Breast Cancer

Fluid-filled sacs, commonly found in the breasts of women between the ages of 35 and 50, are a frequent occurrence. Cysts can range from very tiny to about the size of an egg. They can increase in size or become tender just before your menstrual period and may disappear completely after it. Postmenopausal women are less prone to cysts compared to other age groups.

These are solid, noncancerous tumors that often occur in women during their reproductive years. A fibroadenoma is a firm, smooth, rubbery lump with a well-defined shape. It will move under your skin when touched and is usually painless.

Breast infections (mastitis) are common in women who are breast-feeding or who recently have stopped breast-feeding, although you can also develop mastitis that’s not related to breastfeeding. Your breast will likely be red, warm, tender, and lumpy, and the lymph nodes under your arm may swell. You also feel slightly ill and have a low-grade fever.

Sometimes a blow to your breast or a bruise also can cause a lump. But this doesn’t mean you’re more likely to get breast cancer.

These tiny deposits of calcium can appear anywhere in your breast and often show up on a mammogram. For the majority of women, there are certain areas with microcalcifications of different sizes. They may be caused by secretions from cells, cellular debris, inflammation, trauma, or prior radiation. They’re not the result of the calcium supplements you take. The majority of calcium deposits are harmless, but a small percentage may be precancerous or cancer. If any appear suspicious, your doctor will likely recommend additional tests.

If you notice any changes in your breast and you haven’t reached menopausal age yet, it’s a good idea to wait until your next menstrual cycle before consulting a doctor. If your symptoms remain for a period of one month, it is important to consult a doctor without further delay.

Early detection is the key to successful treatment of breast cancer – look for signs and symptoms before they become visible to increase chances of finding a cure. Depending on your age and risk factors, screening may include breast self-examination, examination by your nurse or doctor (clinical breast exam), mammograms (mammography), or other tests.

For years, women have been advised to examine their breasts on a monthly basis starting around age 20. The hope was that by becoming proficient at breast self-examination and familiar with the usual appearance and feel of their breasts, women would be able to detect early signs of cancer.
But some studies have shown that teaching women to perform breast self-exams may not accomplish this goal. A large, randomized clinical study in Shanghai, China, for example, concluded that breast self-exams don’t actually reduce the number of deaths from breast cancer. In addition, the study found that women who perform regular breast self-exams may be more likely to undergo unnecessary biopsies after finding breast lumps. This was one of the primary reasons that in May 2003 the American Cancer Society changed its recommendations on breast self-examination, stating that the procedure should be considered an option, rather than a requirement, for most women.

In the newly released guidelines, more emphasis is given to being conscious about breast health rather than mandating monthly self-exams. Although the guidelines don’t say you shouldn’t perform the exams, the importance of self-exams has been replaced by a general need to become more familiar with your breasts. If you’d like to continue performing breast self-exams, ask your doctor to review your technique.

Unless you have a family history of cancer or other factors that place you at high risk, the American Cancer Society recommends having clinical breast exams once every three years until age 40. After that, the American Cancer Society recommends having a yearly clinical exam.

During this exam, your doctor examines your breasts for lumps or other changes. He or she may be able to feel lumps you miss when you examine your own breasts and will also look for enlarged lymph nodes in your armpit (axilla).

Mammograms are the most effective tool for detecting tumors in the breast before they can be physically felt. This imaging technique utilizes X-ray images to detect any irregularities in the breast tissue. Consequently, the American Cancer Society suggests screening mammography for all women above 40 years of age in order to detect potential cases at an early stage.
Yet mammograms aren’t perfect. About 10 percent to 15 percent of breast cancers sometimes even lumps you can feel don’t show up on X-rays (false-negative result). The rate is higher about 25 percent for women in their 40s. Women in their 20s and younger have denser breast tissue, making it harder to identify any irregularities. Thus, mammograms become all the more important for this age group.

In some cases, mammograms may suggest an issue when in reality there is none (false-positive result). This can lead to unnecessary biopsies, fear, and anxiety, as well as increased healthcare costs. The general agreement is that if mammograms have the power to prolong life, all qualified women should be screened for them. That assumption has been challenged in recent years, especially by a 2001 analysis of several large, long-term studies that raised questions about the benefit of mammography screening for breast cancer. The report concluded that several prior studies didn’t clearly show that screening mammograms result in fewer deaths from breast cancer. This led to great confusion about mammography for both women and doctors.

