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
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
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.