Why Jump to Conclusions? Abnormality on Mammogram May Not Indicate Breast Cancer, Advises MedSolutions.

October 2007 is Breast Cancer Awareness Month

NASHVILLE, Tenn. -- When an abnormality is detected on examination or on mammogram, it is not a foregone conclusion that the diagnosis is breast cancer, advises MedSolutions, a trusted partner for radiology management services for the nation's leading health plans. Regardless of whether the findings are due to malignant or benign disease, accurate diagnosis is critical to a woman's health and can only be achieved with a biopsy.

"Most abnormalities found by imaging or on physical examination are non-cancerous or benign, although women immediately presume that it is cancer and often question why the doctor is pressing so hard for a biopsy," says Daniel Garner, MD, a board-certified physician in radiation oncology and associate medical director of MedSolutions. "For some women, an abnormality may never be fully explained. However, it is always in a woman's best interest to arrive at an accurate diagnosis, with a continuing regimen of breast self-examination, physician examination, and mammogram continuing to be universally recommended."

He says that there are many conditions that may cause an abnormality on mammogram or physical examination, pointing to several:

Fat necrosis is not really a tumor, but it can act like one. This is simply a small portion of the breast that has lost its blood supply, then becomes firm. It is frequently mistaken for a breast tumor upon initial examination, and can be painful and sometimes, can become infected. Although rarely a cause for concern, an underlying breast cancer can be hidden by a coincidentally existing area of such necrosis, with surgical excision frequently advised.

Fibroadenomas appear as marble-like lumps in the breast that can range in size from microscopic to several inches in diameter. These tumors may appear singly in some women, while other women develop multiple fibroadenomas. These can be diagnosed with a simple needle biopsy. The presence of fibroadenomas is not associated with an increased risk of developing breast cancer, and they can spontaneously shrink without treatment. Once a single abnormality is found to be a fibroadenoma, similar appearing abnormalities can be assumed to be the same without biopsy. They are usually only surgically excised for cosmetic reasons or for usual growth rate.

Granular cell tumors are uncommon masses that appear in the breast as movable, firm lumps that measure about one-half to one inch in diameter. These tumors occur more frequently in the skin or mouth than in the breast, although they are rare in any location. They rarely cause symptoms, but are hard to distinguish from malignant lumps. The curative treatment for granular cell tumors is surgical removal of the mass along with a margin of normal tissue. These are also not associated with an increased risk of developing breast cancer.

Intraductal papillomas are small, wart-like, non-cancerous growths in the breast ducts that sometimes cause a nipple discharge. Obviously, nipple discharge is also a sign of cancer, so eliminating the source of a discharge is important. These are often found in women 45 to 50 years of age. Intraductal papillomas are treated by removing the tumor and a segment of the duct it is found in, usually through an incision at the edge of the areola (the dark area of skin surrounding the nipple). If a woman has multiple intraductal papillomas, the risk of developing breast cancer is slightly increased.

Hamartomas are a circumscribed benign nodule composed of variable amounts of fat, glandular tissue, and fibrous connective tissue. They usually do not cause symptoms, but unlike some of the other tumors discussed here, some hamartomas continue to grow, and this growth can be worrisome when noticed on repeated mammograms. Also, this growth can become a local problem, causing discomfort and possible cosmetic concerns. The majority occur in women over age 35 years. Surgical excision eliminates this potential problem. These are also not associated with an increased risk of developing breast cancer.

Benign hemangiomas are basically abnormal clusters of the tissues that form the walls of blood vessels. Frequently, these are not symptomatic, and can be diagnosed by typical appearances on mammogram or ultrasound. Rarely, the appearance changes or the mass becomes very hard, and biopsy is recommended and is curative. Again, not associated with a increased risk of breast cancer.

Atypical Ductal Hyperplasia is not technically a tumor but can feel or appear to be a mass on imaging. This is an abnormal collection of breast duct tissue cells which are growing at an abnormal rate. This condition is associated with an increased risk of cancer, but not all women with this condition go on to develop cancer. Surgical excision may eliminate the problem, but careful follow-up, and occasionally, repeated biopsies, are required.

"There are many other types of such benign conditions, in addition to those noted above," says Dr. Garner. "Also, other types of malignancies can be found in the breast, other than 'classic' breast cancer. These other types of malignancies are very rare, but are usually very curable."

About MedSolutions

MedSolutions specializes in managing radiology services for national and regional health plans as well as federal and state government agencies, maintaining management contracts for nearly 25 million individuals nationwide. The company leverages sophisticated analytics, personalized call center operations and extensive radiology care management experience to provide the most innovative, cost-effective radiology management solutions in the industry. Visit www.medsolutions.com.