No - many women have "lumpy" breasts which is usually related to the combination of glandular tissue and fatty tissue in the breast, but lumpy is not the same as dense. Breast density refers to the appearance of the breast tissue on imaging, usually mammogram. Dense breast tissue appears more "white" on mammogram, which makes it harder to detect cancer, also usually "white" on mammogram. Younger women naturally have dense breast tissue, but some women still have dense breast tissue even as they get older. Hormone therapy will maintain the dense breast appearance on mammogram.

Women with dense breast tissue on imaging are at higher risk for the future development of breast cancer, and as mammograms may miss more cancers in women with dense breast tissue, additional imaging such as ultrasound or MRI may be helpful. No - many women have "lumpy" breasts which is usually related to the combination of glandular tissue and fatty tissue in the breast, but lumpy is not the same as dense. Breast density refers to the appearance of the breast tissue on imaging, usually mammogram. Dense breast tissue appears more "white" on mammogram, which makes it harder to detect cancer, also usually "white" on mammogram. Younger women naturally have dense breast tissue, but some women still have dense breast tissue even as they get older. Hormone therapy will maintain the dense breast appearance on mammogram.

Women with dense breast tissue on imaging are at higher risk for the future development of breast cancer, and as mammograms may miss more cancers in women with dense breast tissue, additional imaging such as ultrasound or MRI may be helpful.

Metastatic breast cancer means that the breast cancer has spread outside of the breast and outside of the underarm (axillary) lymph nodes. The most common sites of spread are to lymph nodes above the clavicle, in the chest, and to the lung, liver, bones, and brain. Metastatic breast cancer, or Stage IV breast cancer, is not considered curable, but modern treatments do allow for much longer survival with a better quality of life than older treatment regimens. Metastatic breast cancer means that the breast cancer has spread outside of the breast and outside of the underarm (axillary) lymph nodes. The most common sites of spread are to lymph nodes above the clavicle, in the chest, and to the lung, liver, bones, and brain. Metastatic breast cancer, or Stage IV breast cancer, is not considered curable, but modern treatments do allow for much longer survival with a better quality of life than older treatment regimens.

Stage 0 Breast cancer is also known as Ductal Carcinoma In-Situ, or DCIS. This means that the cancer cells are filling the milk ducts, but have not broken through the lining or wall of the milk duct. This means that the cancer generally does not have the potential to spread to other areas of the body. DCIS can be quite extensive throughout the breast however and sometimes mastectomy is needed. In addition, DCIS can be harder to detect on mammogram, ultrasound, or MRI, and often the extent of disease is underestimated by imaging. Stage 0 Breast cancer is also known as Ductal Carcinoma In-Situ, or DCIS. This means that the cancer cells are filling the milk ducts, but have not broken through the lining or wall of the milk duct. This means that the cancer generally does not have the potential to spread to other areas of the body. DCIS can be quite extensive throughout the breast however and sometimes mastectomy is needed. In addition, DCIS can be harder to detect on mammogram, ultrasound, or MRI, and often the extent of disease is underestimated by imaging.

Breast cysts are completely benign, in other words, not related to breast cancer. Think of them like little "water balloons" in the breast - they develop due to enlargement of an area of the milk duct that fills with fluid. They will often enlarge and may become painful right before the menstrual period, and then often decrease without any intervention. An ultrasound can be used to ensure that a lump is indeed a fluid filled cyst and not a solid tumor. "Simple" cysts, which have a thin wall and no solid growth associated with them can safely be observed, but sometimes fine needle aspiration is recommended if a cyst is large or painful. Breast cysts are completely benign, in other words, not related to breast cancer. Think of them like little "water balloons" in the breast - they develop due to enlargement of an area of the milk duct that fills with fluid. They will often enlarge and may become painful right before the menstrual period, and then often decrease without any intervention. An ultrasound can be used to ensure that a lump is indeed a fluid filled cyst and not a solid tumor. "Simple" cysts, which have a thin wall and no solid growth associated with them can safely be observed, but sometimes fine needle aspiration is recommended if a cyst is large or painful.

