You wake up feeling fine. You grab your morning coffee -- and maybe a
doughnut -- and head for the shower. But not more than five minutes pass when
suddenly you get a shock.
What's different? You find a lump in your breast. And even though studies
show up to 80% of all breast lumps are harmless, you still feel threatened and
want to know you'll be OK.
Fortunately, that's a lot easier now, thanks to advances in diagnostics -- a
variety of options that pull together not only the specifics of your breast
lump, but also look to your personal and family history, your age, even the
results of a previous mammogram, to ensure you have the quickest and most
accurate diagnosis possible.
"One of the real advances we are seeing in breast diagnostics is this trend
toward individualized care. It's no longer a one-size-fits-all mentality. When
it comes to diagnosing and treating breast abnormalities, it's a little bit
different for every woman," says Cheryl Perkins, MD, scientific advisor for the
Susan G. Komen Breast Cancer Foundation.
Advances in diagnostics include new uses for
ultrasound, the advent of digital mammography, the increased use of
magnetic resonance imaging (MRI), and the development of newer and more
complete biopsy techniques. Experts say these methods are allowing doctors to
get better at reducing patient
anxiety and the need for unnecessary surgery -- while helping to find and
eliminate more breast cancers than ever.
But what does this all mean on the morning you discover your lump? And what
do you do first? Experts say the journey should always begin with a call to
your primary care doctor.
"Some really exciting things are going on in the diagnosis of breast cancer," says Constance
Lehman, MD, PhD. Lehman is principal investigator of the American College of
Radiology Imaging Network (ACRIN) Breast MRI Trial, and director of breast
imaging at the University of Washington Medical Center in Seattle.
"But still," says Lehman, "the most important thing to do when you find a
lump, or see or feel any breast irregularity, is to call your personal
physician and have it evaluated. And don't schedule a mammogram or try to see a
surgeon on your own."
One reason is that for many women -- particularly young women -- the next
step won't be a mammogram at all, but an ultrasound exam; it's a painless,
radiation-free way of determining if the lump is a mass or a harmless,
"If it's a cyst, testing stops here; there is nothing to fear," says
Moreover, if a mammogram does become necessary, and particularly if it's
been a year or more since your last one, Lehman says an ordinary screening
mammogram won't do.
"It takes only four pictures, two of each breast. A diagnostic mammogram
uses the same equipment and technique but focuses intently on the area of
concern, compressing tissue and magnifying the images so that we can get a much
more detailed look," says Lehman.
With the advent of digital mammography -- which, much like your digital
camera, uses electronic imaging rather than film -- pictures can be
computer-manipulated, making them even cleaner, clearer, and some say easier to
"In the area of screening, but particularly in diagnosis of breast
abnormalities, digital is one of the exciting and very promising new
technologies," says Perkins.