But a study published in April 2003, in which researchers followed more than 200,000 Swedish women for 20 years, hopes to end the confusion. That study found that mammogram screening does indeed reduce breast cancer mortality for women between the ages of 40 and 69 by as much as 28 percent. What’s more, the study’s authors say that mammography screening along with improved treatments can halve the number of deaths from breast cancer.

In 2003, the American Cancer Society released updated guidelines concerning breast cancer screening, strongly advocating the need for women aged 40 or more to have regular mammograms. The American Cancer Society suggests a few additional screening processes which include:

• People in their 20s and 30s should get a clinical breast exam every three years, whereas those 40 or older should have one each year.
• Being aware of the usual shape and size of your breasts can help you to detect any changes and tell your doctor about it. From the age of 20, women can opt for monthly breast self-examinations to detect potential problems early on.
• If you’re at greater risk of breast cancer due to family history, genetic makeup, or past breast cancer, talk with your doctor. You may benefit from more frequent exams, earlier mammography, or additional tests.

Mammograms require the compression of breasts between two plastic plates to get an accurate X-ray image. The process should be completed in approximately half an hour or less. You may find mammography somewhat uncomfortable. Should you experience any excessive discomfort, be sure to let the technician know right away. To avoid unnecessary discomfort, scheduling a mammogram after your menstrual period is recommended if you have tender breasts. Avoiding caffeine for two days before the test also helps reduce breast tenderness.

Mammography centers are now making mammograms more comfortable by providing a soft foam pad for compression plates, improving the experience for women. The pad doesn’t interfere with the image quality of the mammogram.

Combining your mammogram and physical exam is recommended for maximum efficiency. In this manner, the radiologist is able to carefully analyze any potential anomalies that your physician may have identified. Most importantly, don’t let a lack of health insurance keep you from having regular mammograms. Many state health departments and Planned Parenthood clinics offer low-cost or free screenings. So does the Encore Plus program available through many YWCAs.

Computer-aided detection (CAD)

In traditional mammography, your X-rays are reviewed by a radiologist, whose skill and experience play a large part in determining the accuracy of the test results. After a radiologist reviews your mammogram, a computer scans it using CAD. CAD identifies more suspicious areas on the mammogram, but many of these areas may later prove to be normal. Still, using mammography and CAD together may increase the cancer detection rate by nearly 20 percent.

Digital mammography

This procedure involves the use of electronic technology to acquire and visually display X-ray images on a computer monitor. This allows your radiologist to alter contrast and darkness, making it easier to identify subtle differences in tissue. In addition, the images can be transmitted electronically, so women who live in remote areas can have their mammograms read by an expert who is based elsewhere. Because it’s not yet known whether digital mammography is more accurate or effective than conventional mammography, the procedure is undergoing further investigation.

Magnetic resonance imaging (MRI)

This technique uses a magnet linked to a computer to take pictures of the interior of your breast. Although not used for routine screening, MRI can reveal tumors that are too small to be detected through physical examination or are difficult to see on conventional mammograms. It’s used at some centers to screen women at high risk of breast cancer as a complementary test to mammograms. MRI isn’t recommended for routine screening because it has a high rate of false-positive results, which can lead to unnecessary anxiety and biopsies.

Ductal lavage

In this procedure, your doctor inserts a tiny, flexible tube (catheter) into the lining of a duct in your breast the site where most cancers originate, and withdraws a sample of cells. Subsequently, the cells are carefully scrutinized for any precancerous alterations that might eventually result in disease. These changes show up long before tumors can be detected on a mammogram. But because ductal lavage is a new procedure, many unknowns remain, including the rate of false-negative results and whether abnormal cells will necessarily lead to cancer. Clinical trials are underway in an effort to answer the pressing questions that need to be addressed. In the meantime, some doctors are recommending ductal lavage to women who are at high risk of breast cancer either because they have a personal or family history of the disease or because they have a genetic defect that makes them more likely to develop cancer.

Ductal lavage is still considered experimental, so many insurers don’t cover it. If you have an interest in or questions about the procedure, talk to your doctor.

Breast ultrasound (ultrasonography)

Your medical practitioner may use this approach to investigate any irregularities that appear on a mammogram or felt when doing a physical examination. Ultrasound uses sound waves to form images of structures deep within the body. Because it doesn’t use X-rays, ultrasound is a safe diagnostic tool that can help determine whether an area of concern is a cyst or solid tissue. Breast ultrasound is unsuitable for regular screening due to its high rate of false positives – incorrectly detecting an issue where none exists.