It depends on the patient and if reconstruction is performed, and what type of reconstruction. If a mastectomy without reconstruction is performed, usually a 24-48 hour hospital stay is required, and a patient is discharged with drainage tubes in place. The drains are usually removed after about 7-10 days, but may stay in place longer depending on the amount of fluid that is being produced. Overall recovery in terms of return to work and other normal activities can take anywhere from 2-3 weeks up to 6-8 weeks.

If reconstruction is performed using tissue expanders or implants, the recovery is similar to that of a mastectomy without reconstruction but the initial pain is usually more as the tissue expanders or implants are placed underneath the pectoralis muscle. If reconstruction using muscle or fatty tissue is performed, the hospital stay is usually 3-5 days, and may include an intensive care unit stay; overall recovery is typically 6-8 weeks and sometimes longer. It depends on the patient and if reconstruction is performed, and what type of reconstruction. If a mastectomy without reconstruction is performed, usually a 24-48 hour hospital stay is required, and a patient is discharged with drainage tubes in place. The drains are usually removed after about 7-10 days, but may stay in place longer depending on the amount of fluid that is being produced. Overall recovery in terms of return to work and other normal activities can take anywhere from 2-3 weeks up to 6-8 weeks.

If reconstruction is performed using tissue expanders or implants, the recovery is similar to that of a mastectomy without reconstruction but the initial pain is usually more as the tissue expanders or implants are placed underneath the pectoralis muscle. If reconstruction using muscle or fatty tissue is performed, the hospital stay is usually 3-5 days, and may include an intensive care unit stay; overall recovery is typically 6-8 weeks and sometimes longer.

The HALO test is a way to obtain fluid from the nipple which then can be analyzed to see if there are any abnormal, or atypical cells. Cellular atypia is a risk factor for the future development of breast cancer, and patients who have atypia usually are followed more closely. The HALO test is not a substitute for mammogram or other imaging as it is not meant to diagnose breast cancer - it is a way to determine if a woman might be at increased risk and therefore might need additional imaging. The HALO test is typically used in women under the age of 40, who are not yet undergoing routine screening with mammography.
The HALO test is a way to obtain fluid from the nipple which then can be analyzed to see if there are any abnormal, or atypical cells. Cellular atypia is a risk factor for the future development of breast cancer, and patients who have atypia usually are followed more closely. The HALO test is not a substitute for mammogram or other imaging as it is not meant to diagnose breast cancer - it is a way to determine if a woman might be at increased risk and therefore might need additional imaging. The HALO test is typically used in women under the age of 40, who are not yet undergoing routine screening with mammography.

Most often a woman will see a breast surgeon early in the process - either before diagnosis as many breast surgeons perform their own minimally invasive biopsies, or shortly after diagnosis. The breast surgeon will usually consult with the medical oncologist, radiation oncologist and plastic surgeon and the specialists will all work as a team to determine the breast treatment approach for a patient. Most often a woman will see a breast surgeon early in the process - either before diagnosis as many breast surgeons perform their own minimally invasive biopsies, or shortly after diagnosis. The breast surgeon will usually consult with the medical oncologist, radiation oncologist and plastic surgeon and the specialists will all work as a team to determine the breast treatment approach for a patient.

This may be a woman's individual choice - if a woman is a candidate for immediate reconstruction, she may have a preference regarding the timing of the surgery. Some prefer to undergo the mastectomy and other treatment first, delaying the reconstruction, while some women like the idea of having a large part of the reconstruction performed at the time of the mastectomy. Some patients with more aggressive tumors are not candidates for immediate reconstruction, but if the woman has a choice, it is really an individual decision. This may be a woman's individual choice - if a woman is a candidate for immediate reconstruction, she may have a preference regarding the timing of the surgery. Some prefer to undergo the mastectomy and other treatment first, delaying the reconstruction, while some women like the idea of having a large part of the reconstruction performed at the time of the mastectomy. Some patients with more aggressive tumors are not candidates for immediate reconstruction, but if the woman has a choice, it is really an individual decision.

