Learning if you have breast cancer

You wake one morning and find a lump in your breast or you go for a screening mammogram and get recalled for additional views.

Welcome to the roller coaster of breast disease.  However, this process need not be frightening, as you are in control and you determine where you are going. What you need now is information.

Where do you begin this daunting task?

The most important thing to do is to get the answers to all of your questions. A mass in your breast or an abnormality on your mammogram will require further evaluation. An ultrasound is often required to further characterize a mass as solid, requiring biopsy, or cystic which may or may not require aspiration.

There are also microscopic findings on mammograms called calcifications that may require spot magnification views. Depending upon the findings of your radiologic studies, you may be referred to a surgeon or radiologist for a biopsy.

Most procedures to biopsy the breast can be performed in an out patient setting, which will allow you to have the procedure performed more quickly. Oftentimes an ultrasound or mammogram is used to guide your surgeon to the abnormal area of your breast. If the lump in your breast is not apparent on any studies, it still needs to be evaluated and likely require a biopsy to determine whether it is or is not cancerous. Remember, 20% of all cancers are not seen on mammograms or ultrasounds; therefore, palpable masses with negative x-ray studies need to be thoroughly evaluated.

The bottom line with an abnormal mammogram or ultrasound or a palpable mass is that a tissue biopsy is the gold standard to determine whether the mass is benign (not cancer) or malignant (cancer). If your questions are not adequately answered, get a second opinion.