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Breast Cancer

Contents:

Diagnosis

There are several types of breast tumors. In fact, some of the most common lumps in the breasts aren't really "tumors" at all - many lumps are fibrocystic changes, which are not malignant. Other tumors are malignant. Some common breast cancers include:

Ductal carcinoma in situ (DCIS): the cancer is confined to the ducts and has not spread through the walls of the ducts into the fatty tissue of the breast. Nearly all women with cancer at this stage can be cured.

Infiltrating (invasive) ductal carcinoma (IDC): the cancer starts in a milk passage or duct, breaks through the wall of the duct, and invades the fatty tissue of the breast. From there it can spread to other parts of the body. IDC is the most common type of breast cancer. It accounts for nearly 80% of breast cancer.

Infiltrating (invasive) lobular carcinoma (ILC): This cancer starts in the milk glands (lobules). It can spread to other parts of the body. Between 10% and 15% of invasive breast cancers are of this type.

Screening is the most important way to find breast cancer early. To do this, the American Cancer Society recommends that a woman have a:

  • Mammogram yearly (for women 40 and over)
  • Clinical breast exam (CBE) yearly (for women 40 and over; every 3 years prior to this)
  • Breast self-examination (BSE) every month (for women over 20)

These screening criteria are set up because the most common sign of breast cancer is a new lump or mass. A lump that is painless, hard, and has irregular edges is more likely to be cancer. It's important to have anything unusual checked by your doctor. Other signs of breast cancer include the following:

  • A swelling of part of the breast
  • Skin irritation or dimpling
  • Nipple pain or the nipple turning inward
  • Redness or scaliness of the nipple or breast skin
  • A nipple discharge other than breast milk
  • A lump in the underarm area

If breast cancer is found early, prompt treatment could save your life. If a lesion is found and it is questionable whether or not it is malignant, PET Scanning may help.

Mammograms are used most commonly to x-ray the breast. During a mammogram, the breast is pressed between two plates for a few seconds while pictures are taken. Although this may cause some discomfort, it is necessary to get a good picture. Very low levels of radiation are used.

The current standard of care relies on physical examination, mammography and/or ultrasound, and fine needle aspiration to diagnose a breast cancer. PET can show whether or not a lump in the breast is benign or malignant. PET may prove to be a very useful addition to mammography. Specifically, patients with breast implants, dense breasts, and others may benefit from having a PET scan to help look for a lesion in the breast.

PET scans, now available at the PET centers nearest you , are a relatively new test that helps doctor's learn more about breast cancer - it may even prevent an unnecessary biopsy in some patients.

Source: Clinical Positron Imaging Journal, the official Journal of the Academy of Molecular Imaging, Vol 3, Number 5, Sept-Oct 2000.

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