Detection & Diagnosis

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Understanding the Risk Factors of Breast Cancer

Breast cancer occurs mostly in women, but men are also at risk. Most breast cancers start in the cells that line the ducts and the lobules and are called ductal or lobular cancers.  

A number of factors can increase your risk of getting ductal breast cancer or lobular breast cancer. Some of the major risk factors are:

• Menstruation at an early age


• Having a baby later in life or never having given birth at all


• A personal history of benign (non-cancerous) breast disease


• A mother or sister who has had breast cancer


• Treatment to the breast or chest region using radiation therapy


• Taking estrogen, progesterone or similar hormones


• Drinking alcohol


• Being Caucasian

If you are between the ages of 20 and 39 you should:

• Have a breast exam at least every three years as part of your annual checkup.


• Report any breast changes to your physician promptly. A monthly breast self-exam is recommended.

If you are 40 years of age or older you should:

• Get an annual mammogram.


• Make sure a breast exam is part of your yearly checkup.


• Report any breast changes to your physician right away. Doing a monthly breast self-exam is recommended.

Diagnosing Breast Cancer

Early detection is an essential part of successfully fighting breast cancer. At the Florida Hospital Cancer Institute (FHCI) we utilize a broad range of traditional and state-of-the-art technologies and procedures to accurately diagnose your cancer.
If cancer is detected, our highly trained breast cancer specialists will be able to identify the type and stage of the cancer so a treatment plan can be developed and implemented.

Mammogram

The FHCI’s imaging specialists rely on screening mammograms to detect lumps in the breast before they can be felt. If a lump or cluster of calcifications is discovered, it will be tested further to see if it is cancerous or precancerous. Additionally, your doctor may recommend a diagnostic mammogram to learn about any unusual changes in the breast, such as a lump, thickening, nipple discharge or an unexpected change in breast size or shape. At the FHCI we offer digital mammography which offers superior imaging with less discomfort to the patient. If a lump has been detected, your doctor may also use a breast ultrasound to examine its structure. Echoes created by bouncing ultrasound waves through the tissue produce a detailed image of the lump on a computer monitor. 

Additional Testing

If needed, your doctor may request that you have an MRI. This imaging will include views of the axillary lymph nodes, which are the most common site for the initial spread of cancer beyond the breast. An MRI can offer more details about the location and size of the growth. Finally, a Positron Emission Mammography (PEM) may be utilized to detect very small areas of cancer that can’t be seen in other tests. In a PEM, a radioactive glucose substance is injected into the vein. Since cancer cells have a higher metabolic rate, the glucose accumulates more readily in them, making them visible in the imaging. Each of these tests provide additional information that is critical to treating your cancer effectively.

Biopsy

If an abnormality shows up in these initial tests, your doctor may recommend that you have a biopsy. This involves the removal of a small piece of the lump so that this tissue can be checked for signs of cancer under a microscope by a pathologist. 

The most common method of obtaining samples from the breast is through a core biopsy where a special needle is inserted into the area of concern and several samples of the tissue are removed. Alternately, a fine need aspirate (FNA) may be performed. Using a small needle, only a portion of cells or fluid is removed. A surgeon or radiologist on an outpatient basis does both the core biopsy and FNA. A clip or marker is usually placed at the site of the biopsy so that this site can be easily identified if necessary.

Two other biopsies can be performed and both take place in an operating room under anesthesia. An incisional biopsy removes a portion of a mass or lump while an excisional biopsy removes the entire mass.

Cells or tissue obtained in a biopsy are sent to a pathologist to be examined and tested. If the sample is benign (non-cancerous) then further tests may be required. If the biopsy results show a malignancy (cancer), treatment options will need to be explored.

An FHCI doctor will be happy to answer any questions you have about a biopsy or any of the other procedures mentioned here.

Used together or separately, these diagnostic tools help the breast cancer specialists at FHCI determine the presence of cancer, its type and staging so that a complete treatment plan can be developed and implemented; resulting in the best possible outcomes. Treatment may include a combination of surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy as well as new techniques made available through the institute’s clinical trials.