Intro / Screening & Prevention / Breast Cancer Screening FAQ

Why should I do a breast self-examination if my health care provider examines my breasts when I go for an annual exam?
All women beginning at age 20 should become familiar with their own breast tissue. The goal is to be able to identify any abnormality and bring it to the attention of a health care professional for prompt evaluation and early treatment if needed.

Why isn't Mammography offered to women under age 40?
Premenopausal women have dense breast tissue that makes mammographic evaluation less sensitive. Younger women should be doing monthly self-examination and bring any abnormality to the attention of a health care professional for diagnostic evaluation.

Diagnostic evaluation of an abnormality may include an ultrasound and a mammogram even in a woman under age 40.

Why isn't ultrasound done alone, instead of mammography?
Research to date has not shown ultrasound alone to be effective for screening for breast cancer. It is useful in conjunction with mammography in diagnostic evaluation of abnormal findings.

Should I have a clinical breast exam with my mammogram?
A mammogram and clinical breast exam should be performed during the same visit, or alternatively, the mammogram should be performed within 2 weeks of the clinical breast exam to ensure that any palpable abnormality (something that can be detected by touch) is identified and brought to the attention of the radiologist.

If I don't have a family history of breast cancer, does that mean I am not at risk for the disease?
Only a quarter of women with breast cancer have family history of the disease. All women are at risk for breast cancer with advancing age, regardless of family history. Those with a family history may require closer follow up with biannual clinical breast examination.

What is Stereotactic Breast Biopsy?
Breast-imaging specialists in the Department of Radiology are now refining and demonstrating the benefits of stereotactic needle biopsy, a procedure for diagnosing a suspicious area that can be seen on a mammogram but is too small to be felt. The procedure uses computer-imaging techniques to guide a needle into the breast to collect abnormal cells from a suspicious area observed on an x-ray. For many women, stereotactic needle biopsy can spare them a more uncomfortable and expensive surgical biopsy. It can also allow them to start their treatment sooner.

Are there new surgical techniques for breast cancer?
Doctors are now offering a new surgical procedure to many women who come to Parrish Medical Center for breast-cancer care - one that is easier to tolerate, speeds their recovery, and enables them to return sooner to their normal day-to-day activities. Called "sentinel node biopsy," the new technique spares many women from extensive surgery to remove a cluster of lymph nodes from under the arm to see if they contain cancer cells.

This year alone, more than 180,000 American women will learn that they have breast cancer. About 75 to 80 percent of them will need to have 12 to 15 under-arm lymph nodes surgically removed near the affected breast and examined for cancer cells. If a woman's lymph nodes contain cancer, she may need more aggressive treatment, such as chemotherapy.

Until now, such "axillary node dissection" has been the only way doctors could reliably tell if cancer had spread beyond the breast to nearby lymph nodes. But it may leave women with a disorder called lymphedema - a painful swelling of the arm due to fluid accumulation � or put them at increased risk for infection.

Today more breast cancers are being diagnosed at an early stage, thanks to improved screening. But in 80 percent of these patients, axillary node dissection shows that the lymph nodes are cancer free.

With the new procedure, surgeons need to remove only one lymph node for examination � the "sentinel" node, where cancer cells from a breast tumor would travel first. Here's how it works: Before surgery, a radiolabeled dye is injected into the area around a woman's breast tumor. "skin-sparing mastectomy." The surgeon removes the inner breast tissue and nipple, leaving a shell of skin in place; then the surgeon fills in the shell with tissue from the woman's abdomen and, later, reconstructs the nipple, resulting in a natural-looking breast.

About one hour later, in the operating room, surgeons inject a special blue dye around the tumor and make a small incision in the armpit. To identify the sentinel lymph node, the surgeons track the path of the blue dye and also use a device that detects the radioactive source. They remove the sentinel node and, while the woman is still in the operating room, send it to a laboratory for examination.

If this lymph node turns out to be free of cancer, the remaining nodes can be left intact, and the surgery to remove the tumor is completed. If it contains cancer cells, the remaining nodes are also removed and analyzed using standard axillary node dissection. Sentinel node biopsy can be performed on patients who opt either for lumpectomy or mastectomy.

Parrish Medical Center is one of only a handful of cancer centers now offering the technique to women with early-stage breast cancer.

Besides reducing the chances of developing lymphedema, sentinel node biopsy offers other benefits: It can be done under local anesthesia, does not require an overnight hospital stay, decreases the risk of surgical complications, and results in lower medical costs.