Frequently Asked Questions
Is it normal for my breasts to change?
Yes. Every woman's breasts change during the course of her menstrual cycle, pregnancy, breast-feeding and menopause. Sometimes, however, a change in the size, appearance or feel of your breasts indicates a more serious problem, one requiring a physician's attention.
What kinds of problems occur in the breast?
The most common problem is the presence of benign (non-cancerous) cysts in the breast. Cysts are small, fluid-filled lumps, ranging in size from very tiny to the size of a golf ball. Fibrocystic change, which most often affects women between 25 and 50 years old, may cause your breasts to feel tender and heavy. Medical research links fibrocystic breasts to changes in diet. For some women, caffeine stimulates the formation of cysts. Cutting down on the consumption of coffee, tea, cola beverages and chocolate may help to improve breast symptoms.
Approximately one in eight women will develop breast cancer during their lifetime. The word cancer refers to a group of diseases, all involving the rapid growth of abnormal cells somewhere in the body. Fortunately, breast cancer can be successfully treated when detected early. Yearly physical examinations, monthly breast self-examinations and mammography, if your doctor recommends it, greatly increase your chance to detect breast cancer early.
How do I know I have developed a breast problem?
The first noticeable sign of a breast problem is a lump. Both you and your doctor can detect the presence of a lump by doing a physical exam. The earlier you detect a lump, the more successful the treatment of the disease. Because of this, you should get into the habit of performing routine breast self-examination. Women practicing regular breast self-exams discover many of their own breast lumps. During your regular visit, your gynecologist or gynecological nurse practitioner (gyn np) will also examine your breasts for any abnormalities.
How do I examine my breast?
Make a commitment to do the examination routinely, every month. Do the exam on the same day each month so that you won't forget. The best time to perform a breast self-exam is 7-14 days after your menstrual period, when your breasts are no longer swollen or tender. If you do not get a menstrual period, then pick a time every month to exam your breasts. Regular breast exams will familiarize you with the way your breasts normally look and feel. is makes it easier for you to notice any changes.
1. Sit or stand in front of a mirror, and examine the way your breasts look. Has either of your breasts changed in appearance or in size or shape? Look for puckering or dimpling of the breast skin, and retraction (pushing in) of your nipples. Then, lift your arms and place your hands on your head, and check the appearance of your breasts again. Finally, press your hands firmly against your hips and inspect your breasts a third time.
2. Now, lie down. Flatten your right breast by placing a pillow under your right shoulder. Place your right arm behind your head.
3. Use the sensitive finger pads (where your fingerprints are, not the tips) of the middle three fingers on your left hand. Feel for lumps using a circular, rubbing motion in small, dime-sized circles without lifting the fingers. Powder, oil or lotion can be applied to the breast to make it easier for the fingers to glide over the surface and feel changes.
4. Press firmly enough to feel different breast tissues, using three different pressures. First, light pressure to just move the skin without jostling the tissue beneath; then, medium pressure pressing midway into the tissue; and finally, deep pressure to probe more deeply down to the ribs or to the point just short of discomfort.
5. Completely feel all of the breast and chest area up under your armpit, up to the collarbone and all the way over to your shoulder and down to your bra line.
6. Use the same pattern to feel every part of the breast tissue. Choose the method easiest for you:
Circles - Beginning at the outer edge of your breast, move your fingers slowly around the breast in a circle. Move around the breast in smaller and smaller circles, gradually working toward the nipple. Don't forget to check the underarm and upper chest areas too.
Lines - Start in the underarm area and move your fingers downward little by little until they are below the breast. Then, move your fingers slightly toward the middle and slowly move back up. Go up and down until you cover the whole area.
Wedges - Starting at the outer edge of the breast, move your fingers toward the nipple and back to the edge. Check your whole breast, covering one small wedge-shaped section at a time. Be sure to check the underarm area and the upper chest. After you have completely examined your right breast, examine your left breast using the same method, and your right hand with a pillow under your left shoulder. You may want to examine your breasts or do an extra exam while showering. It's easy to slide soapy hands over your skin and feel anything unusual.
What should I look for when I examine my breasts?
Many breasts feel naturally lumpy. This is no cause for alarm. Pay attention to anything that seems new or unusual - new lumps, puckering, dimpling, a thickening or hardening under the skin, a retraction of the nipple, or any other change in the way your breasts or nipples look. Discharge or bleeding from your nipple also signals a problem which needs to be evaluated by a physician.
What if I discover one of these signs?
None of these warning signs prove that cancer is present, but it might be. If you have any of these symptoms and notice a change in your breasts, see your doctor immediately to evaluate. If you do not have cancer, you will feel reassured. If you do have cancer, the earlier your doctor can begin treating it, the better your chances for cure.
Your doctor will perform a thorough breast examination, similar to the one you do at home. Based on that exam, and on your medical history, your doctor may recommend further tests to determine the cause of your breast abnormalities. These tests include mammography, breast ultrasound, breast MRI or a biopsy.
What is mammography?
Mammography is a procedure that uses X-rays to detect small changes in breast tissues. The American Cancer Society recommends annual mammography for the average women starting at age 40. Mammography can detect cancer and other tumors and cysts long before you would be able to feel them in your monthly self-exam. is early detection significantly increases the chances of successful treatment.
What is breast ultrasound?
Ultrasound, a painless, noninvasive diagnostic procedure Ð utilizes sound waves to examine organs inside the body. By bouncing sound waves off your breast, your doctor produces a picture indicating the location and consistency of breast masses. e breast ultrasound can identify a solid mass from a fluid-filled one (cyst).
What is a biopsy?
A biopsy is the removal of a piece of tissue for examination under a microscope. Based on the physical breast examination and the results of the other tests, your doctor may decide to perform a biopsy to determine what the abnormality is.
How can I receive palliative care?
Palliative care is provided if a person has a serious illness and one or more of the following:
- Patient, family, or team need assistance with complex decision making and determination of goals of care
- Difficult-to-control pain or other symptom distress (such as dyspnea, delirium, nausea) related to a serious medical illness
- Difficult-to-control psychosocial or spiritual issues related to a serious medical illness
- Multiple hospitalizations for same diagnosis
- Progressive decline in functional status
- Progressive metastatic cancer
- New diagnosis of life limiting illness for symptom control or determination of goals of care
- Need for Advance Care Planning or clarification of DNR status
- Utilization of ICU setting in patient with documented poor prognosis
- Prolonged ICU stay or transfer to the ICU setting without evidence of progress
- Questions regarding artificial nutrition or hydration in cognitively impaired, seriously ill or actively dying patients
- Patient or family requests for care determined by primary team to be differences in family and team goals of care
- Patient, family, or team request for information regarding hospice appropriateness
What can I expect?
At Jefferson, palliative care is provided in the hospital and in an outpatient setting. In addition, you can expect:
- Relief from symptoms such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite and difficulty sleeping
- Support with emotional, spiritual, or financial stressors that may affect you or a family member during treatment for cancer
- Help carrying on with your daily life
- Improved ability to go through medical treatments.
- Help with understanding your cancer diagnosis and your choices for medical care
- An improved overall quality of life
Will my insurance cover palliative care?
Most insurance plans, including Medicare and Medicaid, cover palliative care. If costs concern you, a social worker or financial consultant can help you navigate through the benefits process.