If you, your doctor or a mammogram detects a lump in your breast, you’ll likely have one or more diagnostic procedures to determine if the lump is cancerous, including:

Ultrasound

Often, your doctor will suggest a less invasive procedure, such as an ultrasound, before deciding on a biopsy. Ultrasound is a procedure that uses sound waves to create an image of your breast on a computer screen. By investigating this image, your doctor may be able to discern whether the lump is an empty cavity (cyst) or a solid mass. Cysts, which are sacs of fluid, usually aren’t cancerous, although you may want to have a painful cyst drained with a needle.

Biopsy

In some cases, your doctor may want to remove a small sample of tissue (biopsy) for analysis in the laboratory. To do so, he or she may use one of the following procedures:

• Fine-needle aspiration biopsy. The simplest type of biopsy is used for lumps you or your doctor can feel. During the procedure, your doctor uses a thin, hollow needle to withdraw cells from the lump. He or she then sends the cells to a lab for analysis. The procedure isn’t uncomfortable, takes about 30 minutes, and is similar to drawing blood. Another procedure, fine-needle aspiration, is used primarily to remove the fluid from a painful cyst, but it can also help distinguish a cyst from a solid mass.
• Core needle biopsy. During this procedure, a radiologist or surgeon uses a hollow needle to remove tissue samples from a breast lump. As many as 15 samples, each about the size of a grain of rice, may be taken, and a pathologist then analyzes them for malignant cells. The advantage of a core needle biopsy is that it removes tissue, rather than just cells, for analysis. Sometimes your radiologist or surgeon may use ultrasound to help guide the placement of the needle.
• Stereotactic biopsy. This technique is used to evaluate an area of concern that can be seen on a mammogram but that cannot be felt or seen on an ultrasound. A radiologist performs a core needle biopsy, using the mammogram for directions, during the procedure. The stereotactic biopsy usually takes about an hour and is performed using local anesthesia.
• Wire localization. Your doctor may recommend this technique when a worrisome lump is seen on a mammogram but can’t be felt or evaluated with a stereotactic biopsy. Using your mammogram as a guide, a thin wire is placed in your breast and the tip is guided to the lump. Wire localization is a pre-surgery process that helps doctors precisely locate where to perform a biopsy. It gives the surgeon important guidance to ensure the best results.
• Surgical biopsy. This remains one of the most accurate methods for determining whether a breast change is cancerous. During this procedure, your surgeon removes all or part of a breast lump. Complete removal of a small lump will typically be performed through an excisional biopsy. If the lump is larger, only a sample will be taken (incisional biopsy). The biopsy is generally performed on an outpatient basis in a clinic or hospital.
• Estrogen and progesterone receptor tests

If a biopsy reveals malignant cells, your doctor will recommend additional tests such as estrogen and progesterone receptors tests on the malignant cells. These tests help determine whether female hormones affect the way cancer grows. If the cancer cells have receptors for estrogen or progesterone or both, your doctor may recommend treatment with a drug such as tamoxifen that prevents estrogen from binding to these sites.

Staging tests

Staging tests are essential for assessing the size and scope of a cancerous tumor, as well as determining if it has spread beyond its original site. Also, they help your doctor determine the most effective treatment for you. A cancer diagnosis is classified into several stages, ranging from 0 to IV. Stage 0 cancers are also called noninvasive or in situ (in one place) cancers.

Although they don’t have the ability to spread to other parts of your body or invade normal breast tissue, it’s important to have them removed because they eventually can become invasive cancers. Finding and treating a cancerous lump at this stage offers the best chance for a full recovery. Stage I to IV cancers are invasive tumors that have the ability to spread to other areas. Stage I cancer is small and well-localized and has a very successful treatment rate. As the stage of the medical condition progresses, the chances of a cure become slimmer. By stage IV, cancer has spread beyond your breast to other organs, such as your bones, lungs, or liver. Although it may not be possible to eliminate cancer at this stage, its spread may be controlled with radiation, chemotherapy, or both.

