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"I Feel a Lump. Now What?"

Our step-by-step guide to what to do next if you suspect breast cancer.

By Janis Graham

Step 1: See Your Doctor

Your suspicious finding needs to be thoroughly checked out, so make an appointment with your doctor. What's reassuring is that 90% of women under age 55 who detect a lump turn out not to have cancer. Here's what to expect checkup day:

"I kept thinking I was too young."

Five years ago Becky Cwiek, a 43-year-old mother of two from Brighton, Michigan, felt a grape-size lump in her breast after taking a shower. "I wasn't too worried. I told myself it must just be a cyst." Instead, it was an aggressive form of cancer that was caught early enough to treat successfully—all because Becky didn't blow off her discovery. "On the one hand, I was so sure it was nothing, but on the other, I did make an appointment to have it checked out right away."

Step 2: Get Ready for a Biopsy

Reality check: Just because your doctor wants a tissue sample doesn't mean you have cancer. As many as 77% of the 1 million breast biopsies performed each year in the U.S. turn out to be benign, according to a recent study. But if the images of your lump leave doubts about a diagnosis, a biopsy is the only way to be certain. Depending on how big your lump is, where it's located, and how suspicious it seems, you'll need at least one of these three procedures:

"It didn't hurt at all."

Forty-four-year-old Belinda Smith had an X-ray-guided core needle biopsy last year. The mother of two, who lives in Orlando, lay facedown on a table with her breast placed in an opening; the table then rose so the radiologist could work underneath her. "It was like a mechanic working on a car," she says. A mammography unit compressed her breast while computer images helped pinpoint the area to be biopsied. "It was so cutting edge," says Belinda, who admits the process left her "worn out and achy the next day." Her biopsy revealed a small, early-stage cancer that was treated with a breast-sparing lumpectomy and a brief course of radiation.

Step 3: Understand Your Lab Results

Biopsy results usually arrive in dribs and drabs over the course of days or even weeks. Together, they make up your pathology report—a document that can seem like it's written in a foreign language. But if you do have cancer, you'll want to make sense of it, since it's key for deciding what treatments will be best. A "translation" of important answers your report contains:

The Fine Print on a Benign Biopsy

Don't breathe a sigh of relief: Some types of noncancerous lumps increase your chances of breast cancer in the future. In a study of 9,000 women, those whose benign biopsies revealed excessive or atypical cell growth were four times as likely to develop cancer in the next 15 years as those whose biopsies showed no abnormalities. "'Negative' is not a complete answer," says Stuart Schnitt, M.D., director of anatomic pathology at Beth Israel Deaconess Medical Center in Boston. "Ask for details and find out if you should have more frequent examinations and mammograms or consider preventive drug therapy."

Step 4: Explore Your Treatment Options

You may be anxious to "get the cancer out," but it's important to obtain a second opinion. "It could make a big difference in your chances of a cure," says Michael Sabel, M.D., an author of a University of Michigan study that found that 52% of women who sought additional input received new advice. Ask your local hospital for the names of breast cancer specialists. Once you have a second opinion you can choose your treatment, which typically will include some of the following elements:

Chemo Jitters, Conquered

Before leaving for her first chemo treatment early in 2006, Lisa Vitantonio, a 48-year-old retired nurse from Chagrin Falls, Ohio, began furiously cleaning her house. "My husband begged me to stop since we were late," she recalls. "I kept delaying. I was scared." But it turned out she was so well cared for she sometimes mused that her chemo appointments were her "spa" days. "I would lie on a comfortable lounger in a pleasant room for five to nine hours. Staff would come in to make sure everything was fine and to see if I needed anything," she recalls. "I read, slept, journaled, and watched movies."

Copyright © 2007. Used with permission from the October 2007 issue of Family Circle magazine.

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