Full preparation includes review of all imaging studies such as mammogram, ultrasound, and MRI, as well as consultation with appropriate specialists such as the medical oncologist, radiation oncologist, and plastic surgeon. Of course reviewing all options with the patient and making sure she is understands her treatment options and is comfortable with her decision is of utmost importance. Full preparation includes review of all imaging studies such as mammogram, ultrasound, and MRI, as well as consultation with appropriate specialists such as the medical oncologist, radiation oncologist, and plastic surgeon. Of course reviewing all options with the patient and making sure she is understands her treatment options and is comfortable with her decision is of utmost importance.

It is an excellent idea to use Arnica both before and after surgery. I call this remedy the ‘homeopathic exception’ because it is one that works for almost every person for the same condition (this is contrary to how homeopathy generally works in that a remedy needs to be prescribed on an individual basis).

It works to reduce inflammation and speed healing which in turn helps to relieve some of the pain associated with surgery. It has a particular action on soft tissue and is well known as a remedy for bruising. Many sportsmen keep it in their kitbags for knocks and scrapes on the sports field. It is also available as a topical ointment or massage oil for sprains.

Most doctors are aware of this remedy and in my experience, regardless of their understanding of homeopathy, agree that it is very helpful.

Homeopathic remedies are prepared to an extremely dilute potency and there is no risk of an interaction with anaesthesia or other medications.

A good surgical protocol would be as follows:
Arnica 200c the day before surgery.
Arnica 200c just before surgery and just after.
Arnica 200c 3 x daily for 2 – 5 days as needed.
It is always best to consult with a homeopath before taking any remedies and of course, make your surgeon aware of any remedies you are taking.
It is an excellent idea to use Arnica both before and after surgery. I call this remedy the ‘homeopathic exception’ because it is one that works for almost every person for the same condition (this is contrary to how homeopathy generally works in that a remedy needs to be prescribed on an individual basis).

It works to reduce inflammation and speed healing which in turn helps to relieve some of the pain associated with surgery. It has a particular action on soft tissue and is well known as a remedy for bruising. Many sportsmen keep it in their kitbags for knocks and scrapes on the sports field. It is also available as a topical ointment or massage oil for sprains.

Most doctors are aware of this remedy and in my experience, regardless of their understanding of homeopathy, agree that it is very helpful.

Homeopathic remedies are prepared to an extremely dilute potency and there is no risk of an interaction with anaesthesia or other medications.

A good surgical protocol would be as follows:
Arnica 200c the day before surgery.
Arnica 200c just before surgery and just after.
Arnica 200c 3 x daily for 2 – 5 days as needed.
It is always best to consult with a homeopath before taking any remedies and of course, make your surgeon aware of any remedies you are taking.

The stage of cancer is determined by the size of the tumor and the presence or absence of spread to the lymph nodes and other areas of the body. While often the stage can be estimated by imaging studies of the breast (such as mammogram, ultrasound, and MRI) or imaging of the body (such as CT scan, PET/CT scan, bone scan), the pathologic stage can only be determined after the tumor and lymph node(s) have been removed and have been evaluated by the pathologist. Examination under the microscope remains the most accurate way to determine if the cancer has spread to the underarm lymph nodes (assuming that they are not abnormally enlarged). If a woman has received chemotherapy prior to surgery, the "true" pathologic stage may never be known, as the tumor will often decrease significantly in size as a result of preoperative chemotherapy. The stage of cancer is determined by the size of the tumor and the presence or absence of spread to the lymph nodes and other areas of the body. While often the stage can be estimated by imaging studies of the breast (such as mammogram, ultrasound, and MRI) or imaging of the body (such as CT scan, PET/CT scan, bone scan), the pathologic stage can only be determined after the tumor and lymph node(s) have been removed and have been evaluated by the pathologist. Examination under the microscope remains the most accurate way to determine if the cancer has spread to the underarm lymph nodes (assuming that they are not abnormally enlarged). If a woman has received chemotherapy prior to surgery, the "true" pathologic stage may never be known, as the tumor will often decrease significantly in size as a result of preoperative chemotherapy.