Genetic testing

The discovery of BRCA1, BRCA2, and other genes that may significantly increase breast cancer risk has raised a number of emotional and legal questions about genetic testing. A simple blood test can help identify defective BRCA genes, but it’s only 85 percent accurate, and most experts believe that only those women at high risk of hereditary breast or ovarian cancers should be referred for testing. If you’re one of these women, it’s important to know that having a defective BRCA gene doesn’t mean you’ll get breast cancer. In addition, test results cannot determine how high your risk is, at what age you might develop cancer, how aggressively cancer might progress, or what your risk of death may be.

Testing can help assess the risk of breast cancer, enabling you to make better-informed decisions about reducing your risk and staying healthy. Options range from lifestyle changes, closer screening, and therapy with medications such as tamoxifen to extreme measures such as preventive (prophylactic) bilateral mastectomy or removal of your ovaries (oophorectomy). Making these choices can be extremely difficult for any woman. Talking to a genetic counselor is the best way to make a fully-informed decision about genetic testing, taking into account positives, negatives, and restrictions. It can also help to talk to other women who have had to make similar decisions.

At one time, the only type of breast cancer surgery was radical mastectomy, which removed the entire breast, along with chest muscles beneath the breast and all the lymph nodes under the arm. Today, this operation is rarely performed. Instead, the majority of women are candidates for breast-saving operations, such as lumpectomies. Apart from radical mastectomies, other alternatives such as less aggressive mastectomies and those accompanied by reconstruction are also available.
Breast cancer operations include the following:

• Lumpectomy. It is a procedure that attempts to preserve as much of the breast as it can while taking out only the lump and its adjacent normal tissue. Your surgeon will likely also do a sentinel lymph node dissection to check for the possible spread of cancer. In most cases, your operation will be followed by radiation therapy to kill any remaining cancer cells. Generally, radiation therapy is administered every weekday for a period of six to seven weeks. In many cases, women can opt for lumpectomy in combination with radiation therapy instead of mastectomy, and the survival rates for both types of operations are comparable. In addition, many more women are satisfied with their appearance after lumpectomy. Lumpectomy may not be possible in cases where the tumor is too deep or if you have already undergone radiation treatment or have more than one area of cancer in the same breast that is far apart, have a connective tissue disease that makes you sensitive to radiation, or is pregnant. Remember that if you opt for a lumpectomy, radiation treatment may be necessary for follow-up.
• Partial or segmental mastectomy. Partial mastectomy is a breast-conserving surgery where part of the breast tissue, the tumor, and the lining of the chest muscles are removed. that lie beneath it. A few of the lymph nodes under your arm may need to be removed. Following surgery, radiation therapy is usually the next step in most cases.
• Simple mastectomy. During a simple mastectomy, your surgeon removes all your breast tissue the lobules, ducts, fatty tissue, and a strip of skin with the nipple and areola. Depending on the results of the operation and follow-up tests, you may also need further treatment with radiation, chemotherapy, or hormone therapy.
• Modified radical mastectomy. During this operation, the surgeon will take out your entire breast as well as some of the lymph nodes in your armpit (axillary) area. Fortunately, your chest muscles will still remain untouched. This makes breast reconstruction less complicated. But serious arm swelling (lymphedema) a common complication of mastectomy is more likely to occur in modified radical mastectomy than in simple mastectomy with sentinel node biopsy. Your lymph nodes will be tested to see if the cancer has spread. Depending on those results, you may need further treatment.
• Sentinel lymph node biopsy. Breast cancer first spreads to the lymph nodes under the arm. It is essential for all women diagnosed with invasive cancer to have their lymph nodes examined. If your surgeon doesn’t intend to follow this process, make sure you comprehend the justification behind it. Up until recently, surgeons would practice a technique of taking out as many lymph nodes as possible during surgical procedures. But this greatly increased the risk of numbness, recurrent infections, and lymphedema a serious swelling of the arm. That’s why a procedure has been developed that focuses on finding the sentinel nodes the first nodes to receive the drainage from breast tumors and therefore the first to develop cancer. If a sentinel node is removed, examined, and found to be healthy, the chance of finding cancer in any of the remaining nodes is very small and no other nodes need to be removed. By opting for these alternative treatments, many women can avoid undergoing more intensive surgeries and the potential risks associated with them.

Many female mastectomy patients have the option to opt for breast reconstruction after their surgery. When it comes to this decision, there’s no universal answer – it all depends on your individual circumstances. You may find, however, that you have feelings you didn’t expect about your breasts. It is essential to comprehend these emotions before making any decision as this can help you make the right choice.

If you would like reconstruction but aren’t a candidate for the procedure, you’ll need to find a way to come to terms with your disappointment. It may be extremely helpful to talk to other women who have experienced the same situation.

