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Kent Hospital
Kent Hospital

Answers to Your Breast Health Questions

What is a digital mamogram? Is that the same as thermography?

Digital mammography is similar to film mammography in that it uses xrays to visualize breast tissue. However, it is equipped with a digital receptor and a computer instead of a film cassette.  It provides a faster and clearer picture. It's like high definition TV compared to regular TV. The picture is clearer and crisper and shows more and better detail.

Thermography is different from mammography. It uses heat to provide images. The concept is that breast cancers are highly metabolic and are very vascular, thus they give off more heat than normal tissue. This is the case in  some instances, but slow growing tumors may not show up. Thermography has not been proven to be as good as mammography for screening women for breast cancer.

Answered by Candace Dyer, MD, Physician Director, The Breast Health Center at Kent 
 


  
What risk reducing steps would you advise someone who is BRCA1+ take?

If someone is BRCA1 positive there are many risk reducing steps that one can take which include heightened surveillance (for the breast this can include mammography alternating with MRI along with clinical breast exam; for the ovary transvaginal ultrasound with concurrent CA125 values/gynecologic exam over time), medical risk reduction (for the breast this could include the use of tamoxifen; for the ovary the use of oral contraceptives and not both at the same time) and prophylactic surgery options (such as bilateral mastectomy for the breast and bilateral salpingo-oophorectomy for the ovary).
 
Having a clear plan and review of options is critical.  Most importantly, I would recommend an appt with a genetic counselor to review all of these issues, put them into overall and temporal perspective and to "get a game plan".  This can also help, along with your primary doctor, to determine which specialists you need to see.  You can call the Breast Center for an appt with a genetic counselor. 
 
Answered by Robert Legare, MD, Director, The Breast Health Center at Women & Infants, Program in Women's Oncology


 

I am unemployed and unisured, are you holding Mammograms at no charge.  My last one was in January 2008.

Yes, please call 736-3737 to schedule an appointment.


 

10 years ago I had atypical cells removed from my right breast and was on tamoxifen for 5 years.
Is that considered cancer?
 
Atypical cells are not cancer, but are associated with an increased risk of breast cancer in either breast in the future. Tamoxifen has been shown to reduce new cancers in the breast in large multicenter studies. We use it to reduce the rate of new cancers in women at risk. It sounds as though you had Tamoxifen for this indication.

Answered by Jennifer Gass, MD, Assistant Director, The Breast Health Center at Women & Infants, Program in Women's Oncology


 

Will sitting in front of a computer all day cause you to get breast cancer?

I am not aware of any correlation between computer work and breast cancer.

Answered by Candace Dyer, Physician Director, The Breast Health Center at Kent


All my life my right nipple has been inverted and now for the past 6 months i noticed that it is erect like my left nipple. I had a mammogram last february telling me that the mammogram was normal. Should I be concerned about this?

Any change should prompt a clinical exam, even if the mammogram is normal. However, eversion of the nipple with a normal exam and a normal mammogram is unlikely to be anything worrisome.

Answered by Candace Dyer, MD, Physician Director, The Breast Health Center at Kent 


I go for my mammogram every year. I am 72. If you have breast cancer do you have pain with it. I am due for my mammogram in December.

Yearly mammograms are recommended for women between the ages of 50 and 70. There is no standard as to how long women should be screened for breast cancer with mammograms but the general consensus depends on how healthy the woman is and what other risk factors she might have. If her life expectancy is over 10 years I recommend continuing screening mammograms every year, or every other year in low risk patients.

Breast cancers do not usually cause pain. They are more likely to present with a lump, slight distortion of the breast or an abnormal mammogram. Pain is usually caused by a benign finding but anything that is different should be evaluated.

Answered by Candace Dyer, MD, Physician Director, The Breast Health Center at Kent 


I have two maternal aunts who tested positive for the BRCA gene.Should I be tested, and if so, what is involved?

Given that you have two maternal aunts who have been identified to harbor a BRCA mutation, I would strongly advise that you undergo genetic counselling.  This involves acquiring a family history before the appointment (and in your situation if your aunts could give you a copy of their genetic results this would be very helpful).  Then you would meet for 60 - 90 minutes in consultation with a genetic counselor to review family history, chances of harboring a BRCA mutation yourself and, if you so desire, you could have your blood drawn for the test on that visit.  Defining whether or not you have also inherited this mutation would likely have major impact on medical decision making.  You could make an appointment with a genetic counselor by calling the Breast Center. 
 
Answered by Robert Legare, MD, Director, The Breast Health Center at Women & Infants, Program in Women's Oncology  


    
 
I am hoping you can clarify something for me. My mom passed away from breast cancer at the age of 44. I lost my sister to breast cancer 2 years ago at the age of 51. My sister had genetic testing and she relayed to me she did NOT carry the gene that predisposes you to cancer. Do I need to be tested? I'm under the impression that since she's negative, I would be negative as well because if it's genetic, siblings would all be the same. I'm hearing different things about it. I also have 2 girls...ages 19 and 23. Would appreciate some advice. 