There are many ways to perform risk assessment, and the most important is by taking a personal and family history. A prior breast biopsy, especially if it demonstrated "atypical hyperplasia", increases a woman's risk for the future development of breast cancer. Also the number of relatives who have had breast cancer, and their age at diagnosis, is also important. A history of other cancers in the family, especially ovarian cancer, may lead to a recommendation for BRCA gene testing.

There are various risk assessment models available - the most commonly used one is the Gail Model: http://www.cancer.gov/bcrisktool/ and it uses known risk factors such as age, age at first menstrual period and first term pregnancy, whether or not prior biopsies have been performed (and if so, was atypia present?), and family history. A disadvantage of the Gail model is that it only takes into account first-degree relatives (mother, sister, daughter) and it may underestimate the risk of disease in some women.

A form of genetic testing, known as the OnvoVue test, is a saliva test which assesses various genes involved in breast cancer development; results are reported as standard risk, moderately elevated, and significantly elevated - this test can help us determine if an otherwise asymptomatic woman might be at higher risk for the future development of breast cancer. Additional information on the OncoVue test can be found here - http://www.cancerriskassessment.com/what-is-oncovue-2.

Another form of risk assessment testing uses milk duct fluid (nipple aspirate fluid) to determine if there are abnormal cells present; the presence of abnormal cells or atypia would mean that a woman is at increased risk for the development of breast cancer and additional testing may be recommended.

Realize that no risk assessment test is a crystal ball - we do not at this point have the ability to predict with certainty if someone will or will not develop breast cancer. However they can help to identify women that might be at higher than average risk for which additional testing might be indicated. Additional information on risk assessment can be found here - http://www.cfbci.com/halo.html. There are many ways to perform risk assessment, and the most important is by taking a personal and family history. A prior breast biopsy, especially if it demonstrated "atypical hyperplasia", increases a woman's risk for the future development of breast cancer. Also the number of relatives who have had breast cancer, and their age at diagnosis, is also important. A history of other cancers in the family, especially ovarian cancer, may lead to a recommendation for BRCA gene testing.

There are various risk assessment models available - the most commonly used one is the Gail Model: http://www.cancer.gov/bcrisktool/ and it uses known risk factors such as age, age at first menstrual period and first term pregnancy, whether or not prior biopsies have been performed (and if so, was atypia present?), and family history. A disadvantage of the Gail model is that it only takes into account first-degree relatives (mother, sister, daughter) and it may underestimate the risk of disease in some women.

A form of genetic testing, known as the OnvoVue test, is a saliva test which assesses various genes involved in breast cancer development; results are reported as standard risk, moderately elevated, and significantly elevated - this test can help us determine if an otherwise asymptomatic woman might be at higher risk for the future development of breast cancer. Additional information on the OncoVue test can be found here - http://www.cancerriskassessment.com/what-is-oncovue-2.

Another form of risk assessment testing uses milk duct fluid (nipple aspirate fluid) to determine if there are abnormal cells present; the presence of abnormal cells or atypia would mean that a woman is at increased risk for the development of breast cancer and additional testing may be recommended.

Realize that no risk assessment test is a crystal ball - we do not at this point have the ability to predict with certainty if someone will or will not develop breast cancer. However they can help to identify women that might be at higher than average risk for which additional testing might be indicated. Additional information on risk assessment can be found here - http://www.cfbci.com/halo.html.

Most of the time the breast surgeon will want to review all of your records, so make sure you have all reports from mammograms, ultrasound, MRI exams, and any biopsy pathology. In addition, most breast surgeons will want to view the actual films (often they are provided on a CD), not just the reports. Your history will be taken and questions will be asked not only about the current problem, but of any other breast-related problem. Other medical history and family history will also be reviewed. A breast examination will also be performed and additional imaging such as ultrasound may also be performed.

