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Important answers about breast cancer

Hospital news | Monday, October 1, 2018

National statistics show that one in eight women will develop breast cancer.

Cleveland Clinic Oncologist Mohammed Varghai, MD, who practices full-time at ACMC, said with early detection, there are more treatment options and better results.

Here are potentially lifesaving answers to five key questions about breast cancer:

Q: What are the warning signs of breast cancer?

A: The most common symptom is a new lump in your breast. Often, cancerous lumps feel different than noncancerous ones. In most cases, lumps that are painless, hard, oddly shaped and feel as though they are firmly attached within the breast are the most likely to be cancerous. However, this is not true 100 percent of the time – any lump or mass can become cancerous.

So don't take chances. Dr. Varghai said it is better to see your family physician if you notice any new lump or mass – even if a mammogram is normal, any breast changes should be checked by a physician.

"There are specific signs or symptoms we look for. Of course, a mammogram can tell us so much about the risk of a cancerous growth. However, you should immediately tell your family physician if you have any signs or changes," Dr. Varghai said.

Those signs include:

  • Swelling of all or part of a breast, even if you can't feel a distinct lump.
  • Dimpling or puckering in the breast skin.
  • Redness, scaliness or thickening of a nipple or breast skin.
  • A nipple turned inward.
  • Breast or nipple pain.
  • Nipple discharge (other than breast milk), especially if it's bloody.

Keep in mind that breast cancer sometimes spreads to lymph nodes under the arm or around the collarbone—even before the original tumor in a breast is large enough to be felt. This means you should also tell your doctor about any lumps or swelling in these areas.

Q: How often should I have a mammogram?

A: Most women should have a mammogram every year starting at age 40. Regular mammograms are a must because they can find tumors that are still so tiny that they cannot be felt during a regular exam. In addition, detecting breast cancer at an early stage increases the chances that it can be treated successfully.

However, if you have an above-average risk of breast cancer—for instance, if you have a family history of the disease—you may need to start getting mammograms before age 40. Talk to your doctor about a screening schedule that is best for you.

Be aware that growing older is never a reason to stop having regular mammograms. It is just as important for older women to have a mammogram as it is for younger women.

Finally, it is important to remember that mammography should be accompanied by regular clinical breast exams by a health professional.

Q: How often should I have a clinical breast exam?

A: Schedule one every three years if you're in your 20s and 30s. Starting in your 40s, you should have one every year.

Q: Do I need to have an MRI too?

A: Because of a risk of false positives, MRI is reserved strictly for women with a heightened risk of breast cancer. Ask your doctor if this imaging test is appropriate for you.

Q: If there is a shadow or area of concern, what's next?

A: If a physician determines a biopsy is needed, ACMC offers stereotactic breast biopsies. With this procedure, a physician uses a digital image to guide a needle into the breast to collect a sample of tissue. Stereotactic breast biopsy is minimally invasive and eliminates the need for an open surgery under general anesthesia. Patients who have had stereotactic breast biopsy at ACMC have reported little to no pain during and after the procedure.

Your family physician may refer you to an oncologist or suggest additional testing if there is a concern about cancer.

"The earlier we can detect the cancerous growth, the more options we have for treatment. Do not put off scheduled exams or recommended tests," Dr. Varghai said. "We do all the tests and, if necessary, treatment right here in Ashtabula."

ACMC offers 3-D digital mammography in Ashtabula and Conneaut. A referral from your healthcare provider is needed to schedule a mammogram. Once you have the referral, schedule an appointment with ACMC's radiology by calling 440-997-6686. Walk-in service is available in Conneaut for screening mammograms, but the provider referral is still required. Visit for more information on cancer and your health.