Breast Health

Many people diagnosed with breast cancer never have symptoms. Breast cancer is often first detected from a mammogram or clinical breast exam by your doctor. If your mammogram shows something abnormal, your doctor may recommend other tests, such as a breast biopsy, breast MRI, or breast ultrasound.  

If you are diagnosed with breast cancer, you will be referred to breast cancer specialists, including a breast surgeon and oncologist. At Novant Health, you’ll have access to advanced treatment options and dedicated breast cancer specialists who will surround you with compassionate care throughout your journey.

Fibrocystic breasts, also called fibrocystic change, is a common breast condition. While not harmful, it can be painful. The pain in the breast is caused by fluid-filled round or oval sacs, called cysts. It normally affects women from puberty to around age 50 and often disappears during menopause.  

Fibrocystic breasts are often found when conducting monthly self-examinations. You may find lumps or tender areas in one or both of your breasts. Your doctor can provide a clinical exam and offer options to treat your condition or refer you for additional testing if needed.

Symptoms

• Multiple lumps in one or both breasts that are tender and offer resistance when pressed with your fingertips
• Generalized breast pain, most often just before menstrual periods due to hormonal changes
• Lumps that enlarge before menstrual periods and shrink after menstruation
• Pain under your arms

You can help prevent fibrocystic breast pain by avoiding smoking and caffeine.

A breast biopsy is a common procedure during which we collect a small sample of breast tissue. We then pass the sample on to a pathologist to examine and provide a diagnosis.

We use many methods to collect breast tissue samples. The type of biopsy we use depends on things like the location, appearance, and size of the abnormal breast tissue needing examination. Breast biopsy types include:

• Ultrasound-guided breast biopsy
• MRI-guided breast biopsy
• Stereotactic breast biopsy

If you are at high risk for breast cancer or your provider needs a more detailed look at your breast tissue, your care team may recommend a breast magnetic resonance imaging (MRI) exam. Using a strong magnet and radio waves instead of X-rays, MRI technology produces a highly detailed image of the breast. A breast MRI does not take the place of a mammogram, the preferred exam to annually screen for breast cancer. However, when used with mammography for high-risk women, MRI can be a powerful tool for finding breast cancer.

Your doctor may recommend that you have a breast MRI exam if you have:

• Recent diagnosis of breast cancer
• Extremely dense breast tissue
• High risk for breast cancer:
  • Carrier of genetic mutations such as BRCA1 and BRCA2
  • Personal history of breast cancer or a prior breast biopsy that showed abnormal cells
  • Strong family history of breast cancer
  • Had chest radiation for Hodgkin's Lymphoma before age 30
• Silicone breast implants and possible implant rupture (implant evaluation)

If you have dense breast tissue, you may need an abbreviated screening breast MRI. Dense breast tissue is less fatty, and instead more fibrous or glandular. Dense breast tissue may make it more difficult to find cancer on a mammogram.

An abbreviated breast MRI:

• Is a shorter version of a full breast MRI
• Doesn't use as many images
• May find breast cancer that does not show on mammography or ultrasound

This is not a replacement for your annual mammogram — it is an additional screening exam for those who may be at a higher risk for breast cancer.

Be sure to check with your insurance provider if they cover this type of exam.

If your mammogram shows changes in your breast tissue, an ultrasound may be your next recommended step. Ultrasounds make it easy to locate, measure, and evaluate lumps or other changes discovered in your screening mammogram to see if the lump is a cystic or solid mass.

Your care team may: 

• Combine ultrasound with diagnostic mammography if you are 30 or older and have suspicious lumps in your breasts
• Determine whether a breast lump is solid or fluid-filled
• Evaluate nipple discharge or other potential breast concerns
• Use ultrasound as a guide tool during other procedures, such as breast biopsies or when removing fluid from a cyst

If you are under 30, you are required to have a breast ultrasound instead of a mammogram (unless a radiologist decides otherwise).

If you have nipple discharge after a normal mammogram, your care team may recommend you get a ductogram. A ductogram (also called galactography) examines the inside of your breast milk ducts to discover what's causing abnormal nipple discharge.