The breast cancer team at the Columbia Surgical Specialists has expertise across the full spectrum of breast cancer & breast disease care: breast imaging, breast surgery, medical and radiation oncology, reconstructive surgery, clinical genetics, pathology and nursing. Through our integrated approach, patients receive a comprehensive treatment plan that optimizes the quality of life and survival rate.
But, it’s not enough to offer every breast cancer treatment. Each breast cancer patient is unique, so our breast cancer experts take the time to thoroughly and thoughtfully explain each patient’s disease and treatment options so they can make an informed choice about their preferred care.
Compassionate, one-on-one attention to each cancer patient is part of the high caliber of care patients can expect from Columbia Surgical Specialists. We’re dedicated to making the breast cancer care experience as seamless and accommodating as possible.
Diseases & Conditions Treated
Breast cancer is a malignant or potentially life-threatening tumor that can spread throughout the breast and other areas of the body. Breast cancer usually starts to form in the milk ducts, but can also start in the lobe. Other types of cancer that can form in the breast include sarcomas and lymphomas. What many don’t know is that men can get breast cancer, though the majority of breast cancer cases are in women.
Cysts are fluid filled sacs. The National Institute of Health (NIH) says they occur most often in women ages 35 to 50, and they often enlarge and become tender and painful just before the menstrual period. They are usually found in both breasts. Some cysts are so small they cannot be felt; rarely, cysts can be several inches across. Cysts often show up clearly on an ultrasound.
Although a cyst is not cancer, it’s important for a woman who notices any lump or change to see her HCP. According to NIH, when a cyst is suspected, some doctors proceed directly with aspiration, a procedure that uses a very thin needle and a syringe. Sometimes the cyst will disappear after that. If the lump turns out to be solid, it may be possible to use the needle to biopsy or withdraw a clump of cells that can then be sent to a laboratory for further testing.
Fat necrosis is the name given to painless, round and firm lumps formed by damaged and disintegrating fatty tissues. According to the NIH, this condition typically occurs in obese women with very large breasts. It often develops in response to trauma, such as a bruise or blow to the breast, even though the woman may not remember the specific injury. Sometimes the skin around the lumps looks red or bruised. It is important that any woman who notices a lump or change in her breast sees her HCP.
Fibroadenomas are solid and round benign tumors that are made up of both structural (fibro) and glandular (adenoma) tissues. Usually, these lumps are painless and found by the woman rather than a doctor. They feel rubbery and can easily be moved around. Fibroadenomas are the most common type of tumors in women in their late teens and early twenties, and NIH says they occur twice as often in African American women than in other American women.
Fibroadenomas have a typically benign appearance on mammography (smooth, round masses with a clearly defined edge), and they can sometimes be diagnosed with fine needle aspiration. Although fibroadenomas do not become malignant, they can enlarge with pregnancy and breastfeeding. It is essential that a woman who notices a lump or other change in her breast sees her HCP.
Galactorrhea occurs when a woman’s breast makes milk even though she is not breastfeeding a baby. The American Academy of Family Physicians (AAFP) says this may occur when the breasts are touched, or it may start spontaneously.
Men can have galactorrhea too, but it is much less common. Causes can include hormonal imbalance, medications such as hormones, antidepressants or blood pressure medicines, use of herbs, pregnancy, pituitary tumor and a number of other causes. The condition can go away on its own. It is essential that a woman who notices changes or discharge in her breast sees her HCP.
Recent studies show that certain types of microscopic changes that feature excessive cell growth or hyperplasia put a woman at higher risk of developing breast cancer. Approximately five percent of benign breast biopsies reveal both excessive cell growth (hyperplasia) plus cells that are abnormal (atypical). The location of these abnormal cells can be in the lobules (atypical lobular hyperplasia) or the milk ducts (atypical ductal hyperplasia).
If a biopsy finds hyperplasia, surgery can remove the abnormal cells and also determine if cancer is also present. Since atypical hyperplasia increases your risk of developing breast cancer, it is essential that you continue to monitor your breasts with regular mammograms and clinical breast exams. Depending on other risk factors such as family history, your doctor may also want to use magnetic resonance imaging for screening. Your doctor may suggest preventive medications to inhibit the effect of estrogen on your breast tissue.
One of the most common causes of bloody or sticky breast discharge is an intraductal papilloma, which is a small, wart-like growth that projects into breast ducts near the nipple. Any slight bump or bruise in the area of the nipple can cause the papilloma to bleed. Solitary intraductal papillomas usually affect women nearing menopause. Multiple intraductal papillomas, in contrast, are more common in younger women.
If the discharge becomes bothersome, the diseased duct can be removed surgically without damaging the appearance of the breast. Multiple intraductal papillomas or any papillomas associated with a lump need to be removed. It is important that any woman who notices a lump or change in her breast sees her HCP.
Mammary duct ectasia is a disease of women nearing menopause. Ducts beneath the nipple become inflamed and can become blocked. Mammary duct ectasia can become painful, and it can produce a thick/sticky discharge that is gray to green in color. A woman who notices pain or discharge should see her doctor. Treatment consists of warm compresses, antibiotics and, if necessary, surgery to remove the duct.
Mastitis (sometimes called “postpartum mastitis”) is an infection most often seen in women who are breast-feeding. A duct may become blocked, allowing milk to pool, which causes inflammation and may lead infection by bacteria. Bacteria can also enter via cracked nipples. In its earlier stages, mastitis can be cured by antibiotics. If an abscess forms, it will need to be drained or surgically removed. It is important that a woman who notices pain or changes in her breast sees her doctor immediately.
Nipple discharge accompanies some breast conditions. Since the breast is a gland, secretions from the nipple of a mature woman are not necessarily a sign of disease. For example, NIH says that small amounts of discharge of a milky fluid called galactorrhea commonly occur in women taking hormonal or other medications, including sedatives and tranquilizers.
Nipple discharge can also be a warning sign of benign disease or of breast cancer. The American Cancer Society (ACS) says most nipple discharges or secretions are not cancer. Even so, it’s important that a woman who notices discharge or unusual changes consult her doctor.
Nipple discharges come in a variety of colors and textures. A milky discharge can be traced to many causes, including thyroid malfunction or certain medications. A bloody discharge needs to be evaluated immediately. Women with generalized breast lumpiness may also experience nipple discharge.
Doctors can take a sample of the discharge and send it to a laboratory to be analyzed. Benign discharges are treated chiefly by keeping the nipple clean. A discharge caused by infection may require antibiotics.
Sclerosing adenosis is a benign condition involving the excessive growth of tissues in the breast’s lobules. It frequently causes breast pain. Usually the changes are microscopic, but adenosis can produce lumps that show up on a mammogram, often as calcifications. Short of biopsy, adenosis can be difficult to distinguish from cancer. NIH says surgical biopsy, which furnishes both diagnosis and treatment, is a common option. It is important that any woman who feels pain or notices a lump or change in her breast sees her HCP.