Understanding

Breast Changes

A Health Guide 

for Women

National Cancer Institute

U.S. Department 

of Health and

Human Services

National Institutes

of Health
“It was easier to talk with my 

doctor after reading this booklet. 

And I was glad to learn that most 

breast changes are not cancer.” 
Table of Contents

Introduction..........................................................1

Anatomy of the breast...........................................2

1. Breast and lymphatic system basics...................3

2. Check with your health care provider 

about breast changes.........................................4

3. Breast changes during your lifetime that 

are not cancer ...................................................7

4. Finding breast changes ......................................9

5. Getting your mammogram results ..................13

6. Follow-up tests to diagnose breast changes .....16

7. Breast changes and conditions:

Getting follow-up test results......................... 20

8. Getting the support you need .........................24

Breast conditions and follow-up care................. 25

Resources to learn more..................................... 29

Words to know ....................................................31

To order free copies 

of this booklet, call 

the National Cancer 

Institute (NCI) at

1-800-4-CANCER 

(1-800-422-6237) 

or visit us online at 

www.cancer.gov. 

Mammograms

save lives.

Mammograms are 

tests to check for 

breast changes that are 

often too small to feel. 

Getting mammograms 

on a regular basis is the 

best way to find breast 

cancer early in most 

women. Talk with your 

health care provider 

about how often to 

get mammograms.
d

Does your breast look or feel 

different? Were you told that your 

mammogram is abnormal? 

Did you find a lump? Then call your 

health care provider and make an 

appointment. In the meantime, 

use this booklet to learn more.
1

Introduction 

You may be reading this booklet because you, or your health care provider, 

found a breast lump or other breast change. Keep in mind that breast 

changes are very common. Most breast changes are not cancer. But it is 

very important to get the follow-up tests that your health care provider 

asks you to. 

What are breast changes? 

Many breast changes are changes in how your breast or nipple looks or 

feels. You may notice a lump or firmness in your breast or under your 

arm. Or perhaps the size or shape of your breast has changed. Your nipple 

may be pointing or facing inward (inverted) or feeling tender. The skin on 

your breast, areola, or nipple may be scaly, red, or swollen. You may have 

nipple discharge, which is an abnormal fluid coming from the nipple. 

If you have these or other breast changes, talk with your health care 

provider to get these changes checked as soon as possible. 

This booklet can help you take these steps:

u Call your health care provider to make an appointment as soon as you 

notice any breast changes.

u Go back to see your health care provider if your mammogram result is 

abnormal.

u Get all of the follow-up tests and care that your health care provider 

asks you to.

It may be helpful to bring this booklet with you. It discusses breast changes 

that are not cancer (benign), as well as changes that are abnormal or 

could be signs of cancer. Feel free to read different sections in this booklet 

as you need them. The Words to know section in the back of this booklet 

defines words that are shown in bold the first time they are used.
 

2

Anatomy of the breast
3

1 Breast and lymphatic system basics

To better understand breast changes, it helps to know what the breasts and 

lymphatic system are made of.

What are breasts made of?

Breasts are made of connective tissue, glandular tissue, and fatty tissue.

Connective tissue and glandular tissue look dense, or white on a 

mammogram. Fatty tissue is non-dense, or black on a mammogram. 

Dense breasts can make mammograms harder to interpret. 

Breasts have lobes, lobules, ducts, an areola, and a nipple. 

u Lobes are sections of the glandular tissue. Lobes have smaller sections 

called lobules that end in tiny bulbs that can make milk. 

u Ducts are thin tubes that connect the lobes and lobules. Milk flows 

from the lobules through the ducts to the nipple.

u The nipple is the small raised area at the tip of the breast. Milk flows 

through the nipple. The areola is the area of darker-colored skin around 

the nipple. Each breast also has lymph vessels.

What is the lymphatic system made of?

The lymphatic system, which is a part of your body’s defense system, 

contains lymph vessels and lymph nodes.

u Lymph vessels are thin tubes that carry a fluid called lymph and 

white blood cells. 

u Lymph vessels lead to small, bean-shaped organs called lymph nodes. 

Lymph nodes are found near your breast, under your arm, above your 

collarbone, in your chest, and in other parts of your body.

u Lymph nodes filter substances in lymph to help fight infection

and disease. They also store disease-fighting white blood cells 

called lymphocytes.
4

2 Check with your health care provider about breast changes

Check with your health care provider if you notice that your breast looks or 

feels different. No change is too small to ask about. In fact, the best time to 

call is when you first notice a breast change. 

Breast changes to see your health care provider 

about:

A lump (mass) or a firm feeling

u A lump in or near your breast or under your arm

u Thick or firm tissue in or near your breast or under your arm

u A change in the size or shape of your breast

Lumps come in different shapes and sizes. Most lumps are not cancer. 

If you notice a lump in one breast, check your other breast. If both breasts 

feel the same, it may be normal. Normal breast tissue can sometimes 

feel lumpy. 

Some women do regular breast self-exams (BSE). Doing a BSE regularly 

can help you learn how your breast normally feels and make it easier to 

notice and find any changes. 

