and staff are trained and equipped to perform a wide variety of medical services and treat patients suffering from an equally extensive spectrum of illnesses. Whether you’re facing the possibility of a breast biopsy, debating your options for diagnosing and treating back or joint pain, or suffering with ulcerative complications due to varicose veins, MIIGS may be able to help. We offer same- and next-day appointments and focus on identifying and treating health issues quickly and accurately. Check out our website. Give us a call at 318.528.7560, or submit an online form today. With the right information, you may finally be able to lay your worries aside.