Is it breast cancer? Getting a good diagnosis
An interview with Toni Storm-Dickerson, MD, Southwest Medical Group Surgical Specialists
As a woman, you are an expert at knowing when something may be amiss with your own body. Regular breast self-exams, an annual physical exam and mammogram (the "trifecta of breast health") all empower you with good baseline information. So when you or your healthcare providers detect a lump or something suspicious, additional tests will help determine the next step. Toni Storm-Dickerson, MD explains how and why it's important to get a good diagnosis.
What kinds of diagnostic procedures might be recommended?
Depending on your situation, treatments could range from biopsy to lumpectomy (removing the tumor and some surrounding tissue) to mastectomy (removing the entire breast). In addition to breast surgery, associated lymph nodes often need surgical attention. This can be accomplished with a sentinel node biopsy or lymph node dissection. Our surgeons can discuss all of these options with you. Our surgeons also see many patients for the treatment of non-cancerous breast lumps and other breast conditions.
Your healthcare provider will explain which diagnostic procedure is best for your situation, but do not hesitate to ask questions. You are important member of the team during the stages of discovery.
What is a breast biopsy?
If your healthcare provider says you need a breast biopsy, it's natural to be worried. But rest assured, having a breast biopsy does not necessarily mean you have cancer. It means that tissue, cells or fluid need to be removed and examined more closely.
Not all breast biopsies are alike. The kind you have will depend on several things, including the size of the suspicious area, where it's located, how troublesome it appears, and your preferences. For example:
- Fine needle aspiration: This is the simplest type of biopsy, and it's often used to evaluate a lump that can be felt. Your healthcare provider will use a very thin needle and syringe to collect a small amount of tissue or cells. If the lump is a harmless cyst, chances are, fluid taken during the aspiration will cause the lump to collapse.
- Core needle aspiration: A slightly larger, hollow needle is used to remove small cylinders, or cores, of tissue.
- Stereotactic core needle biopsy: When a mass can't be felt, breast x-rays can help guide the needle into place. This type of biopsy may be used to sample tiny deposits of calcium in the breast that sometimes are red flags for cancer.
- Surgical biopsy: A surgeon will cut away all or part of an abnormal area. If the lesion can be felt by examination, excisional biopsy generally is a brief, straightforward surgery performed in an operating room.
- Wire localization: Sometimes a breast lump may be very small and deep or difficult to locate. In this situation, the surgeon may place a special wire, using x-ray guidance, to locate the breast lump.
What is a sentinel node biopsy?
Sometimes the surgeon performs a sentinel node biopsy to determine if cancer cells have spread to the lymph nodes. This surgical procedure also helps to identify the staging of the breast cancer. This procedure may also be referred to as an axillary lymph node dissection.
With a sentinel node biopsy, a dye and/or radioactive substance is injected near the tumor. The procedure helps to locate and remove the lymph node closest to the tumor (the sentinel node), which is the one most likely to have cancer cells present if the cancer has spread.
Why are these diagnostic procedures so important?
According to the American Cancer Society, four out of every five women who have breast biopsies ultimately get good news-they find out they don't have cancer. But this doesn't mean you can afford to skip your biopsy. It's important to safeguard your health every step of the way.
How can I find out more about diagnostic procedures?
Southwest Medical Group Surgical Specialists is located in the Medical Center Physician's Building on the Southwest Washington Medical Center campus, off Mill Plain Blvd. at 87th Ave. Suite 301 (Building B) in Vancouver. For more information, go to www.sw-medicalgroup.org or call 360.213.9955
The Kearney Breast Center is located in the Physicians' Pavilion on the Southwest Washington Medical Center campus, off Mill Plain Blvd. at Mother Joseph Place in Vancouver. For more information, go to www.becauseitspersonal.org or call 360.514.6161.
About Dr. Storm-Dickerson
Toni Storm-Dickerson, MD is a board certified general surgeon. She graduated with honors from Oregon State University in Microbiology. She then took a position at Oregon Health Sciences University at The Center for Research on Occupational and Environmental Toxicology, where she published several papers on neurotoxicology with Dr. Bruce Gold. This position strengthened an already strong interest in medicine.
Dr. Storm-Dickerson then attended the University of Iowa Medical School where she obtained her medical degree. While in Medical School she worked at the free clinic and became increasingly interested in surgery. She subsequently completed her internship and surgical residency at Akron General Medical Center in Ohio, where she was also on the teaching faculty for Northeast Ohio Universities College of Medicine. At this level one trauma center she had extensive exposure to trauma, burn, general and minimally invasive surgery, including cancer surgery of the entire GI tract, breast, thyroid, and lung.
Dr. Storm-Dickerson, her husband and two children moved to Vancouver following completion of residency in 2003. She was recently featured in Southwest Health magazine's special issue on breast health.
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