Remember—doing a BSE regularly is not a substitute for regular 

mammograms.

Always get a lump checked. Don’t wait until your 

next mammogram. You may need to have tests 

to be sure that the lump is not cancer. 
5

Nipple discharge or changes

u Nipple discharge (fluid that is not breast milk)

u Nipple changes, such as a nipple that points or faces inward (inverted) 

into the breast

Nipple discharge may be different colors or textures. Nipple discharge is 

not usually a sign of cancer. It can be caused by birth control pills, some 

medicines, and infections.

Get nipple discharge checked, especially fluid that 

comes out by itself or fluid that is bloody.

Skin changes

u Itching, redness, scaling, dimples, or puckers on your breast

If the skin on your breast changes, get it checked as 

soon as possible. 

“I was in the shower one 

morning, when I felt a 

small lump in my breast. 

I was afraid and busy, 

but I didn’t let that stop 

me. I made an appointment 

to see my doctor. I got the 

answers I needed.”
 

6

Talk with your health care provider.

To get the most from your visit, talk with your health care provider about 

any breast changes you notice, as well as your personal medical history and 

your family medical history.

Tell your health care provider about breast changes 

or problems:

u These are the breast changes or problems I have noticed: __________________

u This is what the breast change looks or feels like: _________________________

(For example: Is the lump hard or soft? Does your breast feel tender or 

swollen? How big is the lump? What color is the nipple discharge?)

u This is where the breast change is: ______________________________________

(For example: What part of the breast feels different? Do both breasts feel 

different or only one breast?)

u This is when I first noticed the breast change: ____________________________

u Since then, this is the change I’ve noticed: _______________________________

(For example: Has it stayed the same or gotten worse?)

Share your personal medical history:

u I’ve had these breast problems in the past: _______________________________

u These are the breast exams and tests that I have had:______________________

u My last mammogram was on this date:__________________________________

u My last menstrual period began on this date: ____________________________

u These are the medicines or herbs that I take: _____________________________

u	Right now, I: Have breast implants Am pregnant Am breastfeeding

u I’ve had this type of cancer before: ______________________________________

Share your family medical history:

u My family members have had these breast problems or diseases:____________ 

u These family members had breast cancer:_______________________________

u They were this old when they had breast cancer:__________________________
7

3 Breast changes during your lifetime that are not cancer 

Most women have changes in their breasts during their lifetime. Many of 

these changes are caused by hormones. For example, your breasts may feel 

more lumpy or tender at different times in your menstrual cycle. 

Other breast changes can be caused by the normal aging process. As you 

near menopause, your breasts may lose tissue and fat. They may become 

smaller and feel lumpy. Most of these changes are not cancer; they are 

called benign changes. However, if you notice a breast change, don’t wait 

until your next mammogram. Make an appointment to get it checked. 

Young women who have not gone through menopause often have more 

dense tissue in their breasts. Dense tissue has more glandular and connective 

tissue and less fat tissue. This kind of tissue makes mammograms harder to 

interpret—because both dense tissue and tumors show up as solid white areas 

on x-ray images. Breast tissue gets less dense as women get older. 

Before or during your menstrual periods, your breasts may feel swollen, 

tender, or painful. You may also feel one or more lumps during this time 

because of extra fluid in your breasts. These changes usually go away by the 

end of your menstrual cycle. Because some lumps are caused by normal 

hormone changes, your health care provider may have you come back for a 

return visit, at a different time in your menstrual cycle. 

During pregnancy, your breasts may feel lumpy. This is usually because the 

glands that produce milk are increasing in number and getting larger. 
 

8

While breastfeeding, you may get a condition called mastitis. This 

happens when a milk duct becomes blocked. Mastitis causes the breast 

to look red and feel lumpy, warm, and tender. It may be caused by an 

infection and it is often treated with antibiotics. Sometimes the duct 

may need to be drained. If the redness or mastitis does not go away with 

treatment, call your health care provider.

As you approach menopause, your menstrual periods may come less 

often. Your hormone levels also change. This can make your breasts feel 

tender, even when you are not having your menstrual period. Your breasts 

may also feel more lumpy than they did before.

If you are taking hormones (such as menopausal hormone therapy, 

birth control pills, or injections) your breasts may become more dense. 

This can make a mammogram harder to interpret. Be sure to let your 

health care provider know if you are taking hormones.

When you stop having menstrual periods (menopause), your hormone 

levels drop, and your breast tissue becomes less dense and more fatty. You 

may stop having any lumps, pain, or nipple discharge that you used to 

have. And because your breast tissue is less dense, mammograms may be 

easier to interpret. 

“I pay more attention 

to my breasts since 

my doctor did followup tests on changes 

that were found.”
9

4 Finding breast changes

Here are some ways your health care provider 

can find breast changes:

Clinical breast exam

During a clinical breast exam, your health care provider checks your breasts 

and nipples and under your arms for any abnormal changes. This exam is 

part of a routine check-up. 

Mammogram

A mammogram is an x-ray picture 

of your breast tissue. This test may 

find tumors that are too small 

to feel. During a mammogram, 

each breast is pressed between two 

plastic plates. Some discomfort is 

normal, but if it’s painful, tell the 

mammography technician. 

