Freuently Asked Questions

Q. What is Breast Cancer?
A. Breast cancer occurs when abnormal cells develop and grow out of control in the ducts or lobules of the breast. These abnormally growing cells form a mass and can have the capability of invading normal tissues and spreading to other organs by the lymphatics and blood stream. Ductal carcinoma is the most common and begins in the cells lining the milk ducts. Lobular carcinoma develops in the lobules of the gland where the milk is produced. Breast cancers have different growth rates and biological characteristics that contribute to the variablility in its presentation, behavior and outcome.

Q. What is "in situ" cancer?
A. These are cancerous cells that are confined to the ducts (ductal carcinoma in situ) and do not have the ability to invade and spread to other organs. This is an early cancer usually found on mammogram. Ductal carcinoma in situ does require treatment. Lobular neoplasia or LCIS (lobular carcinoma in situ) is an indicator of increased risk of invasive breast cancer developing in either breast over the next ten years.

Q. What is fibrocystic condition?
A. This variation in the normal breast tissue in response to cyclic hormonal changes is the most common cause of breast lumps. A cyst is a fluid filled space or sac in the breast that develops from the breast ducts and glands in response to hormonal stimulation. Fibrous tissue around the cysts and ducts can become swollen. This condition results in varying degrees of tenderness and "lumpiness" in response to fluctuating hormonal levels during a menstrual cycle.

Q. What is a fibroadenoma?
A. This benign solid tumor is the most common mass found in women under age 30. It is characteristically smooth, round and mobile and is easily identified on breast ultrasound.

Q. What is a "core" biopsy?
A. This simple office procedure, done under local anesthesia, uses a specialized biopsy devise or probe through a tiny incision to obtain tissue samples from a mass that is palpated or visualized under ultrasound. Ultrasound is very helpful in identifying the mass and confirming proper tissue sampling.

Q. What is a Stereotactic Core biopsy?
A. This is a minimally invasive procedure used to obtain tissue samples of an abnormal area identified on mammogram, such as microcalcifications, that is not seen on ultrasound. The abnormal area is identified on the digital imaging mammogram and the tissue samples are removed through a tiny incision with a vacuum assisted biopsy devise.

Q. Will surgery still be needed after a biopsy?
A. The options of management for the diagnosis will be discussed once the pathology report is available. Many benign lesions will not require surgery and can be followed. High risk atypical lesions and malignancies will require a surgical procedure.

Q. What is an excisional biopsy?
A. An excisional biopsy surgically removes a mass or abnormality on a mammogram for diagnostic purposes. This is sometimes recommended or chosen instead of a core biopsy.

Q. What is a needle or wire localization biopsy?
A. This is an excisional biopsy of an abnormality seen on mammogram or ultrasound that is not palpable. The area to be removed at surgery is identified by means of a special wire placed into the breast at the site of the finding on mammogram or ultrasound. The breast tissue around the wire is surgically removed thereby removing the abnormal area.

Q. What is a "lumpectomy"?
A. This refers to a procedure that removes a malignant tumor with a rim of normal tissue around it to obtain "clear" margins. The tissue at the edges is checked microscopically for cancer cells to be sure the margins are clear. If they are not, more tissue will need to be removed.

Q. What is a mastectomy?
A. This refers to the operation that removes the entire breast including the nipple-areolar complex. This is an option to treat breast cancer and may be necessary for large tumors or multiple tumors. A simple or total mastectomy removes only the breast and no lymph nodes. A modified radical mastectomy removes the breast and some of the lymph nodes under the arm.

Q. What is a sentinal node biopsy?
A. This procedure is used to locate the first lymph node in the drainage of the breast that would be the most likely to contain cancer cells if they have traveled out of the breast into the lymphatic system. A blue dye and/or a radioactive isotope injected into the breast travels in the lymphatic vessels to identify which node or nodes to remove for pathologic evaluation. If the sentinal nodes are negative for malignancy, no further lymph nodes are removed.

Q. What is an axillary lymph node dissection?
A. This procedure, done at the time of lumpectomy or mastectomy, removes the fatty tissue in the axilla (arm pit) that contains the lymph nodes that drain the breast. A complete axillary dissection is usually done when the nodes are found to contain cancer. The lymph node involvement can be determined before surgery by ultrasound in some cases.

Q. What is a port or vascular access device?
A. Many patients with breast cancer will need chemotherapy as part of the treatment. This is given intravenously (in a vein). A port is placed in the subcutaneous tissue and is attached to an IV catheter that is introduced into a vein. This allows the port to be accessed (punctured with a needle) when a treatment is needed. In addition to preventing scarring of the veins, it is a convenience and comfort for the patient. The port is easily removed when treatment is completed.