When you make the appointment, ask if there is paperwork that you can fill out ahead of time; many of our patients find it helpful to fill out their paperwork in consultation with another family member so that important medical conditions and family history are included. Providing your surgeon with as much information as possible will ensure that you receive a thorough consultation. Most of the time the breast surgeon will want to review all of your records, so make sure you have all reports from mammograms, ultrasound, MRI exams, and any biopsy pathology. In addition, most breast surgeons will want to view the actual films (often they are provided on a CD), not just the reports. Your history will be taken and questions will be asked not only about the current problem, but of any other breast-related problem. Other medical history and family history will also be reviewed. A breast examination will also be performed and additional imaging such as ultrasound may also be performed.

When you make the appointment, ask if there is paperwork that you can fill out ahead of time; many of our patients find it helpful to fill out their paperwork in consultation with another family member so that important medical conditions and family history are included. Providing your surgeon with as much information as possible will ensure that you receive a thorough consultation.

No - many women have "lumpy" breasts which is usually related to the combination of glandular tissue and fatty tissue in the breast, but lumpy is not the same as dense. Breast density refers to the appearance of the breast tissue on imaging, usually mammogram. Dense breast tissue appears more "white" on mammogram, which makes it harder to detect cancer, also usually "white" on mammogram. Younger women naturally have dense breast tissue, but some women still have dense breast tissue even as they get older. Hormone therapy will maintain the dense breast appearance on mammogram.

Women with dense breast tissue on imaging are at higher risk for the future development of breast cancer, and as mammograms may miss more cancers in women with dense breast tissue, additional imaging such as ultrasound or MRI may be helpful. No - many women have "lumpy" breasts which is usually related to the combination of glandular tissue and fatty tissue in the breast, but lumpy is not the same as dense. Breast density refers to the appearance of the breast tissue on imaging, usually mammogram. Dense breast tissue appears more "white" on mammogram, which makes it harder to detect cancer, also usually "white" on mammogram. Younger women naturally have dense breast tissue, but some women still have dense breast tissue even as they get older. Hormone therapy will maintain the dense breast appearance on mammogram.

Women with dense breast tissue on imaging are at higher risk for the future development of breast cancer, and as mammograms may miss more cancers in women with dense breast tissue, additional imaging such as ultrasound or MRI may be helpful.

Metastatic breast cancer means that the breast cancer has spread outside of the breast and outside of the underarm (axillary) lymph nodes. The most common sites of spread are to lymph nodes above the clavicle, in the chest, and to the lung, liver, bones, and brain. Metastatic breast cancer, or Stage IV breast cancer, is not considered curable, but modern treatments do allow for much longer survival with a better quality of life than older treatment regimens. Metastatic breast cancer means that the breast cancer has spread outside of the breast and outside of the underarm (axillary) lymph nodes. The most common sites of spread are to lymph nodes above the clavicle, in the chest, and to the lung, liver, bones, and brain. Metastatic breast cancer, or Stage IV breast cancer, is not considered curable, but modern treatments do allow for much longer survival with a better quality of life than older treatment regimens.

Stage 0 Breast cancer is also known as Ductal Carcinoma In-Situ, or DCIS. This means that the cancer cells are filling the milk ducts, but have not broken through the lining or wall of the milk duct. This means that the cancer generally does not have the potential to spread to other areas of the body. DCIS can be quite extensive throughout the breast however and sometimes mastectomy is needed. In addition, DCIS can be harder to detect on mammogram, ultrasound, or MRI, and often the extent of disease is underestimated by imaging. Stage 0 Breast cancer is also known as Ductal Carcinoma In-Situ, or DCIS. This means that the cancer cells are filling the milk ducts, but have not broken through the lining or wall of the milk duct. This means that the cancer generally does not have the potential to spread to other areas of the body. DCIS can be quite extensive throughout the breast however and sometimes mastectomy is needed. In addition, DCIS can be harder to detect on mammogram, ultrasound, or MRI, and often the extent of disease is underestimated by imaging.

