Effective at 7PM, 03/17/20, Charlton Urgent Care is closed until further notice. All patients must call the Oxford UCE number prior to arrival: 508-499-1760

Coronavirus Hotline: 508.765.8191 (intended for questions or concerns related to COVID-19 only)
Our staff is available from 8am to 4:30pm, Monday through Friday, where callers may speak with clinical experts for answers to questions.

COVID-19 (coronavirus) updates and info View current ER Wait Times

September 29, 2019
How is Breast Cancer Diagnosed?

Breast cancer is the leading cancer among women in the United States, the second most common cause of cancer death in women, and the main cause of death in women aged 40 to 59 years.1 Treatment is not straightforward or based on simple decision-making. A number of factors influence a provider’s treatment decision and which path the patient ultimately chooses. This article explores the complexity of diagnosing early-stage breast cancer and the importance of understanding how this condition is defined to help make sense of the available therapeutic options. The goal is to describe the process from diagnosis to treatment planning in a clear, concise, and understandable way.

Most breast abnormalities are detected by mammogram.2 However; an abnormal mammogram alone is not diagnostic. After an abnormality is found, the patient is referred for additional views and/or ultrasound-guided core-needle biopsy (CNB). The CNB is the preferred method over fine-needle aspiration (FNA), as it has several advantages, including histologic diagnosis.2 Knowing the histologic characteristics (type: ductal, lobular; grade: high, intermediate, low) is essential to the planning of surgery and treatment. In addition, the status of estrogen receptors in samples obtained via CNB can easily be ascertained.3

Early-stage breast cancer is defined as a tumor measuring <2 cm with negative axillary lymph nodes.2 The diagnosis is further broken down based on its pathology: Is it invasive (spread from the duct or lobule into surrounding, healthy tissue) or in situ (the cancer cells have begun to multiply but are confined inside the breast)? Is the cancer ductal or lobular? Ductal carcinoma is the most common breast cancer, accounting for approximately 75% of all cases.4

Once the type of breast cancer has been identified, testing for hormone receptor status is conducted on either the CNB specimen or tissue from the surgical excision of the tumor. This immunohistochemical assay will reveal the hormone status of the tumor: estrogen receptor (ER), negative or positive; and progesterone receptor (PR), negative or positive. Women with early-stage ER-positive breast cancer who receive no systemic therapy (hormone-blocking therapy or chemotherapy) after surgery have a 5%-10% lower risk of recurrence at five years than those who are ER-negative.5

The Cancer Center at Harrington, as in many cancer centers throughout the United States, becomes involved early on once a patient has been diagnosed with breast cancer. The patient’s first encounter with our breast cancer nurse navigator is when she reaches out to them pre/post breast biopsy.  At Harrington, our nurse navigator is an experienced oncology nurse certified in Breast Cancer Navigation.  The navigator plays a key role in helping patients access the care they require across the oncology specialty areas – they assist the patients, their families and caregivers to help overcome barriers to care through the healthcare system; they also guide patients through the complicated steps in managing a cancer diagnosis during active treatment and in survivorship.

Donna Kentley, PA-C, works at The Cancer Center at Harrington in Southbridge. She completed her Physician Assistant program at Northeastern University Bouve’ College of Pharmacy and Health Sciences in Boston.

References

  1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225-249.
  2. OE Silva and S Zurrida, eds. Breast Cancer: A Practical Guide, 3rd ed., Philadelphia, Pa.: Elsevier Saunders; 2005.
  3. Litherland JC, Evans AJ, Wilson AR, et al. The impact of core-biopsy on pre-operative diagnosis rate of screen-detected breast cancers. Clin Radiol. 1996;51:562-565.
  4. Li CI, Uribe DJ, Daling JR. Clinical characteristics of different histologic types of breast cancer. Br J Cancer. 2005;93:1046-1052.
  5. Allred DC, Harvey JM, Berardo M, Clark GM. Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol. 1998;11:155-168.

Do you have an upcoming appointment? CALL FIRST

If you have an upcoming appointment at any Harrington HealthCare System facility and have the following symptoms, fever, or cough, please call your doctor prior to arriving to your appointment.

Our top priority is to protect you, our patients, communities, and healthcare workers.

Current Visitor Policy

For the health and safety of our patients and employees, the following policy is in effect as of Monday, March 30

There will be NO visitors allowed in any inpatient or outpatient services (this includes the Emergency Department, Harrington Physician Services offices, and all other Harrington HealthCare Facilities)

Please note that the Main Lobby at Harrington Hospital in Southbridge will be closed at 7pm. All patients who need to enter the hospital after that time should come in through the ED.

The implementation of this policy is in an effort to limit the spread of potential illnesses that could be harmful to you, our patients, community, and staff. Thank you for your cooperation.

Coronavirus Hotline: 508.765.8191

This hotline is intended for questions or concerns related to COVID-19. For all other inquiries, please use our regular number.