The best time to get a mammogram 

is at the end of your menstrual 

period. This is when your breasts are 

less tender. Some women have less breast tenderness if they don’t have any 

caffeine for a couple of days before the mammogram. 

After the x-ray pictures are taken, they are sent to a radiologist, who 

studies them and sends a report to your health care provider. 
 

10

Both film and digital mammography use x-rays to make a picture of the 

breast tissue. The actual procedure for getting the mammogram is the 

same. The difference is in how the images are recorded and stored. It’s like 

the difference between a film camera and a digital camera.

u Film mammography stores the image directly on x-ray film.

u Digital mammography takes an electronic image of the breast and 

stores it directly in a computer. Digital images can be made lighter, 

darker, or larger. Images can also be stored and shared electronically.

A research study sponsored by the National Cancer Institute (NCI) showed 

that digital mammography and film mammography are about the same 

in terms of detecting breast cancer. However, digital mammography may 

be better at detecting breast cancer in woman who are under age 50, have 

very dense breasts, or are premenopausal or perimenopausal (the times 

before and at the beginning of menopause).

Talk with your health care provider to learn more about what is best for you. 

Talk with the women in your life. Let them know 

that mammograms save lives. Take time to care for 

yourself and those who need you.

“I’m glad to know that 

a test as simple and 

easy as a mammogram 

can find most breast 

changes early.”
11

Mammograms are used for both screening and diagnosis.

u Screening mammogram

A screening mammogram is the kind of mammogram that 

most women get. It is used to find breast changes in women who 

have no signs of breast cancer. 

u Diagnostic mammogram

If your recent screening mammogram found a breast change, or 

if a lump was found that needs to be checked, you may have a 

diagnostic mammogram. During a diagnostic mammogram, 

more x-ray pictures are taken to get views of the breast tissue 

from different angles. Certain areas of these pictures can also 

be made larger. 

MRI

Magnetic resonance imaging, also called MRI, uses a powerful magnet, 

radio waves, and a computer to take detailed pictures of areas inside 

the breast. MRI is another tool that can be used to find breast cancer. 

However, MRIs don’t replace mammograms. They are used in addition to 

mammograms in women who are at increased risk of breast cancer. 

MRIs have some limits. For example, they cannot find breast changes such 

as microcalcifications. MRIs are also less specific than other tests. This 

means that they may give false-positive test results—the test shows that 

there is cancer when there really is not.

Talk with your health care provider about having other screening tests, 

such as an MRI, in addition to mammograms. Ask your health care 

provider if you are at increased risk of breast cancer due to:

u Harmful changes (mutations) in the BRCA1 or BRCA2 gene 

u A family history of breast cancer

u Your personal medical history 
 

12

Mammograms and breast implants

When you make your appointment, be sure to tell the staff if you have 

breast implants. Ask if they have specialists who are trained in taking 

and reading mammograms of women with breast implants. This is 

important because breast implants can make it harder to see cancer or 

other abnormal changes on the mammogram. A special technique called 

implant displacement views is used.

u If you have breast implants for cosmetic reasons, you may have either a 

screening mammogram or a diagnostic mammogram. This will depend 

on the facility that does the mammogram.

u If you have breast implant(s) after having a mastectomy for breast cancer, 

talk with your breast surgeon or oncologist to learn about the best 

screening test for you.
13

5 Getting your mammogram results

You should get a written report of your mammogram results within 

30 days of your mammogram, since this is the law. Be sure the 

mammography facility has your address and phone number. It’s helpful 

to get your mammogram at the same place each year. This way, your 

current mammogram can be compared with past mammograms.

If your results were normal:

u Your breast tissue shows no signs of a mass or calcification.

u Visit your health care provider if you notice a breast change before your 

next appointment.

If your results were abnormal:

u A breast change was found. It may be benign (not cancer), 

premalignant (may become cancer), or cancer.

u It’s important to get all the follow-up tests your health care provider 

asks you to.

If you don’t get your results, call your health care provider.

Keep in mind that most breast changes are not cancer. But all changes need 

to be checked, and more tests may be needed.

“I used to think when a mammogram 

found something, it was cancer. 

It turns out that most breast 

changes are not cancer. That’s one 

thing I sure was glad to learn!”
 

14

What can a mammogram show?

Mammograms can show lumps, calcifications, and other changes in 

your breast. The radiologist will study the mammogram for breast changes 

that do not look normal and for differences between your breasts. When 

possible, he or she will compare your most recent mammogram with past 

mammograms to check for changes.

Lump (or mass)

The size, shape, and edges of a lump give the radiologist important 

information. A lump that is not cancer often looks smooth and round 

and has a clear, defined edge. Lumps that look like this are often cysts. 

See page 20 for more information about cysts. However, if the lump on 

the mammogram has a jagged outline and an irregular shape, more tests 

are needed. 

