BREAST CANCER FAQ

1. Are all Breast Lumps Cancer? No. The majority of breast lumps are NOT cancer. Fluid filled cysts, nodular breast tissue and solid benign masses are all more common than cancer. Get every breast lump checked by a professional to be safe.
2. How often do I need to get Mammograms? If otherwise healthy, with no breast masses or increased risk factors for breast cancer, you should get mammograms annually starting at age 40.
3. What if I have an abnormal Mammogram? The majority of abnormal mammograms are NOT cancer but need further evaluation including additional imaging studies (ultrasound, magnification/compression mammograms, MRI) and either close follow up with repeat mammogram in 6 months or occasionally biopsy to rule out malignancy. Consult with a breast specialist in addition to a radiologist whenever you have an abnormal mammogram.
4. Why do I have nipple discharge? Nipple discharge is common and can be green, yellow, clear or bloody. It is generally benign but must be evaluated by a breast specialist. Spontaneous, bloody nipple discharge is most concerning and requires workup including physical exam, discharge fluid testing for cytology, imaging and occasionally biopsy.
5. Why do my breasts hurt? Painful breasts are common among women and are generally related to hormone stimulation, dense breast tissue and benign cysts rather than cancer. If the mammogram is normal, and the pain is not associated with a mass, the pain is treated symptomatically. A supportive bra, vitamin E and oil of primrose supplement may help. If the pain is associated with redness of the breast, you may have an infection and require antibiotics. Consult a professional whenever pain is new, persists for several weeks, or is associated with redness or a mass.
6. Does Breast Cancer always require mastectomy (removal of the breast)? Most commonly, breast cancer can be treated by removal of the tumor alone (lumpectomy) and radiation, thereby preserving the breast. Aggressive tumors, multiple tumors, large tumors or tumors in BRCA gene positive patients may require mastectomy.
7. Should I get tested for the BRCA gene? The majority of the women that develop breast cancer do NOT have the BRCA gene and most people without breast cancer do not need to be tested for this gene. If you get breast cancer at a young age (less than 50 and/or in premenopausal period), and/or have a strong family history of breast and other cancers especially ovarian, colon, lung, pancreatic, prostate and melanoma, you may be a candidate for gene testing. Consult a breast specialist or geneticist to discuss your risk.
8. Do hormones cause Breast Cancer? This is a complicated question. We know that the majority of breast cancers are estrogen receptor positive and respond to hormones. Studies also demonstrate that estrogen increases the risk of breast cancer if taken longer than 10 years and taken along with progesterone. Current recommendations are for women with breast cancer to stop all hormones and those women without breast cancer to take hormones only if they need them (for disabling side effects of menopause), and take them at the lowest dose possible for the shortest time necessary. This is also true for “bioidentical” hormones. Hormones have not proven to protect women from cardiac disease, alzheimer’s disease or other cancers.
9. How common is breast cancer?
   
10. Besides breast cancer what can cause a lump in the breast?
    
11. How do I check for breast cancer?
    
12. How do I minimize my risk of getting breast cancer?
    
13. Nipple discharge is also common in women. Is that a concern?
    
14. So if I make lifestyle changes am I safe?
    
15. What are the risks for breast cancer?
    
16. If I decide to remove my breast how will it look?
    
17. What causes breast pain?
    
18. What if I have a lump or an abnormal mammogram?