Thoughts about diagnosis

Not much different today so I thought I would give a few of my thoughts about the diagnosis of breast cancer based on our experience.

• Mammograms can miss even extensive breast cancer. Sally had a normal mammogram 2 weeks before her diagnosis of extensive cancer. An alert clinician examining Sally noted that the consistency of the breast had changed in the past year and suggested ultrasound. Ultrasound was equivocal so a biopsy was done at our request that revealed the cancer. Of course mammograms are useful for detecting early cancer in many cases and every woman should get them, but they are no guarantee that there is no cancer.
• If a biopsy is suggested, do it. Even if there is some equivocation about whether you could wait, don't. Get the biopsy and get the answer one way or another.
• Not all breast cancer is the same. There are many different types of cancer. With breast cancer there is ductal carcinoma (about 85-90% of cases) and lobular carcinoma (10-15%). Sally has lobular carcinoma. This type arises out in the peripheral parts of the breast, often is not detected by mammogram, and often does not form a discrete mass that can be felt. It may arise in several places in the breast or in both breasts and may not be discovered until it has spread. This was the case with Sally.
• Do not continue hormone replacement therapy (HRT) indefinitely. This definitely increases the risk of breast cancer and was a risk factor with Sally. If you can, don't use HRT at all.

I guess that is enough for now. Keep vigilant and don't ignore any suspicious changes in the breast--whether it is a change in consistency, appearance of the skin, or appearance of the nipple.