Depending on the size and shape of the lump, your health care provider 

may ask you to have:

u Another clinical breast exam 

u Another mammogram to have a closer look at the area 

u An ultrasound exam to find out if the lump is solid or is filled 

with fluid 

u A test called a biopsy to remove cells, or the entire lump, to look at 

under a microscope to check for signs of disease

Normal 

mammogram

Benign cyst 

(not cancer)

Cancer
15

Calcifications

Calcifications are deposits of calcium in the breast 

tissue. They are too small to be felt, but can be seen on a 

mammogram. There are two types:

u Macrocalcifications look like small white dots on a 

mammogram. They are common in women over 50 

years old. Macrocalcifications are not related to cancer 

and usually don’t need more testing.

u Microcalcifications look like tiny white specks on a 

mammogram. They are usually not a sign of cancer. 

However, if they are found in an area of rapidly dividing 

cells, or grouped together in a certain way, you may need more tests.

Depending on how many calcifications you have, their size, and where they 

are found, your health care provider may ask you to have:

u Another mammogram to have a closer look at the area

u A test called a biopsy to check for signs of disease

Are mammogram results always right?

Mammography is an excellent tool to find breast changes in most women 

who have no signs of breast cancer. However, it may not detect all breast 

cancers. See your health care provider if you have a lump that was not seen 

on a mammogram or notice any other breast changes. 

Calcium in your 

diet does not 

cause calcium 

deposits 

(calcifications) 

in the breast. 

“Even though I was nervous, I’m glad 

I got the breast biopsy my doctor 

asked me to. As I waited for my 

results, it helped to remember the 

words of my doctor: ‘Most breast 

changes are not cancer.’ ”
 

16

6 Follow-up tests to diagnose breast changes

An ultrasound exam, an MRI, a biopsy, or other follow-up tests may be 

needed to learn more about a breast change. 

Ultrasound

An ultrasound exam uses sound waves to make a picture of breast tissue. 

This picture is called a sonogram. It helps radiologists to see if a lump or 

mass is solid or filled with fluid. A fluid-filled lump is called a cyst. 

MRI

Magnetic resonance imaging, also called MRI, uses a powerful magnet, 

radio waves, and a computer to take detailed pictures of areas inside 

the breast. Sometimes breast lumps or large lymph nodes are found 

during a clinical breast exam or breast self-exam that were not seen on a 

mammogram or ultrasound. In these cases, an MRI can be used to learn 

more about these changes. 

“My doctor said my mammogram 

found something ‘abnormal.’ 

That scared me, so I went back 

for more testing. It turned out 

that I had a benign cyst. 

It wasn’t cancer. 

That was a relief.”
17

Breast biopsy

A breast biopsy is a procedure to remove a sample of breast cells or tissue, 

or an entire lump. A pathologist then looks at the sample under a 

microscope to check for signs of disease. A biopsy is the only way to find 

out if cells are cancer. 

Biopsies are usually done in an office or a clinic on an outpatient basis. 

This means you will go home the same day as the procedure. Local 

anesthesia is used for some biopsies. This means you will be awake, 

but you won’t feel pain in your breast during the procedure. General 

anesthesia is often used for a surgical biopsy. This means that you 

will be asleep and won’t wake up during the procedure. 

Common types of breast biopsies:

u Fine-needle aspiration biopsy

A fine-needle aspiration biopsy is a simple procedure that takes 

only a few minutes. Your health care provider inserts a thin needle into 

the breast to take out fluid and cells. 

u Core biopsy

A core biopsy, also called a core needle biopsy, uses a needle to remove 

small pieces or cores of breast tissue. The samples are about the size of a 

grain of rice. You may have a bruise, but usually not a scar.

u Vacuum-assisted biopsy 

A vacuum-assisted biopsy uses a probe, connected to a vacuum 

device, to remove a small sample of breast tissue. The small cut made 

in the breast is much smaller than with surgical biopsy. This procedure 

causes very little scarring, and no stitches are needed.

Your doctor may use ultrasound or mammography 

during a breast biopsy to help locate the breast change.
18

u Surgical biopsy

A surgical biopsy is an operation to remove part, or all, of a lump 

so it can be looked at under a microscope to check for signs of disease. 

Sometimes a doctor will do a surgical biopsy as the first step. Other 

times, a doctor may do a surgical biopsy if the results of a needle biopsy 

do not give enough information. 

When only a sample of breast tissue is removed, it’s called an incisional 

biopsy. When the entire lump or suspicious area is removed, it’s called 

an excisional biopsy. 

If the breast change cannot be felt, wire localization, also called 

needle localization, may be used to find the breast change. During 

wire localization, a thin, hollow needle is inserted into the breast. A 

mammogram is taken to make sure that the needle is in the right place. 

Then a fine wire is inserted through the hollow needle, to mark the 

area of tissue to be removed. Next, the needle is removed, and another 

mammogram is taken. You then go to the operating room where the 

surgeon removes the wire and surrounding breast tissue. The tissue is 

sent to the lab to be checked for signs of disease. 

“My doctor found what felt like a 

lump during an exam. She said I 

should get a biopsy. I was afraid. 

