by Lisa F. Baron, M.D., Chief of Mammography, Hollings Mammography Center

One in eight American women will develop breast cancer by the age of 85. This means that approximately 182,000 women will be diagnosed with breast cancer this year. Yet, most of these women will do very well despite the diagnosis and will live a normal life expectancy. Early detection is the key to help maximize the chances for a healthy and long life following the discovery of breast cancer.

What are the warning signs of breast cancer? How does one perform breast cancer screening?

The most important factor in breast cancer screening is commitment and education. Breast cancer screening involves three parts: monthly self-breast examinations, yearly clinical breast examinations by a health care provider and yearly mammograms beginning at age 40.

When used routinely, breast cancer screening can be highly effective in detecting cancer. However, it is important to understand that the three components of breast cancer screening are not 100 percent effective in discovering all breast cancers. This is because there is a threshold of when cancer can be detected through mammograms and physical examination. Thus, a constant vigilance is needed to detect the earliest warning signs of cancer.

Knowing the warning signs of breast cancer can allow you to alert your health care provider as early as possible that there may be a problem.

Each month you should perform a self-breast examination. It is best to perform the exam a week after the menstrual period. If you discover any of the findings listed below you should consult with your health care provider promptly so that additional testing may be performed, if needed. Findings that are of concern include:

• A visible lump in the breast or a lump that can be felt within the breast. It is important to alert your health care provider immediately even if your last mammogram was normal. This is because mammograms do not detect all breast cancers, even if the lump can be felt.
• Changes in the skin color or texture in the breast. Skin thickening, redness, ridging are important findings to discuss with your health care provider.
• Depression or dimpling of the skin. Sometimes this findings are noticed best when the arm is lifted up or down. By observing the breasts in the mirror when the arms are raised or lower may alert you to this important finding. If you notice skin dimpling or depressions you need to notify your health care provider.
• Changes (new findings) in the appearance of the nipple such as retraction or inversion (pulling in of the nipple). Some women are born with the nipple(s) being turned inward. This can be a normal finding. However, if this is a new finding then you need to contact your health care provider. Pulling in of the nipple may indicated a cancer growing behind the nipple.
• Bloody or spontaneous discharge of any color from the nipple. Clear, greening or milky discharge can sometimes be squeezed from the nipple - this is normal. However, if the discharge is not clear it should be tested for blood. Sometimes, your health care provider may send a sample of the fluid to have it examined under the microscope.
• Swelling of the breast or of the lymph nodes (in the arm pit). Your health care provider needs to be contacted if you notice a change in the size of one breast (swelling or shrinkage) compared to the other side. Sometimes breast cancer growth results in the breast tissue being pulled in resulting in an overall “shrinking” of the breast. Other times it may result in a diffuse (widespread) swelling of the breast.

If you notice any of these warning signs of breast cancer do not panic. Call your health care provider early and have it checked out. Not all these changes may represent cancer but you will not know unless you are examined. If you do not have a health care provider or want more information about breast cancer screening and treatment you may call the MUSC Health Connection at 792-1414. If you have any questions regarding breast cancer screening or need to schedule a mammogram please call the Hollings Mammography Center at 792-1999.