What Do All of My Doctors Do?

Gynecologist

For many women, their gynecologist is their primary care doctor.  Your gynecologist will be caring for you throughout your treatment and beyond.  She may be the person who provides a referral to a breast surgeon and/or oncologist.  She will be the one keeping an eye on your ovaries because there is an increased risk of ovarian cancer once you are diagnosed with breast cancer.   She will also be the one you will go to if you want a hysterectomy (procedure to remove the uterus and cervix) and/or oophorectomy (procedure to remove the ovaries).

Radiologist

The radiologist is the doctor who reviews the results of screening tests such as mammograms and ultrasounds.  This doctor may be the one that finds your cancer while it is still very small (perhaps still too small to feel).  Apart from reading films, radiologists also perform biopsies in their offices utilizing mammogram or ultrasound technology. (more…)

When you have all or some of your lymph nodes removed, you run the risk of getting a condition known as Lymphedema. This happens when the body cannot filter the lymphatic fluid properly throughout your arm or chest area because of scarring and/or the absence of lymph nodes.  As a result, swelling can occur in your arm and sometimes your chest and trunk area. The swelling must be taken seriously because the trapped fluid is a prime host for bacterial infections that can lead to cellulitis (inflammation of connective tissue including severe inflammation of the outer layers of the skin) and sepsis (a potentially deadly medical condition characterized by a whole-body inflammatory state caused by severe infection).

The treatment for lymphedema is compression and lymphatic massage that trains the body to use its superficial lymphatic pathways to channel the fluid out of your affected area. There is a very high success rate with treatment if you get it early.

The best treatment for lymphedema is prevention.

Preventing Lymphedema

There are things that can be done in the very early stages of lymphedema that can prevent it from becoming a problem. The key is to recognize the symptoms of swelling and act quickly.

Things that produce lymphatic fluid in your arm

• Extreme heat (hot baths, doing the dishes)
• Strenuous repetitive exercises (mopping, sweeping, raking, etc)
• Sunbathing, sun exposure, sun burn
• Extreme cold (ice packs)

Things to Avoid

• Tight clothing around your wrist
• Tight bras that leave an indentation
• Carrying grocery bags, heavy purses, etc. with affected arm
• Getting your blood pressure checked in that arm

Breast Abnormalities

Breast tissue can develop abnormalities.  Sometimes these abnormalities are cancerous and sometimes they are not.  A breast abnormality is usually referred to as a lump.

A lump in the breast can be made of normal cells or cancer cells.  A lump may be found using mammography, ultrasound or MRI or felt during a breast exam (by your doctor or you).  Once a lump is found, a biopsy can be done to remove a piece of the tissue from it to determine if there are cancer cells present.

Cancer cells are cells that are abnormal and grow in an uncontrolled way.  They may stay in the place where they started to grow, or they may grow into the normal tissue around them.  Usually breast cancer begins either in the cells of the lobules, which are the glands that produce milk, or in the ducts, which are the passages that drain milk from the lobules to the nipple.  Cancer cells can also spread beyond the breast into other parts of the body.

Non-invasive cancers stay within the milk ducts or milk lobules.  They do not grow into or “invade” the normal tissue within or beyond the breast.  Non-invasive cancers are sometimes called in situ.

If the cancer has grown into normal tissues, it is called invasive.  Most breast cancers are invasive.  Sometimes cancer cells spread to other parts of the body through the blood or lymph system.  When cancer spreads to other parts of the body it is called Metastatic breast cancer.

The Most Common Types of Breast Cancer

DCIS – Ductal Carcinoma In Situ.  This is cancer is non-invasive; it stays within the milk ducts.  DCIS is considered the earliest form of breast cancer.

LCIS – Lobular Carcinoma In Situ. This is cancer is non-invasive; it stays within the milk lobules.   LCIS usually doesn’t show up on mammograms; the condition is most often discovered as a result of a biopsy done for another reason, such as a suspicious breast lump or an abnormal mammogram.   Women with LCIS have an increased risk of developing invasive breast cancer.

IDC – Invasive Ductal Carcinoma.  This is a cancer that began in the milk duct but has grown into the surrounding normal tissue within the breast.  This is the most common kind of cancer; about 80% of all breast cancers are invasive ductal carcinomas.   Sometimes IDC is called infiltrating ductal carcinoma.

ILC – Invasive Lobular Carcinoma.  This is a cancer that began in the milk lobule but has grown into the surrounding normal tissue within the breast.  ILC typically doesn’t form a lump, as most women expect with breast cancer.  Instead, ILC more often causes a thickening of the tissue or fullness in one part of the breast.

Other, Less Common Types of Breast Cancer

Inflammatory Breast Cancer.  Inflammatory breast cancer is a very rare (found in 1%-5% of breast cancers diagnosed) but aggressive form of breast cancer. It presents itself with swelling, a feeling of heat inside the skin, a red hue to the breast area and the breast sometimes swells up too.  Often this is often initially misdiagnosed as mastitis, which is a breast infection.   Inflammatory breast cancer occurs when cancer cells block the lymphatic passages in skin covering the breast, causing the characteristic red, swollen appearance of the breast.  Inflammatory breast cancer is considered a locally advanced cancer — meaning it has spread from its point of origin to nearby tissue and possibly to nearby lymph nodes.

Medullary carcinoma.  This is a form of invasive ductal carcinoma but it is found in only 3%-5% of all breast cancers diagnosed.  Medullary carcinoma of the breast may not always feel like a lump, but rather, like a thick, spongy area of breast tissue.  This type of breast cancer can produce swelling from within your breast.   The cells for medullary carcinoma are large and tend to stay together and expand in one place.

Phyllodes.  Phyllodes are very rare tumors, accounting for less than 1% of all breast tumors.  Phyllodes tumors tend to grow quickly, but they rarely spread outside the breast.  Although most phyllodes tumors are non- cancerous, some are cancerous.