But my doctor told me that it’s 

always best to find out exactly 

what the problem is and take 

care of it early.”
19

Questions to ask if a biopsy is recommended:

u Why is a biopsy needed? What will it tell us?_____________________

u What type of biopsy will I have? How will the biopsy be done? _____

u Where will the biopsy be done? How long will it take?_____________

u Will it hurt? _________________________________________________

u How much breast tissue will be removed?________________________

u Will I be awake? ______________________________________________

u What tests will be done on the breast tissue? _____________________

u When will I know the results?__________________________________

u Will there be side effects?_____________________________________

u How should I care for the biopsy site? ___________________________

u Will I need to rest after the biopsy? _____________________________

Questions to ask about your biopsy results:

u What were the results of the biopsy? _____________________________

u What do the biopsy results mean? ______________________________

u What are the next steps? Do I need more tests? __________________

u Who should I talk with next? __________________________________

u Do I have an increased risk of breast cancer?_____________________

u Who can give me a second opinion on my biopsy results? _________
 

20

7 Breast changes and conditions: Getting follow-up test results

Test results will tell if you have:

Breast changes that are not cancer

These changes are not cancer and do not increase your risk of breast 

cancer. They are called benign changes.

Adenosis: Small, round lumps, or a lumpy feeling that are caused by 

enlarged breast lobules. Sometimes the lumps are too small to be felt. 

If there is scar-like tissue, the condition may be painful and is called 

sclerosing adenosis. 

Cysts: Lumps filled with fluid. Breast cysts often get bigger and may be 

painful just before your menstrual period begins. Cysts are most common 

in premenopausal women and in women who are taking menopausal 

hormone therapy.

Fat necrosis: Round, firm lumps that usually don’t hurt. The lumps most 

often appear after an injury to the breast, surgery, or radiation therapy.

Fibroadenomas: Hard, round lumps that may feel like a small marble and 

move around easily. They are usually painless and are most common in 

young women under 30 years old.

Intraductal papilloma: A wart-like growth in a milk duct of the breast. 

It’s usually found close to the nipple and may cause clear, sticky, or bloody 

discharge from the nipple. It may also cause pain and a lump. It is most 

common in women 35–55 years old. 

Ask your doctor when you will get your test results. 

See the chart on pages 25–28 for follow-up 

information.
21

Breast changes that are not cancer, but increase 

your risk of cancer

These conditions are not cancer, but having them increases your risk 

of breast cancer. They are considered risk factors for breast cancer. 

Other risk factors include, for example, your age and a family history of 

breast cancer. 

u Atypical hyperplasia:

n Atypical lobular hyperplasia (ALH) is a condition in which 

abnormal cells are found in the breast lobules. 

n Atypical ductal hyperplasia (ADH) is a condition in which 

abnormal cells are found in the breast ducts.

u Lobular carcinoma in situ (LCIS) is a condition in which abnormal 

cells are found in the breast lobules. There are more abnormal cells in 

the lobule with LCIS than with ALH. Since these cells have not spread 

outside the breast lobules, it’s called “in situ,” which is a Latin term 

that means “in place.”

The abnormal cells found in these conditions are not cancer cells. If you 

have ALH, ADH, or LCIS, talk with a doctor who specializes in breast 

health to make a plan that works best for you. Depending on your personal 

and family medical history, it may include:

u Mammograms every year

u Clinical breast exams every 6 to 12 months

u Tamoxifen (for all women) or raloxifene (for postmenopausal 

women). These drugs have been shown to lower some women’s risk of 

breast cancer.

u Surgery. A small number of women with LCIS and high risk factors for 

breast cancer may choose to have surgery. 

u Clinical trials. Talk with your health care provider about whether a 

clinical trial is a good choice for you.
 

22

Breast changes that may become cancer

Ductal carcinoma in situ (DCIS): 

DCIS is a condition in which abnormal 

cells are found in the lining of a breast 

duct. These cells have not spread outside 

the duct to the breast tissue. This is why 

it is called “in situ,” which is a Latin term 

that means “in place.” You may also hear 

DCIS called Stage 0 breast carcinoma 

in situ or noninvasive cancer.

Since it’s not possible to determine which cases of DCIS will become 

invasive breast cancer, it’s important to get treatment for DCIS. Talk with a 

doctor who specializes in breast health to learn more. Treatment for DCIS 

is based on how much of the breast is affected, where DCIS is in the breast, 

and its grade. Most women with DCIS are cured with proper treatment. 

Treatment choices for DCIS include:

u Lumpectomy. This is a type of breast-conserving surgery or breastsparing surgery. It is usually followed by radiation therapy. 

u Mastectomy. This type of surgery is used to remove the breast or as 

much of the breast tissue as possible.

u Tamoxifen. This drug may also be taken to lower the chance that DCIS 

will come back, or to prevent invasive breast cancer.

u Clinical trials. Talk with your health care provider about whether a 

clinical trial is a good choice for you.

“Instead of stressing that 

something abnormal was 

found, I realized how lucky 

I was to have this small 

breast change found early.”
23

Breast cancer

Breast cancer is a disease in which cancer 

cells form in the tissues of the breast. 

