New Patient Information
What to bring:
Your films and reports- If your study was done at Womack, we have the computer images available for review. If not, we need the films from the outside institution. That means the actual mammogram, US, MRI or other images. We look at them personally to plan your care appropriately. Even if your film was performed at another military treatment facility, we need those films to be brought to your appointment.
Pathology slides and reports , doctors notes from any outside providers if you are coming for a second opinion.
Breast Health or Early Detection
Anatomy: The breast is covered with skin and it protects the lobules that produce the milk. The duct that carry the milk come together at the nipple-areola complex. There is also supportive connective tissue and fat. The breast is attached to the pectoralis muscle and the chest wall.
Self Breast Exam (Once a Month): Monthly breast self exams are an important part of breast health. Once a month (10 days after you start your menstrual cycle if you are still getting your period or the first of the month if you are postmenopausal) you should examine your breasts.
You should start your exam by first looking in the mirror. Things you are looking for are any skin changes such as redness of the skin, a dimple or a nipple going the opposite direction than what you are used to, or if your skin takes on the appearance of an orange peel (peau d’orange). These are abnormalities that we would want to see you right away for.
Next, the breast exam should be performed. This can be done lying down, or more commonly standing in the shower. Begin with one arm over your head, and using firm, but gentle pressure, allow the pads of your finger s to glide over your breast moving from side to side or up and down. Remember, you have breast tissue from your clavicle, to your breastbone and even up into your armpit. Remember to cover all the bases. Repeat the exam on the other side.
What does a mass feel like? Well, it can feel like a marble, or pea. It can be hard or rubbery. It can even be a thickening or a ridge. Most women do have thickening of the breast. This is called fibrocystic changes and it is found in over 80% of all women. It can make the breast exam more challenging, but with consistent exams, you will begin to know what is normal for you and what is a change to your normal exam.
Clinical Breast Exam (Once a Year): A clinical breast exam is an exam of your breast by a qualified nurse or doctor. Often it can be incorporated into your well woman exam. Clinical Breast Exams are performed much in the same way as a monthly self breast exam and is done in an effort to check for lumps or other physical changes.
Mammogram (Once a Year): A mammogram is an X-ray of the breast and is the primary tool in diagnosing breast cancer. Generally mammograms are initiated at the age of 40 and are performed yearly or every two years thereafter. You may need more frequent mammograms based on the radiologist's recommendations. Earlier mammograms are at the discretion of your doctor. We perform digital mammograms here at Womack.
What is breast cancer?
Breast cancer is uncontrolled growth of breast cells. These cells take on a different and bizarre appearance compared to their neighboring breast cells. Over time, these cancer cells can grow and invade nearby healthy breast tissue and make their way into the underarm lymph nodes. Once in the lymph nodes, they now have a pathway to other tissues in your body.
Who gets breast cancer?
About 200,000 new invasive breast cancers and 63,000 non invasive (in-situ) breast cancers were diagnosed in 2009. Only about 1% of all breast cancers will be diagnosed in men (Yes, men can get breast cancer too!) A woman’s risk of breast cancer approximately doubles if she has a first degree relative (mother, sister, daughter) who has been diagnosed with breast cancer.
Why do we get breast cancer?
About 10% of all breast cancers are due to a genetic mutation that we inherit from our mother or father. These are known as the BRCA1 and BRCA2 genes. Women with these mutations have up to an 80% risk of developing breast cancer during their lifetime, and they are often diagnosed at a younger age. An increase in other cancers are also associated with these gene mutations, specifically ovarian cancer is among those cancers. All the rest of the cancers we diagnose (90%) are not due to heredity, but to genetic alterations of the breast cell due to aging and life in general. We know that certain things we are exposed to increase our risk of breast cancer. Hormone therapy is among those things that we know increase breast cancer risk.
Where do I go for more information?
Web sites such as www.breastcancer.org
* and www.nationalbreastcancer.org
* are very informative. Cancer support groups are a good source of information and we can provide you with a list of local activities. Family members and friends who have been affected by breast cancer may be a good place to seek more information.