With aging, a woman's breasts lose fat, tissue, and mammary glands, reducing breast size, firmness, and fullness. The breasts lose support. These changes are mostly due to a decrease in the hormone, estrogen.
Aging breasts commonly flatten and sag, and the nipple may turn in slightly. The area surrounding the nipple (the areola) becomes smaller and may nearly disappear. Loss of hair around the nipple is common.
Breasts may change in size as a woman grows older. Lumps are common around the time of menopause. These are often noncancerous cysts. However, if you notice a lump, make an appointment with your doctor. Breast cancer risk increases with age. Women should perform monthly breast self-examinations. However, because breast self-exams do not always pick up early stages of breast cancer, women should also talk to their health care provider about mammograms.
Breast Cancer
Breast cancer affects one in eight women during their lives. Breast cancer kills more women in the United States than any cancer except lung cancer. No one knows why some women get breast cancer, but there are a number of risk factors. Risks that you cannot change include
Age - the chance of getting breast cancer rises as a woman gets older
Genes - there are two genes, BRCA1 and BRCA2, that greatly increase the risk. Women who have family members with breast or ovarian cancer may wish to be tested.
Personal factors - beginning periods before age 12 or going through menopause after age 55
Other risks include being overweight, using hormone replacement therapy (also called menopausal hormone therapy), taking birth control pills, drinking alcohol, not having children or having your first child after age 35 or having dense breasts.
Symptoms
Symptoms of breast cancer may include a lump in the breast, a change in size or shape of the breast or discharge from a nipple. Breast self-exam and mammography can help find breast cancer early when it is most treatable. Treatment may consist of radiation, lumpectomy, mastectomy, chemotherapy and hormone therapy.
Men can have breast cancer, too, but the number of cases is small.
Breast Biopsy
A breast biopsy is the removal of breast tissue to examine it for signs of breast cancer or other disorders. Several different types of biopsy may be done. This article discusses open breast biopsy. An open biopsy involves making a small cut in the breast and removing breast tissue.
An open biopsy may remove part (incisional biopsy) or all (excisional biopsy) of the area of interest. If the entire lump or area of interest is removed, this method may also be called a lumpectomy.
If the surgeon cannot easily feel the lump or cyst, breast ultrasound or mammography may be used before the biopsy. A needle or wire is placed in the area of interest. This will be left in to help the surgeon.
The biopsy will be done in an operating room.
Usually, you lie on your back for the procedure. You may receive local anesthesia with medicine to make you sleepy or you may receive general anesthesia.
A surgical cut is made in the skin. The wire and breast tissue around it are removed. Sometimes, testing is done at the time of the procedure, but a final diagnosis takes more time.
After the tissue sample is taken, the cut is closed with sutures. A dressing and bandage are applied.
If you receive general anesthesia, your vital signs (temperature, pulse, rate of breathing, blood pressure) will be monitored for at least an hour after the procedure. Your health care provider may prescribe pain medication.
How to Prepare for the Test
The health care provider will ask questions about your medical history and perform a manual breast exam.
You must sign an informed consent form. If you are going to have general anesthesia, you may be asked not to eat or drink anything for 8 - 12 hours before the test.
If you take medications (including aspirin or herbal medications), ask your doctor whether you need to stop taking these before the biopsy.
Tell your doctor if you may be pregnant before having an open biopsy.
Do not wear lotion, perfume, powder, or deodorant underneath your arms or on your breasts.
How the Test Will Feel
After the test, the breast may be sore and tender to the touch for several days. If a surgical cut is made, your doctor may prescribe pain medication.
You will probably go home the day of the procedure.
Do not do any heavy lifting for 24 hours after the biopsy. Do not take a shower for the first 24 hours.
Why the Test is Performed
A biopsy may be done if the doctor is concerned about breast cancer because of abnormal findings on a mammogram or breast ultrasound, or seen during a physical exam.
To determine whether someone has breast cancer, a biopsy must be done. Cells from the abnormal area are removed and examined under a microscope.
Normal Results
A normal result means there is no sign of cancer.
Your doctor or nurse will let you know when you need a follow-up mammogram or other tests.
What Abnormal Results Mean
Biopsy may identify a number of breast conditions that are not cancer or precancer, including:
Adenofibroma
Fibrocystic breast disease
Intraductal papilloma
Mammary fat necrosis
Biopsy results may show the following precancerous breast conditions:
Atypical ductal hyperplasia
Atypical lobular hyperplasia
Two main types of breast cancer may be found:
Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
Lobular carcinoma starts in parts of the breast called lobules, which produce milk.
Depending on the biopsy results, you may need further surgery or treatment.
Risks
There is a slight chance of infection at the injection or incision site.
Excessive bleeding is rare, but may require draining or re-bandaging. Bruising is common.
There will be a small scar. Depending on the amount of tissue removed and how the breast heals, the appearance of the breast may be affected.
Alternative Names
Biopsy - breast; Open breast biopsy
Most women experience breast changes at some time. Your age, hormone levels and medicines you take may cause lumps, bumps and discharges.
If you have a breast lump, pain, discharge or skin irritation, see your health care provider. Minor and serious breast problems have similar symptoms. Although many women fear cancer, most breast problems are not cancer.
Some common causes of breast changes are
Fibrocystic breast condition - lumpiness, thickening and swelling, often associated with a woman's period
Cysts - fluid-filled lumps
Fibroadenomas - solid, round, rubbery lumps that move easily when pushed, occurring most in younger women
Intraductal papillomas - growths similar to warts near the nipple
Blocked or clogged milk ducts
Milk production when a woman is not breastfeeding
Injury
NIH: National Cancer Instituteclick to expand your study
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