Breast cysts are completely benign, in other words, not related to breast cancer. Think of them like little "water balloons" in the breast - they develop due to enlargement of an area of the milk duct that fills with fluid. They will often enlarge and may become painful right before the menstrual period, and then often decrease without any intervention. An ultrasound can be used to ensure that a lump is indeed a fluid filled cyst and not a solid tumor. "Simple" cysts, which have a thin wall and no solid growth associated with them can safely be observed, but sometimes fine needle aspiration is recommended if a cyst is large or painful. Breast cysts are completely benign, in other words, not related to breast cancer. Think of them like little "water balloons" in the breast - they develop due to enlargement of an area of the milk duct that fills with fluid. They will often enlarge and may become painful right before the menstrual period, and then often decrease without any intervention. An ultrasound can be used to ensure that a lump is indeed a fluid filled cyst and not a solid tumor. "Simple" cysts, which have a thin wall and no solid growth associated with them can safely be observed, but sometimes fine needle aspiration is recommended if a cyst is large or painful.

It depends on the patient and if reconstruction is performed, and what type of reconstruction. If a mastectomy without reconstruction is performed, usually a 24-48 hour hospital stay is required, and a patient is discharged with drainage tubes in place. The drains are usually removed after about 7-10 days, but may stay in place longer depending on the amount of fluid that is being produced. Overall recovery in terms of return to work and other normal activities can take anywhere from 2-3 weeks up to 6-8 weeks.

If reconstruction is performed using tissue expanders or implants, the recovery is similar to that of a mastectomy without reconstruction but the initial pain is usually more as the tissue expanders or implants are placed underneath the pectoralis muscle. If reconstruction using muscle or fatty tissue is performed, the hospital stay is usually 3-5 days, and may include an intensive care unit stay; overall recovery is typically 6-8 weeks and sometimes longer. It depends on the patient and if reconstruction is performed, and what type of reconstruction. If a mastectomy without reconstruction is performed, usually a 24-48 hour hospital stay is required, and a patient is discharged with drainage tubes in place. The drains are usually removed after about 7-10 days, but may stay in place longer depending on the amount of fluid that is being produced. Overall recovery in terms of return to work and other normal activities can take anywhere from 2-3 weeks up to 6-8 weeks.

If reconstruction is performed using tissue expanders or implants, the recovery is similar to that of a mastectomy without reconstruction but the initial pain is usually more as the tissue expanders or implants are placed underneath the pectoralis muscle. If reconstruction using muscle or fatty tissue is performed, the hospital stay is usually 3-5 days, and may include an intensive care unit stay; overall recovery is typically 6-8 weeks and sometimes longer.

The HALO test is a way to obtain fluid from the nipple which then can be analyzed to see if there are any abnormal, or atypical cells. Cellular atypia is a risk factor for the future development of breast cancer, and patients who have atypia usually are followed more closely. The HALO test is not a substitute for mammogram or other imaging as it is not meant to diagnose breast cancer - it is a way to determine if a woman might be at increased risk and therefore might need additional imaging. The HALO test is typically used in women under the age of 40, who are not yet undergoing routine screening with mammography.
The HALO test is a way to obtain fluid from the nipple which then can be analyzed to see if there are any abnormal, or atypical cells. Cellular atypia is a risk factor for the future development of breast cancer, and patients who have atypia usually are followed more closely. The HALO test is not a substitute for mammogram or other imaging as it is not meant to diagnose breast cancer - it is a way to determine if a woman might be at increased risk and therefore might need additional imaging. The HALO test is typically used in women under the age of 40, who are not yet undergoing routine screening with mammography.

Most often a woman will see a breast surgeon early in the process - either before diagnosis as many breast surgeons perform their own minimally invasive biopsies, or shortly after diagnosis. The breast surgeon will usually consult with the medical oncologist, radiation oncologist and plastic surgeon and the specialists will all work as a team to determine the breast treatment approach for a patient. Most often a woman will see a breast surgeon early in the process - either before diagnosis as many breast surgeons perform their own minimally invasive biopsies, or shortly after diagnosis. The breast surgeon will usually consult with the medical oncologist, radiation oncologist and plastic surgeon and the specialists will all work as a team to determine the breast treatment approach for a patient.