If reconstruction is an option, your surgeon will refer you to a plastic surgeon. The doctor can walk you through the details of the procedure and show pictures of different outcomes for women who have undergone reconstruction. Your options include reconstruction with a synthetic breast implant or reconstruction using your own tissue to rebuild your breast. Mastectomy operations can be carried out immediately or at a later date, depending on your preference.

• Reconstruction with implants. Using artificial materials to reconstruct your breast involves implanting a silicone shell filled either with silicone gel or salt water (saline). If the area around a potential implant site does not have enough muscle and skin to cover it, the doctor may use a tissue expander. This is an empty implant shell that inflates as fluid is injected. It’s placed under your skin and muscle, and your doctor gradually fills it with fluid usually over a period of several months. Upon stretching of the muscle and skin, the temporary expander is removed and replaced with a permanent implant. Recovery may take several weeks. In general, an implant makes your breast firmer than a normal breast. Implants may cause pain, swelling, bruising, tenderness or infection. And they do age over time, requiring replacement. There is also a long-term possibility of rupture, deflation, and shifting.
• Reconstruction with a tissue flap. A TRAM flap reconstruction uses a piece of tissue, including muscle and fat, from your abdominal region to rebuild your breast. Sometimes your surgeon may also use tissue from your back or buttocks. Because the procedure is fairly complicated, recovery may take six to eight weeks. Changes to the breast might be necessary in the future. Complications include the risk of infection and tissue death. If you have little body fat, this type of reconstruction may not be an option for you. On the other hand, a breast reconstructed from your own tissue doesn’t seem to interfere with the detection of tumors. It’s also permanent and has the look and feel of a normal breast.
• Deep interior epigastric perforator (DIEP) reconstruction. In this procedure, fat tissue from your abdomen is used to create a natural-looking breast. However, with traditional breast reconstruction, the risk of complications is less as the abdominal muscles are not affected. You might experience less discomfort and the recovery period may be shorter when you use this treatment.
• Reconstruction of your nipple and areola. After your initial surgery involving tissue transfer or an implant, a follow-up procedure may be necessary to create a nipple and areola. Your surgeon will build an elevated structure resembling a nipple by taking tissue from another area of your body. The artist may then tattoo the area around the nipple to create an areola to complete the look. Your surgeon may also take a skin graft from elsewhere on your body, place it around the reconstructed nipple to slightly raise the skin, and then tattoo the skin graft.

Radiation therapy is an effective way to cure cancer by using high-energy X-rays to destroy malignant cells and reduce the size of tumors. If you choose lumpectomy, or if a biopsy has confirmed that there are cancer cells in more than four lymph nodes in your armpit, your oncologist will likely recommend radiation to your chest wall after your mastectomy.

Although radiation can be intimidating, it’s worth noting that it has become significantly more accurate and less aggressive than in the past. Radiation is usually started three to four weeks after surgery. You’ll typically receive treatment five days a week for six to seven weeks. The treatments are painless and are similar to getting an X-ray.

Each takes about 30 minutes. The effects are cumulative, however, and you may become tired toward the end of the series. Your breasts may likely appear pink, puffy, and quite sensitive as if they had been sunburnt. Although rare, some long-term and serious complications have been observed in certain cases. These include rib fractures, lung inflammation, injury to the heart, nerve damage, and a change in the appearance and consistency of breast tissue. In extremely rare cases, a new tumor may result from radiation therapy.

Chemotherapy uses drugs to destroy cancer cells. After an operation, your physician may suggest chemotherapy to ensure any cancer cells that may have spread beyond the breast are eradicated. Treatments may involve taking a combination of two or more drugs to help manage the condition. These may be administered intravenously, in pill form, or both. Depending on the circumstances, you can have four to eight sessions between three and six months.

In some cases, your doctor may suggest preoperative chemotherapy taking chemotherapy drugs to shrink a breast tumor before surgery. This may make it possible for you to have a lumpectomy rather than a mastectomy to remove cancer, with the same survival rate as if you were to have chemotherapy after breast surgery.

No matter when it’s administered, chemotherapy can feel like another illness. The side effects may include hair loss, nausea, vomiting, and fatigue. These occur because chemotherapy affects healthy cells, especially fast-growing cells in your digestive tract, hair, and bone marrow as well as cancerous ones. Although not everyone experiences side effects, those who do can now manage them in more effective ways.

