Breast Care
Screenings to detect cancer early and personalized treatment plans for after a diagnosis
Your life. Your breasts. Know your risk.
Change Your Odds
Your breast cancer risk depends on genetics, lifestyle and other factors. Change your odds with personalized guidance for healthy living, regular screenings (including mammogram) and more lifesaving treatments to attack breast cancer than ever before.
You’re in The Driver’s Seat
Regular screenings give you the best chance of finding breast cancer early and increasing your chances of successful treatment. We’ll show you how.
In Your Corner
Hormonal or biological therapies, surgery, radiation therapy and chemotherapy - there are more lifesaving treatments to attack breast cancer today than ever before.
Some of our common services:
Early detection of breast cancer is essential for treatment and increases the likelihood of a positive outcome. We recommend the following screening methods:
All women over 20 years of age are encouraged to perform a monthly breast self-exam. Being familiar with the feel and look of your breasts lets you immediately recognize when something is different or does not feel right. Self-exams let you learn what is normal for your breasts, especially as they change through the course of your life.
For women who menstruate, the optimal time of the month to do a BSE is two to three days after your menstrual period ends. If you no longer menstruate, pick a day such as the first day of the month or other regularly occurring event, such as the date your phone bill is due, to help remind yourself that it is time to do your BSE. If you’re unsure how to perform a self-exam, you can visit the American Cancer Society’s website for detailed instructions.
Screening mammography is the type of mammogram that uses a low-dose X-ray of your breasts to check for cancer when you have no symptoms. Diagnostic mammography is done for women who have had a “call back” from a screening mammography or who have a clinical breast symptom, such as a lump. There are different clinical recommendations about when is the best time to start getting screening mammograms, but we suggest women begin getting yearly mammograms after age 40.
There are two types of Mammograms: 2D Mammography takes two images of each breast from different angles, and 3D Mammography (or Tomosynthesis) is a newer type of mammography that takes multiple images of each breast.
For most women, this is not an uncomfortable process, though some mild discomfort may be experienced if a woman’s breasts are sensitive. Discomfort can be minimized by scheduling the mammogram just after the menstrual period ends, and by avoiding caffeinated foods and beverages one to two weeks prior to the examination.
All screening mammograms are read individually by a specialized breast radiologist, aided by a state-of-the-art computer-assisted detection system.
Ultrasounds can be useful for looking at specific breast changes, such as lumps or changes in dense breast tissue, as well as focusing on areas that might look suspicious after an MRI has been performed. Ultrasounds can also tell the difference between fluid-filled cysts (which are unlikely to be cancerous) and solid masses (which may require additional testing). Ultrasounds can also be used to help guide biopsy needles.
Ultrasounds are widely available, easy to have done, are rarely painful and do not expose a person to radiation.
Magnetic resonance imaging (MRI) is a powerful tool for detecting breast cancers that mammography and ultrasound may miss. MRIs are often used in women who already have been diagnosed with breast cancer, to help measure the size of the cancer, look for other tumors in the breast and to check for tumors in the opposite breast. Because it can help measure the size of the cancer and look for other tumors, it may also be useful in planning the best treatment for women newly diagnosed with the disease.
For certain women who are at a high risk for breast cancer, a screening MRI is recommended along with a yearly mammogram. MRI is not recommended as a screening test by itself because it can miss some cancers that a mammogram would find. MRIs are not recommended as a screening test for women at average risk of breast cancer.
A biopsy is the only method of determining whether a breast abnormality is cancerous, and typically will be performed if a screen finds an abnormal lump or mass. A biopsy involves removing a small piece of tissue from the breast, either with a needle or during surgery, and checking it in a lab to see if cancer is present. Once the tissue is sampled, it is sent to a pathology lab for analysis, and that information can reveal details about the cancer that will guide treatment decisions.
There are several different types of biopsies available. Each method is as accurate as a surgical biopsy and is performed on an outpatient basis. Procedures typically take an hour to perform, and patients can normally resume daily non-strenuous activities shortly after.
Stereotactic-guided breast biopsy – Using a specially designed table, two digital X-ray images are taken from different angles, allowing the radiologist to precisely localize the area to biopsied. Once the area has been located, the radiologist numbs the area with a local anesthetic, then uses computer guidance for precise needle placement and collection of small tissue samples.
Ultrasound-guided needle biopsy – The radiologist uses ultrasound to locate the area for biopsy and to direct the needle used in collecting breast tissue samples. If the lesion is a cyst, a cyst aspiration (removing the fluid from a cyst) can also be performed using ultrasound guidance. This procedure takes less than 20 minutes to perform.
MRI-guided needle biopsy – If a lesion is found which is detectable only by MRI, we may perform a MRI-guided biopsy to sample the tissue.
The leading risk factor contributing to a woman's likelihood of developing breast cancer is her age. Other risk factors include:
- Increasing age
- Family or personal history of breast cancer
- Inherited genetic mutations
- Diet and obesity
- Lifestyle habits
A woman is considered to be at particularly high risk for breast cancer if:
- Her mother or sister was diagnosed with breast cancer BEFORE menopause
- She is a known breast cancer gene carrier (genetic testing shows BRCA1/BRCA2)
- She has a history of high-dose radiation to breasts (such as for Hodgkin lymphoma)
For these women, screening mammograms are recommended at an earlier age, usually 10 years before the primary relative was diagnosed with breast cancer.
