There are few things more fearful and panic provoking than finding a lump or a change in your breast. Your immediate thought will probably be of cancer. Everyone reacts differently when this happens to her. Some will call their doctor at once, others might be afraid of confirming their fears and delay making an appointment.

It is only normal for you to feel upset and fearful if you find a lump in your breast. But fear will not make the lump disappear. The earlier you find a lump in its development and the smaller it is, the greater the chance it is curable if it is cancer. Not all breast lumps are malignant. Only a doctor can accurately diagnose if a breast lump is benign (not cancerous) or malignant (cancerous). Do not try to diagnose it yourself.

Beginning with the time a breast lump or lesion is found, women have a number of treatment options. As developments occur, surgeons are continuing to learn about the advantages and disadvantages of these different treatments. Because of the different stages at which breast cancer is diagnosed, there is not one specific treatment that is best for all women. There are too many variables involved to have one standardized treatment plan for breast cancer.

Currently, the basic types of treatment for breast cancer are:

• 1)Surgery
• 2)Radiation
• 3)Chemotherapy
• 4)Hormonal manipulation.

Surgery and radiation are considered local treatment as they treat and affect one area of the breast or body. Chemotherapy and hormonal manipulation are systemic treatment that applies to the entire body.

The options available to you will depend on a number of factors, including the type of tumor, the extent of the disease at the time of diagnosis, your age, and your medical history. But your personal feeling about the treatment, your self-image, and your lifestyle will also be important considerations in your surgeon’s assessment and recommendations. You and your surgeon should discuss these treatment options and how they apply to your situation. Remember, of primary importance in determining the appropriate treatment is the cure rate. Your life should be your number one priority.

YOUR DOCTORS

During your treatment you will meet several health professionals who will perform the various tests and treatments your doctor recommends. It may be difficult at first to talk with them about your illness and your feelings about the treatment. But each of them can offer information to help you feel more at ease. By talking with the professionals who care for you, you will come to understand more about cancer and its treatment, and you will be better prepared to cope with your illness.

In the course of treatment, several doctors will treat you. These doctors will be considered your treatment team, and will be working together on your treatment. These are some of the doctors and specialists you may meet or hear about:

ANESTHESIOLOGIST—A doctor who administers drugs to put you to sleep before surgery.

CLINICAL NURSE SPECIALIST—A nurse with special knowledge in a particular area, such as postoperative care or radiation therapy.

MEDICAL ONCOLOGIST—A doctor who administers anticancer drugs or chemotherapy.

PATHOLOGIST—The doctor who examines and studies the tissues removed by the biopsy and mastectomy to determine if the tissue is malignant and its characteristics.

PLASTIC SURGEON—A doctor who specializes in rehabilitative and cosmetic surgery. Plastic surgeons perform the breast reconstruction.

RADIATION ONCOLOGIST—A doctor who supervises radiation therapy.

SURGEON—A doctor who performs surgery, such as a biopsy and mastectomy. He will be responsible for coordinating your treatment and working with you to ensure that the treatment is satisfactory.

Currently breast cancer strikes more than 135,000 American women annually. One out of nine women will be diagnosed with breast cancer during her lifetime. Every woman should take the time to examine her breasts for signs of possible cancer. All women, not only those with prior breast lumps, benign or malignant, should learn and practice monthly breast self-examination (BSE). Breast cancer cannot be prevented; therefore, early detection is your best protection against breast cancer.

The consistency of breast tissue varies from woman to woman. By examining your breasts carefully at the same time each month, you will be able to notice any unusual changes, signs, or symptoms of breast cancer.

The following list will help you become aware of what to look for:

1. A lump or thickening of the breast
2. A discharge from the nipple
3. Dimpling or puckering of the skin
4. Retraction of the nipple
5. Scaly skin around the nipple
6. Other changes in skin color or texture, such as "Orange Peel" skin
7. Swelling, redness, or heat in the breast
8. A lump under the arm

The best approach to breast health care is three fold:

1) Monthly BSE (Breast Self-Exam),

2) A routine yearly exam by a doctor. An exception is for women with previous breast problems. These women should be examined by their doctor every three months.

3) After age thirty-five a baseline mammogram should be performed. A woman should have a mammogram every two years until age forty (our recommendation). Thereafter, it should be done annually, unless otherwise indicated by your doctor. Mammography is the single most accurate screening tool available to detect cancer in its earliest and most curable stages.

Mammograms are 80 to 85 percent accurate and can even detect lumps that are too small to be felt. In some instances a lump can not be detected on the mammogram even though you or your surgeon can feel it. The reason for this is the lump is transparent and it will not appear on your mammogram. Mammograms are not 100 percent accurate; therefore, it is crucial to have a physical exam as well as a mammogram.

Mammograms can detect very small lumps- less than one quarter of an inch. Most lumps can not be felt until they are at least a half an inch. Precancers can also be found on mammograms. These are the earliest demonstrable forms of breast cancer.

It is best to have all your mammograms done at the same facility so that subtle changes can be detected more easily, and techniques, equipment and interpretation are less likely to vary. Once again, even if you get a clean bill of health from a mammogram, you should still do monthly BSE at home on a regular basis.

Remember the three "ams":

1) Mammogram,

2) Doctor’s exam, and

3) Breast Self-Exam.

Certain women are at a greater risk for developing breast cancer. These women need to be identified and followed more closely. The risk factors for women most likely to get breast cancer are as follows:

MAJOR RISKS:

1. Women 50 years or over
2. Women whose mother or sister has had breast cancer, particularly if the disease occurred when the patient was premenopausal
3. Women who have already had breast cancer

OTHER RISKS:

1. Women with precancerous breast disease
2. Women with breast cysts proven by aspiration or surgery
3. Women who have never had children
4. Women who had first child after age 30
5. Women who started first menstrual period at the age of 12 or younger
6. Women who have experienced menopause after 55
7. Women who are obese
8. Women who consumes large amount of alcohol

Each woman is a separate individual and her risk factors can be quite variable.