FAQs About Your Care

This Q&A section is intended to provide some basic information and should not substitute for consultation with your physician.

What is a breast cyst?

A breast cyst is a benign condition where fluid accumulates in the breast within a cavity. Cysts are often sensitive or painful. They can sometimes be felt on exam or seen on mammogram or ultrasound. Ultrasound is usually definitive in identifying a cyst. Cysts can be followed or may be aspirated with a small needle to remove the fluid. Cysts that contain bloody fluid or do not completely resolve with aspiration should be investigated further.

What is a stereotactic biopsy?

When an abnormality is seen on mammogram and cannot be palpated it can be tested by using a computerized mammogram machine. The patient lies on a table with the breast suspended through an opening. The breast is compressed as in conventional mammography and digital mammograms taking localizing the lesion. The location of the biopsy is determined with calculations performed by the computer. The breast is cleansed, anesthetized and a small incision made to introduce the biopsy needle. Several cores of tissue are taken. A small marker is inserted in the breast to mark the area of biopsy. This is permanent and causes no harm. Results are usually available within 48 hours.

What is a sentinel node biopsy?

Breast cancer may spread through the lymphatic system. One method of detecting spread is sentinel lymph node (SLN) biopsy. This technique involves injection of material into the area under the nipple which has abundant lymphatic channels. The material travels through the lymphatics and taken up in lymph nodes under the arm. These are the sentinel nodes and are the most likely to contain cancer cells if any do. These are removed through a small incision under the arm and tested while the patient is under anesthesia. If positive an axillary node dissection is done. If negative then no further lymph nodes need to be removed. The advantage of the SLN procedure is to avoid the axillary dissection in most people. This reduces the complication of lymphedema which causes swelling of the arm and may cause pain or numbness in the upper arm.

What is an FNA and how is it performed?

Fine needle aspiration (FNA) can be done to evaluate an area of the breast by removing a core of cells with a small needle. This produces a drop of cellular fluid that is prepared for cytological exam that can identify malignant or suspicious cells. This can be done with no anesthesia or a small amount of local. Results are available within 48 hours.

What is the difference between DCIS and invasive ductal carcinoma?

Cancers of the breast are being found earlier with increased use of mammography and ultrasound. Many of these are ductal carcinoma insitu (DCIS) which are preinvasive cancer. These cancers are contained in the ducts and not spread beyond the breast. They have a significant potential to develop into invasive cancers. Invasive cancers do have the potential to metastasize and may spread through lymphatics or the blood system. Sentinel lymph node biopsy or axillary dissection should be done for most invasive cancers and not necessary for most preinvasive cancers.

What are the choices of surgical treatment for breast cancer?

Most breast cancer patients have several options for treatment. The cancer in the breast can be treated by partial mastectomy (lumpectomy) or total mastectomy. If a cancer is very large or multifocal (more than one cancer) then mastectomy is often recommended. Most patients have the choice of saving the breast or removing the breast. The lymph nodes under the arm can be examined by sentinel lymph node biopsy or axillary dissection whether lumpectomy or mastectomy is done. If the breast is saved then some form of radiation is usually necessary. This typically consists of 6-7 weeks of daily (M-F) radiation involving about 30 minutes at the radiation facility. Another form of radiation – partial breast radiation – is available for some patients depending on pathology and anatomy which is administered twice a day for five consecutive days.

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