Breast cancer cells:

u Grow and divide without control

u Invade nearby breast tissue

u May form a mass called a tumor

u May metastasize, or spread, to the 

lymph nodes or other parts of the body

After breast cancer has been diagnosed, tests are done to find out the 

extent, or stage, of the cancer. The stage is based on the size of the tumor 

and whether the cancer has spread. Treatment depends on the stage of 

the cancer. 

For more information about breast cancer and to get answers to any 

questions you may have, call 1-800-4-cancer (1-800-422-6237). Two free 

booklets you can ask for are: What You Need To Know About Breast Cancer

and Surgery Choices for Women with Early-Stage Breast Cancer. You can also 

visit the National Cancer Institute (NCI) online at www.cancer.gov.

Get a second opinion

You may want to talk with another doctor to get a second opinion on your 

diagnosis or on your treatment. Many women do. And remember—

it’s important to talk with a doctor who specializes in breast cancer or in 

the breast condition that you have.

You can talk with your health care provider to find:

u	Another pathologist to review your breast tissue slides and make a 

diagnosis

u	Another surgeon, radiation oncologist, or medical oncologist to talk 

with about your treatment choices

Most doctors welcome a second opinion, especially when treatment is 

involved. Getting a second opinion is often covered, or even required, by 

your health insurance. Talking with another doctor can give you peace of 

mind. It can also help you make the best choices about your health.
24

“I tried not to let the worries 

of tomorrow bother me today. 

It meant figuring out what 

I could and could not control. 

Talking with other women 

helped me.”

8 Getting the support you need

It can be upsetting to notice a breast change, to get an abnormal test 

result, or to learn about a new condition or disease. We hope that the 

information in this booklet has answered some of your questions and 

calmed some of your fears as you talk with your health care provider and 

get the follow-up care you need.

Many women choose to get extra help and support for themselves. It may 

help to think about people who have been there for you during challenging 

times in the past. 

u Ask friends or loved ones for support. Take someone with you while you 

are learning about your testing and treatment choices.

u Ask your health care provider to:

n Explain medical terms that are new or confusing

n Share with you how other people have handled the types of feelings 

that you are having

n Tell you about specialists that you can talk with to learn more 

u Get in touch with the organizations listed on pages 29 and 30 to 

learn more.
25

Breast conditions and follow-up care

continued on next page

Condition

Adenosis

Atypical lobular

hyperplasia (ALH)

Atypical ductal

hyperplasia (ADH)

Features

•	 Small round lumps,

lumpiness, or you may not 

feel anything at all

•	 Enlarged breast lobules

•	 If there is scar-like fibrous

tissue, the condition is 

called sclerosing adenosis. 

It may be painful.

•	 Some studies have

found that women with 

sclerosing adenosis may 

have a slightly increased 

risk of breast cancer.

•	 Abnormal cells in the

breast lobules

•	 ALH increases your risk of

breast cancer.

•	 Abnormal cells in the

breast ducts

•	 ADH increases your risk of

breast cancer.

What your doctor may recommend

•	 A core biopsy or a surgical biopsy may be

needed to make a diagnosis.

Regular follow-up, such as:

•	 Mammograms

•	 Clinical breast exams

Treatment, such as:

•	 Tamoxifen (for all women) or raloxifene

(for postmenopausal women)

Regular follow-up, such as:

•	 Mammograms

•	 Clinical breast exams

Treatment, such as:

•	 Tamoxifen (for all women) or raloxifene

(for postmenopausal women)
 

26

Condition Features What your doctor may recommend

Breast conditions and follow-up care continued

continued on next page

Breast cancer

Cysts

Ductal carcinoma 

in situ (DCIS)

•	 Cancer cells found in the

breast, with a biopsy

•	 A lump in or near your

breast or under your arm

•	 Thick or firm tissue in or

near your breast or under 

your arm

•	 A change in the size or

shape of your breast

•	 A nipple that’sturned inward

(inverted) into the breast

•	 Skin on your breast that is

itchy, red, scaly, dimpled, or 

puckered

•	 Nipple discharge that is not

breast milk

•	 Lumps filled with fluid

•	 Often in both breasts

•	 May be painful just before

your menstrual period 

begins 

•	 Some cysts may be felt.

Others are too small to

be felt.

•	 Most common in women

35–50 years old

•	 Abnormal cells in the lining

of a breast duct

•	 Unlike cancer cells that can

spread, these abnormal 

cells have not spread 

outside the breast duct.

•	 May be called noninvasive

cancer or Stage 0 breast

carcinoma in situ.

Treatment depends on the extent or stage of

cancer. 

Tests are done to find out if the cancer has 

spread to others parts of your body. 

Treatment may include:

•	 Surgery

•	 Chemotherapy

•	 Radiation therapy

•	 Hormonal therapy

•	 Biological therapy

Clinical trials may be an option for you. 

Talk with your doctor to learn more.

•	 Cysts may be watched by your doctor over

time, since they may go away on their own.

•	 Ultrasound can show if the lump is solid or

filled with fluid.

•	 Fine needle aspiration may be used to remove

fluid from the cyst.

Treatment is needed because doctors don’t

know which cases of DCIS may become invasive

breast cancer. Treatment choices include:

•	 Lumpectomy. This is a type of breastconserving surgery or breast-sparing surgery.

