Ask a question

Consult Dr. Sangeetha Kolluri

MONDAY | 9am - 4pm
Austin Cancer Centers - Park St. David's
900 E. 30th Street, Suite 100
Austin, TX 78705
512.334.2777

WEDNESDAY | 9am - 4pm
Austin Cancer Centers - Lakeway
200 Medical Parkway, Suite 120
Lakeway, TX 78738
512.334.2881

FRIDAY | 9am - 4pm
Austin Cancer Centers - Kyle
1180 Section Pkwy, Suite 150
Kyle, TX 78640
512.334.5202

Breast Cancer

What is breast cancer?

Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer. Breast cancer can begin in different parts of the breast. A breast is made up of three main parts: lobules, ducts, and connective tissue. The lobules are the glands that produce milk. The ducts are tubes that carry milk to the nipple.

The connective tissue (which consists of fibrous and fatty tissue) surrounds and holds everything together. Most breast cancers begin in the ducts or lobules. Breast cancer can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.

Kinds of Breast Cancer

The most common kinds of breast cancer are—

  • Invasive ductal carcinoma. The cancer cells grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.
  • Invasive lobular carcinoma. Cancer cells spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.
  • Ductal carcinoma in situ (DCIS) is a breast disease that may lead to breast cancer. The cancer cells are only in the lining of the ducts, and have not spread to other tissues in the breast.

There are several other less common kinds of breast cancer, such as Paget’s disease, medullary, mucinous, malignant phyllodes tumor and inflammatory breast cancer.

Found a lump in your breast?

Finding a lump in your breast can be alarming. Although breast cancer is the most common type of cancer found in women, not all lumps are cancer. Often, a lump in your breast can be caused by a benign breast mass or a fluid-filled breast cyst.

Yet in some cases, a cancerous lump in your breast can be too small to feel or cause any noticeable changes in your breast. Sometimes patients don’t experience any signs or symptoms of breast cancer. These types of breast cancer can only be diagnosed by having regular yearly mammograms and other screening tests.

However, as a rule of thumb, if you feel a change in your breast - something different or new - you should reach out to breast surgeon such as Dr. Kolluri for evaluation.

Symptoms of breast cancer

Breast health and breast self-awareness

Knowing how your breasts feel and look is a critical aspect of breast health. There is no such thing as an idyllic breast. What may feel normal to you may not be normal for others.

Most women examining their breasts for the first time say that their breasts are lumpy. Medication, periods, having children, losing or gaining weight are some of the factors that affect the way your breasts look and feel. Also, your breasts often change in size, shape and texture as you age.

It is important for you to maintain routine breast-self awareness of what is normal for your breasts, and be aware of any changes in your breasts. Knowing the signs and symptoms of breast cancer will help your breast surgeon provide the best possible care to you.

Signs and symptoms of breast cancer
According to the American Cancer Society, any of the following unusual changes in the breast can be a symptom of breast cancer:
  • A breast mass which is not painful
  • Swelling of all or part of the breast (even if no lump is felt)
  • Skin dimpling or nipple retraction (nipple turning inward)
  • Redness, scaliness, or thickening of the nipple or breast skin
  • A nipple discharge other than breast milk, such as blood or clear fluid from a single duct opening
  • A lump in the underarm

Breast cancer diagnosis

Breast cancer that is found early and has not spread is much easier to treat successfully. Since breast cancer tumors can be too small to show up as a lump or a visible change in your breast, the best way to find a tumor is to get regular screening mammograms.

Breast self-exam / breast self-awareness

Performing breast self awareness should be a part of everybody’s daily health care routine. It is critical to both visually inspect and self-palpate all areas of your breast, including your skin, breast tissue, nipple and underarm. This should be done throughout the month, so that you can get a sense of how your breast changes with your menstrual cycles, and what is normal for you. Your goal is to not only look for a lump in your breasts that you can feel, but also thoroughly examine your breasts for other more subtle changes in your breasts such as nipple changes or skin dimpling.

How often should a woman with average breast cancer risk get a screening?

  1. Women age >25 should undergo formal risk assessment for breast cancer
  2. Women with an average risk of breast cancer should initiate yearly screening mammography at age 40
  3. Women with a higher-than-average risk of breast cancer should undergo yearly screening mammography and be offered yearly supplemental imaging; this screening should be initiated at a risk-based age
  4. Screening mammography should cease when life expectancy is <10 years
Table 1 – Summary of ASBrS Recommendations for Breast Cancer Screening*

Ref ASBrS



*All women to undergo risk assessment at age 25-30 and updated at appropriate intervals

^Class A or 1 density = fatty; Class B or 2 density = scattered fibroglandular density; Class C or 3 density = heterogeneously dense; Class D or 4 density = extremely dense

#Women with prior breast cancer who did not undergo bilateral mastectomy

Mammograms

A screening mammogram is a type of imaging that uses a very low dose digital x-ray to evaluate your breasts. Doctors use mammograms to find a cancer in your breast that is still in its very early stages - even before the clinical signs and symptoms of cancer appear - thereby giving you a better chance at a successful treatment and recovery. Mammograms catch 85% of all breast cancers, and are the most critical diagnostic imaging tool we have to help detect breast cancer.

During a mammogram, your breast is placed on a plate by a trained technician and is pressed by another plate from above before taking a x-ray image. A typical screening mammogram will take two pictures of each breast. Mammograms should not be painful, but it sometimes helps to take a Tylenol or ibuprofen tablet 1 hour before your appointment to help minimize any discomfort.

Today, mammograms are performed with 3D / tomosynthesis technology, which helps your radiologist get an even better view of your breast tissue and minimize unnecessary further workup. This is actually even more comfortable than a traditional 2D mammogram, and is covered by insurance.

How often should women at high risk of developing breast cancer get a screening?

According to American Cancer Society, women with the following factors are categorised as women with high risk for developing breast cancer.

  • Has a personal history of breast cancer.
  • Has a first-degree family (parents, siblings and children) with a genetic mutation which increases risk of breast cancer, such as BRCA1 or BRCA2.
  • Ashkenazi Jewish heritage
  • Has a lifetime breast cancer risk greater than 20%
  • Had chest radiation therapy between the ages of 10 and 30

It is also advised for a woman with high risk of developing breast cancer to discuss her screening option with her breast surgeon. High risk patients are usually recommended to undergo both breast MRI and mammogram screenings for early detection of breast cancer and for successful treatment.

Ask a question

Consult Dr. Sangeetha Kolluri

MONDAY | 9am - 4pm
Austin Cancer Centers - Park St. David's
900 E. 30th Street, Suite 100
Austin, TX 78705
512.334.2777

WEDNESDAY | 9am - 4pm
Austin Cancer Centers - Lakeway
200 Medical Parkway, Suite 120
Lakeway, TX 78738
512.334.2881

FRIDAY | 9am - 4pm
Austin Cancer Centers - Kyle
1180 Section Pkwy, Suite 150
Kyle, TX 78640
512.334.5202