Breast pain may have multiple origins, including but not limited to: fibrocystic changes, cysts, infection, hormonal cycle, trauma, dietary factors, inflammation from external sources, etc.
If you have breast pain, it is a good idea to see your breast physician for a workup, diagnosis and treatment.
However, your family history can put you in a higher risk group for breast cancer.
If you have a family history of breast cancer you should see your breast physician for a discussion of the appropriate screening modalities available to you.
Breast MRIs are indicated in some breast cancer patients before surgery to exclude disease in the opposite breast and to evaluate the extent of disease in the affected breast. The decision for a breast MRI will usually be made after discussion with you by your physician and is usually based on your personal risk factors, your age and the type of breast cancer you have.
Breast MRIs are frequently performed for women receiving chemotherapy or hormone therapy before surgery to gauge the response of the tumor to therapy.
Risks that the individual can control include:
- Obesity (fat cells in women produce extra estrogen hormone)
- Alcohol (How much is too much is still being debated. However, most experts agree that alcohol can increase breast cancer risk incrementally)
- Tobacco (Not only can smoking increase your risk of getting breast cancer, but smokers with breast cancer do worse than non-smokers with breast cancer.
- Hormone therapy (Hormones, like estrogen, can increase risk of breast cancer. Risk is related to the length of time used. Risk seems to decrease with time once they are stopped)
Most nipple discharge will be from a benign etiology.
A new, spontaneous, unilateral nipple discharge should initiate a visit with your breast physician.
- Tamoxifen: Original hormone treatment for breast cancer. Can be used in premenopausal women.
- Raloxifene : Primarily used for osteoporosis. Does reduce risk of certain breast cancers in high-risk individuals.
- Main risks: Blood clot, uterine cancer, menopausal symptoms.
- Anastrozole, Exemestane: These drugs have been shown to effectively reduce risk of breast cancer in post-menopausal women
- Risks: osteoporosis, bone pain/muscle cramps, menopausal symptoms
Currently, most physicians involved in breast cancer care agree that for invasive cancer—as long as the pathologist can demonstrate that all of the outside surface of the resected tissue (margin) is free of cancer cells—an adequate excision has been done.
For ductal carcinoma in situ, because of the way this grows, a clean margin of at least two mm is recommended.
Inadequate margins are a possible factor in breast cancer recurrence.
Ductal Carcinoma is graded (1-3). The higher the grade, the more aggressive it can be.
When diagnosed by needle biopsy, it requires further investigation as it may be associated with invasive cancer.
If you are receiving anesthesia of any type (general, twilight, sedation, etc.) a responsible adult (over 18) will have to drive you home. You cannot take public transportation, taxi, or uber/lyft home after having anesthesia.