There are some
limitations because a mammogram may miss some cancers or may find things that
turn out not to be cancer at all. Detecting a tumor early does not guarantee
that a woman's life will be saved. Some fast growing cancers may have already
spread to other parts of the body before being detected. (Dollinger, Rosenbaum
and Cable, 1991). The National Cancer Institute recommends that women in their
forties and older have mammograms on a regular basis, every one to two years.
Symptoms Early breast cancer does not cause pain as a rule. In fact, when breast
cancer first develops, there may be no symptoms at all. According to Dollinger,
Rosenbaum and Cable, 1991), as cancer grows it can cause many changes that women
should watch for: A lump or thickening in or near the breast or in the underarm
area; A change in the size or shape of the breast; Nipple discharge or
tenderness, or the nipple pulled back into the breast; Ridges or pitting of the
breast (looks the skin of an orange); A change in the way the skin of the
breast, areola or nipple looks or feels. Diagnosis The physician is able to tell
a lot about a lump by its size, texture and whether is moves easily. He/she does
this by feeling the lump and the tissues around it. Apparently, benign tumors
have a different feel. The physician finds out a lot of information by reading
the mammogram. Ultrasonography is also used to tell whether a lump is solid or
fluid filled. The following procedures may be performed to make a diagnosis
according to Dollinger, Rosenbaum and Cable, (1991): Fine needle aspiration. A
thin needle is used to remove fluid from a lump. If it is fluid filled it is not
cancer. If it is solid it may or may not be cancer. Needle biopsy. Tissue can be
removed with a needle from an area that is suspicious on a mammogram and cannot
be felt. Surgical biopsy. The surgeon cuts out part or all of a lump or
suspicious area. When cancer is found The pathologist can tell what kind of
cancer it is, if it is invasive, whether the cancer is sensitive to hormones, if
it grows slowly or rapidly. The patient will be referred to an oncologist who
specializes in the treatment of cancer. Generally, treatment will begin within a
few weeks after diagnosis. This is the time to get a second opinion, prepare
self and loved ones. Treatment There are more treatment options and hope for
survival than ever before. The options depend on the size and location of the
tumor, the results of lab test and hormone receptor tests, and the stage of the
disease. The women's age, menopausal status, general health and size of her
breasts are considered.
This is the time to learn all that is possible about the
disease, the treatment choices and to take an active part in decisions about
medical care and options. There are many resources where a patient can learn
about breast cancer. Calling the National Cancer Institute's Cancer Information
Service a 1-800-4-CANCER is a great way to gather the most current up to date
treatment information, including information about current clinical trials. A
cancer specialist can provide answers to questions about breast cancer
treatment. They can also make referrals to other resources. There is so much to
learn about breast cancer and its treatment. As I described in my personal
journey, this is a very difficult time to remember all of the information heard
and understand all of the answers at once. I suggest keeping a journal to refer
to when things seem a lot clearer. Planning treatment Methods of treatment are
local or systemic. Local treatments are used to remove, destroy, or control the
cancer cells in a specific area. Surgery and radiation therapy are local
treatments. Systemic treatments are used to destroy or control cancer cells
throughout the body. Chemotherapy and hormonal therapy are systemic treatments.
A patient may have one form of treatment or both (McEvilly and Hassey, 1998).
Surgery is the most common treatment for breast cancer. An operation to remove
the breast or as much of the breast as possible, is a mastectomy. Breast
reconstruction is often an option at the same time as the mastectomy, or later
on. An operation to remove the cancer but not the breast is called breast
sparing surgery. They usually are followed by radiation therapy to destroy any
cancer cells that may remain in the area. In most cases, the lymph nodes under
the arm are removed to help determine whether cancer cells have entered the
lymphatic system (Dollinger, Rosenbaum and Cable, 1991). In lumpectomy, the
breast cancer and surrounding tissue is removed. Some of the lymph nodes under
the arm are removed. In segmental mastectomy, the surgeon removes the cancer and
a larger area of normal breast tissue around it. Occasionally, some of the
lining over the chest muscles below the tumor is removed as well. Some of the
lymph nodes under the arm may also be removed. (Dollinger, Rosenbaum and Cable,
1991).