Numerous medications are available which can effectively reduce or even eliminate nausea symptoms. Relaxation techniques, including guided imagery, meditation, and deep breathing also may help. Exercise has proved to be an excellent way to combat fatigue caused by chemotherapy treatments.

Hormone therapy is most often used to treat women with advanced (metastatic) breast cancer or as an adjuvant treatment a therapy that seeks to prevent a recurrence of cancer for women diagnosed with early-stage estrogen-receptor-positive cancer. Estrogen-receptor-positive cancer indicates that the presence of estrogen or progesterone in your body might cause the development and growth of breast cancer cells. Normally, estrogen and progesterone bind to certain sites in your breast and in other parts of your body. But during this treatment, a hormonal medication binds to these sites instead and prevents estrogen from reaching them. This may help destroy cancer cells that have spread or reduce the chances that your cancer will recur. Medications that inhibit the impact of estrogen in your system are:

• Tamoxifen (Nolvadex). This is a synthetic hormone belonging to a class of drugs known as selective estrogen receptor modulators (SERMs). It’s used as a treatment for metastatic breast cancer, as adjuvant therapy, especially in women with breast cancer who have gone through menopause, and sometimes as a preventive agent in high-risk women. You take tamoxifen daily, in pill form, for up to five years. Research suggests that it may minimize the odds of breast cancer coming back and is less hazardous than most anticancer drugs. But tamoxifen isn’t trouble-free. Women taking tamoxifen may experience menopausal symptoms such as night sweats, hot flashes, vaginal itch or discharge, and diminished sexual interest. Although rare, there are potentially serious side effects that cannot be ignored. Blood clots in the lungs (pulmonary embolism) and legs (deep vein thrombosis) as well as endometrial cancer are possible side effects of taking this medication. Older women and women who are black are at greater risk of these side effects than younger women or those who are white. In addition, some studies have shown that side effects of systemic adjuvant therapies chemotherapy, and tamoxifen may be more long-term than originally thought.
• Aromatase inhibitors. This class of drugs inhibits the effect of estrogen by reducing its production in your adrenal glands. Aromatase inhibitors are not just restricted to treating metastatic cancer. Research has shown that they may be more successful than tamoxifen when it comes to preventing the recurrence of the disease. of breast cancer. And one drug, anastrozole (Arimidex), may perform better than tamoxifen as adjuvant therapy. Many cancer specialists believe that tamoxifen should still be the preferred adjuvant therapy for women with hormone-positive breast cancer. This is due to the fact that tamoxifen has a proven track record of success and benefits over many years.

Sometimes called biological response modifier or immunotherapy, this treatment tries to stimulate your body’s immune system to fight cancer.

Using substances produced by the body or similar substances made in a laboratory, biological therapy seeks to enhance your body’s natural defenses against specific diseases. Various new treatments – some of which are still in the experimental stage – are available to be tested during clinical trials. One medication, trastuzumab (Herceptin), is a monoclonal antibody a substance produced in a laboratory by mixing cells that are available for treating certain advanced cases of breast cancer. Herceptin is known to be successful in treating tumors that contain very high levels of HER-2 protein, a condition present in roughly one out of four breast cancer cases.

Scientists are currently exploring various novel therapies for the treatment of cancer. The emphasis is on methods that can successfully treat women or extend their survival with minimal side effects. Among these are drugs that block the biochemical switches that cause normal cells to turn cancerous. In addition, a procedure known as anti-angiogenesis which targets the blood vessels that supply nutrients to cancer cells is also being studied. And gene therapy is an area of ongoing research.

Of particular interest to both women and their doctors are methods of removing breast cancer without actually cutting into or removing the breast. Researchers are investigating new, non-invasive therapies to target and destroy cancer cells deep within the breast with minimal scarring, utilizing either heat or cold. One of the most researched techniques, radiofrequency ablation, uses ultrasound to locate the tumor. Then a metal probe about the size of a toothpick is inserted into the tumor where it creates heat that destroys cancer cells. Initial trials of the procedure have been extremely successful.

Even with the potential of this procedure being available to a large population, only 25 percent of women would be eligible for it. Some of these new treatments are available through clinical trials the standard way new therapies are tested in people. If you have advanced breast cancer and are interested in participating in a clinical trial, talk to your doctor or contact the National Cancer Institute’s Information Service at 800-422-6237 for more information.