Your care team will help you identify the relevant risk factors so you take action to reduce your risk.
The most common warning sign of breast cancer is a lump or mass in the breast or under the arm. Some other signs to be aware of include:
- Swelling or abnormal thickening of the breast
- Scaly or dimpling breast skin
- Pain, discharge or retraction of the nipple
There are many advanced therapies that can be combined and coordinated to treat breast cancer based on an individual’s needs.
Some cancer cells may remain after a tumor is removed by surgery. Radiation therapy uses X-rays or other types of radiation to kill cancer cells left behind or keep them from growing. The type of radiation therapy given depends on the type and stage of cancer being treated.
Given by mouth, infusion or injection, chemotherapy drugs either kill cancer cells or stop the cells from growing and spreading in the body. If the cancer is advanced and can’t be controlled, chemotherapy may be used to help ease symptoms and improve one’s quality of life.
Certain cancer cells are affected by hormones, which help the cancer cells grow and spread. For some types of cancer, hormone therapy is used to stop hormones from getting to the tumor. Recent research shows these drugs are effective in helping prevent breast cancer among women at high risk.
This therapy uses drugs to attack cancer cells based on their biological features that help them grow, divide and spread. Sometimes called targeted therapies, these drugs preferentially target cancer cells rather than attacking all fast-growing cells the way chemotherapy drugs do.
Washington's breast density notification law goes into effect on January 1, 2019. After receiving a mammogram, you will be notified if you have dense breasts. This information is meant to increase your awareness about your health and to encourage you to speak with your doctor about any concerns.
Dense breasts are a radiological finding and cannot be felt on a physical exam. Dense breasts are important for two reasons: they can make it more difficult for radiologists to detect cancers on a mammogram and they have been linked to a slightly higher breast cancer risk. About half of women have dense breasts, and it is considered normal.
Having dense breasts does not mean you're at a high risk of getting breast cancer. It's important to talk with your doctor about your overall breast cancer risk to determine if additional breast cancer screening is needed.
We encourage all our patients, as well as their friends and families, to learn as much as possible about breast cancer. The following resources may be useful:
Oncology Rehabilitation – Oncology rehabilitation therapy decrease the risk of infection and reduces swelling of body parts following a cancer diagnosis. Therapy includes lymphatic mobilization; compression bandaging, exercise, and skin care with the goal of learning self-management techniques. Treatment is provided by licensed occupational and physical therapists, who are specially trained in lymphedema management.
Patient Education Room – The Seattle Breast Center offers a resource library, located near our reception desk that includes educational information on breast health and cancer. The room can also be used for small meetings and patient/physician meetings.
Other Resources – In addition to the information and resources provided on this site, there are books and other breast cancer websites that may be useful to you and your family. Keep in mind that no information should replace your doctor’s advice or medical treatment.
RadiologyInfo.com: Radiologic Society of North America’s website features general patient information site and frequently asked questions.
Imaginis: General information for patients about mammography.
FDA Online guide for Mammography Consumers: General mammography information for patients including FDA Consumer Mammography-related articles.
MEDLINE Mammography: Up-to-date news and information on Mammography plus links to other useful sites and resources.
American Cancer Society: This website has basic cancer information and details about breast cancer. ACS programs and special events as well as recent news about breast cancer are also available here.
NCCN Guidelines for patients: National Comprehensive Cancer Network’s website offering guidelines for patients with breast cancer.
National Cancer Institute Breast Information: The National Cancer Institute’s website providing information on all forms of cancer.
Susan G. Komen Foundation: Information about the Komen foundation and its efforts to support breast cancer research. Find out more about the organization’s annual fundraising event, the Race for the Cure.
Oncolink: Find out about clinical trials and review regularly updated news about breast cancer on this site.
Facing Our Risk: This website is for women who have a high hereditary risk for breast cancer. It addresses the issues around family history and genetic status in relation to detection and treatment.
Emotional support is an important part of your treatment. Support groups and community resources can help you and your loved ones get through your treatment and recovery.
Nearly all women with breast cancer have surgery as part of their cancer treatment. It’s done to remove as much of your cancer as possible and give you the best chance of becoming cancer-free.
Also called breast-conserving surgery, a lumpectomy keeps the breast intact. During this procedure, the surgeon removes only the tumor and a small amount of surrounding tissue. He or she may also remove some of the lymph nodes under the arm to see if the cancer has spread.
Mastectomy is surgery to remove the whole breast and may be the best option depending on the type of cancer. A mastectomy can be done in several ways, and your surgeon will talk with you about which option they recommend for you.
This is additional surgery to rebuild the look and shape of the breast after a lumpectomy or mastectomy. Deciding whether to restore the breast can be a difficult decision. Your care team can provide guidance about available options and what to expect.
We're committed to providing thorough and timely follow-up on all lab tests and diagnostic imaging. While it can take up to two weeks for results to be returned, typically we’re able to get them back to you faster. You will receive your test results during an in-person appointment, via a phone call or through the online MyChart portal (if you are signed up).
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