I am sorry about your mom and sister.  It is still possible that there could be a genetic predispostion to breast cancer in your family despite your sisters negative result, though her negative result decreases the probability of this.  Given your family history, I would strongly advise genetic counselling, where you can review your personal and family history and determine the appropriateness of genetic testing for you (which would also be helpful in strategizing for your children).  During that visit, you could also review risk reduction strategies, options for screening etc.  To make an appointment with a genetic counselor, please contact the Breast Health Center. 
 
Answered by Robert Legare, MD, Director, The Breast Health Center at Women & Infants, Program in Women's Oncology 


My mother was diagnosed with breast cancer in her 20's.  What steps should I take to protect myself ?

Given the early age at diagnosis of your mother, I would strongly recommend that you make an appt with one of our genetic counselors to review both hereditary risk as well as strategies for screening and risk reduction.  The best way to start is to call the Breast Center and ask to make an appt with a genetic counslor as part of our Cancer Risk Assessment and Prevention Program.  At this visit your history will be reviewed and recommendations made.

Answered by Robert Legare, MD, Director, The Breast Health Center at Women & Infants, Program in Women's Oncology   


Can using the drug propecia in women cause cancer? 

I am unaware of propecia being implicated in women's cancers.

Answered by Ashley Stuckey, MD, surgeon and gyn oncologist, Women & Infants' Program in Women's Oncology 


Do you believe that the regular intake of vitamin D helps prevent this disease?

Randomized trials have not shown a decrease in cancer risk with Vitamin D.  If vit D were shown to decrease the risk, the intake needed would require substantially higher intakes than are currently recommended.

Answered by Ashley Stuckey, MD, surgeon and gyn oncologist, Women & Infants' Program in Women's Oncology 


What's the best screening for very dense breasts?
 
Mammogram is still recommended for primary breast cancer screening.  Dense breasts only are not an indication for MRI use to screen for breast cancer.   

Answered by Ashley Stuckey, MD, surgeon and gyn oncologist, Women & Infants' Program in Women's Oncology   
 


I was wondering why I have issues with my nipple area always getting very itchy and sometimes I also have a white, dry substance coming out. I do have kids but my youngest is 16, I shouldn't have milk left.

Nipple discharge is often physiologic in nature and a benign finding.  However, you should always have this checked out by your physician.

Answered by Ashley Stuckey, MD, surgeon and gyn oncologist, Women & Infants' Program in Women's Oncology 


I have a friend who keeps getting cysts on her breast but she is too afraid to go to the ob. Why does this happen?

Cysts are fluid filled sacs that can be of varying size. They are very common, especially in pre-menopausal women and develop because of the changes the breast go through every month.  They may be painful and may become large. When this happens, the fluid can be aspirated, or removed with a needle which is not very painful to have done. These cysts are not malignant and have no malignant potential. Why some women get them and others do not is unclear.

Answered by Candace Dyer, MD, Physician Director, Kent Breast Health Center


I had to have one breast removed due to cancer now the other one is starting to leak, should I be worried?

Nipple discharge may be physiologic (normal) or pathologic (not normal). The characteristics of the fluid can often determine how serious it is. Clear, sticky or bloody discharge needs to be investigated. Green or yellow usually does not. Most of the time it is due to a non-malignant condition but women with a discharge should always be evaluated.

Answered by Candace Dyer, MD, Physician Director, Kent Breast Health Center


Do you offer BRCA support groups at your new site?

BRCA support groups are offered at the Breast Health Center in Providence, but open to all BRCA mutation carriers.
 
Answered by Robert Legare, MD, Director, The Breast Health Center at Women & Infants, Program in Women's Oncology 


I have a fluid filled cyst in my breast and the radiologist told me that I could just leave it there in which i did.  My family and I are thinking that she miss informed me due to the fact the fluid was not tested.  Can it be a form of cancer if it is filled with fluid or only if it is a solid mass?

Fluid filled cysts are part of the spectrum that is labeled fibrocystic breast disorder.  Whether or not fibrocystic change is a true disorder is somewhat of a debate, given how commonly it is found in women, particularly in their 40's, but earlier and later in life as well.  Most fibrocystic disease lessens with menopause. Cysts and fibrocystic disease can cause pain that can be cyclic with the menstrual cycle, or persistent. Some women have cysts drained because they are painful. Fluid analysis in this scenario is not particularly useful. A simple fluid filled cyst is almost categorically benign. While not immune from cancer, it is not prone to cancer. Some cysts have features on imaging that makes them complex, and often these are recommended for aspiration. A thickened wall, a septation (wall within the cyst) or an area with solid characteristics are some examples of findings that can make a cyst complex. Solid nodules have a different appearance on ultrasound. Many of these will need imaged guided needle-biopsy. The best way to know if a nodule is solid or fluid filled is an ultrasound.

Answered by Jennifer Gass, MD, Assistant Director, The Breast Health Center at Women & Infants, Program in Women’s Oncology 


Do you give mammograms to women who do not have health insurance? 

Yes. If you are older than 40, a Rhode Island resident, and do not have health insurance.  To schedule an appointment, call 401-736-1988.

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