It is usually followed by radiation therapy.

•	 Mastectomy. Surgery to remove the breast.

•	 Tamoxifen. This drug may be taken to lower

the chance that DCIS will come back after

treatment or to prevent invasive breast cancer.

•	 Clinical trials. Talk with your doctor about

whether a clinical trial is a good choice for you.
27

Breast conditions and follow-up care continued

continued on next page

Condition Features What your doctor may recommend

Fat necrosis

Fibroadenoma

Intraductal

papilloma

•	 Round, firm lumps that

usually don’t hurt

•	 May appear after an injury

to the breast, surgery, or 

radiation therapy

•	 Formed by damaged fatty

tissue

•	 Skin around the lump

may look red, bruised, or 

dimpled

•	 A benign (not cancer)

breast condition 

•	 Hard, round lumps that

move around easily and 

usually don’t hurt

•	 Often found by the woman

•	 Appear on a mammogram

as smooth, round lumps 

with clearly defined edges

•	 The most common benign

breast tumors

•	 Common in women under

30 years old

•	 Most fibroadenomas do

not increase your risk of 

breast cancer. However,

complex fibroadenomas do

slightly increase your risk.

•	 A wart-like growth inside

the milk duct, usually close 

to the nipple

•	 May cause pain and a lump

•	 May cause clear, sticky, or

bloody discharge

•	 Most common in women

35–55 years old

•	 Unlike single papillomas,

multiple papillomas increase 

your risk of breast cancer.

•	 A biopsy may be needed to diagnose and

remove fat necrosis, since it often looks 

like cancer.

•	 Fat necrosis does not usually need treatment.

•	 A biopsy may be needed to diagnose

fibroadenoma.

•	 A minimally invasive technique such as

ultrasound-guided cryoablation or an 

excisional biopsy may be used to remove

the lumps.

•	 These growths may be watched by your

doctor over time, since they may go away on 

their own.

•	 A biopsy may be needed to diagnose the

growth and remove it.
28

Breast conditions and follow-up care continued

More information on these breast conditions 

can be found on www.cancer.gov or 

by calling 1-800-4-CANCER (1-800-422-6237).

Condition Features What your doctor may recommend

Lobular carcinoma

in situ (LCIS)

Macrocalcifications

Microcalcifications

•	 A condition in which

abnormal cells are found in 

the breast lobules

•	 LCIS increases your risk of

breast cancer.

•	 Calcium deposits in the 

breast that look like 

small white dots on a 

mammogram

•	 Often caused by aging

•	 Cannot be felt

•	 Usually benign (not cancer)

•	 Common in women over

50 years old

•	 Calcium deposits in the

breast that look like 

tiny white specks on a 

mammogram

•	 Not usually a sign of cancer.

However, if found in an

area of rapidly dividing cells 

or grouped together in a 

certain way, they may be 

a sign of DCIS or invasive

breast cancer.

Regular follow-up, such as:

•	 Mammograms

•	 Clinical breast exams

Treatment choices:

•	 Tamoxifen (for all women) or raloxifene

(for postmenopausal women) may be 

taken.

•	 A small number of women with LCIS and

high risk factors for breast cancer may 

choose to have surgery.

•	 Clinical trials may be an option for you.

Talk with your doctor to learn more.

•	 Another mammogram may be needed

to have a closer look at the area.

•	 Treatment is usually not needed.

•	 Another mammogram or a biopsy may be

needed to make a diagnosis. 
29

Resources to learn more

National Cancer Institute (NCI)

NCI has comprehensive research-based information on cancer prevention, screening, diagnosis,

treatment, genetics, and supportive care. We also have a clinical trials database and can offer 

tailored searches. 

Phone:	 1-800-4-CANCER (1-800-422-6237)

TTY:	 1-800-332-8615

Web site:	 www.cancer.gov or www.cancer.gov/espanol

LiveHelp:	 www.cancer.gov/livehelp

Email:	 cancergovstaff@mail.nih.gov

Order publications at www.cancer.gov/publications or by calling 1-800-4-CANCER

We invite you to call or go online to talk with our trained information specialists, who speak 

English or Spanish, to:

u	 Get answers to any cancer-related questions you may have

u Get free NCI publications

u	 Learn more about specific resources and organizations in your area

u	 Find information on the NCI Web site www.cancer.gov

American Cancer Society (ACS)

ACS gives cancer information and support to patients, families, and caregivers. It also supports

research, community education, advocacy, and public policy issues. Trained cancer information 

specialists can answer questions about cancer, link you to resources in your community, and

provide information on local events. 

Phone:	 1-800-ACS-2345 (1-800-227-2345)

TTY:	 1-866-228-4327

Web site:	 www.cancer.org

Centers for Disease Control and Prevention (CDC)

CDC conducts, supports, and promotes efforts to prevent cancer and increase early detection

of cancer. CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP)

provides these services for underserved women:

u	 Clinical breast exams

u	 Mammograms (free or low-cost)

u	 Diagnostic tests if results are abnormal

u Referrals to treatment

Toll Free:	 1-800-CDC-INFO (1-800-232-4636)

TTY:	 1-888-232-6348

Web site:	 www.cdc.gov
 

30

Centers for Medicare & Medicaid Services (CMS)

CMS provides information for consumers about patient rights, prescription drugs, and health

insurance issues, including Medicare and Medicaid. 

Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and

any age with permanent kidney failure. It covers an annual screening mammogram, among other 

services. Medicare has information about providers in your area. English- or Spanish-speaking

representatives can help you. 

Phone:	 1-800-MEDICARE (1-800-633-4227)

TTY:	 1-877-486-2048

Web site:	 www.cms.hhs.gov

Medicaid is a program for people who need financial help with medical bills. You can learn more 

about this program by calling your local state welfare offices, state health department, state social 

services agencies, or your state’s Medicaid office. Spanish-speaking staff is available in some offices.

Web site:	 www.cms.hhs.gov

National Women’s Health Information Center (NWHIC)

NWHIC is a gateway to women’s health information. NWHIC has English- and Spanish-speaking

Information and Referral Specialists who will order free health information for you. They can

also help you find organizations that can answer your health-related questions.

Phone:	 1-800-994-9662

TDD:	 1-888-220-5446

Web site:	 www.womenshealth.gov

U.S. Food and Drug Administration (FDA)

The FDA has fact sheets and brochures about mammography, as well as information about a

certified mammography facility near you. It also has laws about how these facilities are run.

Phone:	 1-888-INFO-FDA (1-888-463-6332)

Web site:	 www.fda.gov
31

Words to know

abnormal: Not normal. An abnormal lesion or growth may be cancer, premalignant (may

become cancer), or benign (not cancer).

adenosis: A disease or abnormal change in a gland. Breast adenosis is a benign condition in

which the lobules are larger than usual. 

ADH (atypical ductal hyperplasia): A benign (not cancer) condition in which there are more

cells than normal in the lining of breast ducts and the cells look abnormal under a microscope. 

Having ADH increases your risk of breast cancer.

ALH (atypical lobular hyperplasia): A benign (not cancer) condition in which there are more

cells than normal in the breast lobules and the cells look abnormal under a microscope. Having

ALH increases your risk of breast cancer.

antibiotic: A drug used to treat infections caused by bacteria and other microorganisms.

areola: The area of dark-colored skin on the breast that surrounds the nipple.

atypical hyperplasia: A benign (not cancer) condition in which cells look abnormal under a

microscope and are increased in number.

benign: Not cancer. Benign tumors may grow larger but do not spread to other parts of the body.

biological therapy: Treatment to boost or restore the ability of the immune system to fight

cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused

by some cancer treatments. Agents used in biological therapy include monoclonal antibodies,

growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called

biological response modifier therapy, biotherapy, BRM therapy, and immunotherapy.

biopsy: The removal of cells or tissues for examination by a pathologist. The pathologist may

study the tissue under a microscope or perform other tests on the cells or tissue. There are many

different types of biopsy procedures. The most common types include: (1) incisional biopsy,

in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or

suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed

with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin 

needle is used, the procedure is called a fine-needle aspiration biopsy.

BRCA1: A gene on chromosome 17 that normally helps to suppress cell growth. A person who

inherits certain mutations (changes) in a BRCA1 gene has a higher risk of getting breast, ovarian,

prostate, and other types of cancer. BRCA1 is short for (breast cancer 1, early onset gene).

BRCA2: A gene on chromosome 13 that normally helps to suppress cell growth. A person who

inherits certain mutations (changes) in a BRCA2 gene has a higher risk of getting breast, ovarian,

prostate, and other types of cancer. BRCA2 is short for (breast cancer 2, early onset gene).

breast: Glandular organ located on the chest. The breast is made up of connective tissue, fat,

and glandular tissue that can make milk. Also called mammary gland.
 

32

breast cancer: Cancer that forms in tissues of the breast, usually the ducts (tubes that carry

milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, 

although male breast cancer is rare.

breast density: Describes the relative amount of different tissues present in the breast. A dense

breast has less fat than glandular and connective tissue. Mammogram films of breasts with

higher density are harder to read and interpret than those of less dense breasts.

breast duct: A thin tube in the breast that carries milk from the breast lobules to the nipple.

Also called milk duct.

breast implant: A silicone gel-filled or saline-filled sac placed under the chest muscle to restore

breast shape.

breast-conserving surgery: An operation to remove the breast cancer but not the breast

itself. Types of breast-conserving surgery include lumpectomy (removal of the lump),

quadrantectomy (removal of one quarter, or quadrant, of the breast), and segmental

mastectomy (removal of the cancer as well as some of the breast tissue around the tumor and 

the lining over the chest muscles below the tumor). Also called breast-sparing surgery.

breast self-exam: An exam by a woman of her breasts to check for lumps or other changes.

Also called BSE.

breast-sparing surgery: An operation to remove the breast cancer but not the breast itself.

Types of breast-sparing surgery include lumpectomy (removal of the lump), quadrantectomy

(removal of one quarter, or quadrant, of the breast), and segmental mastectomy (removal of

the cancer as well as some of the breast tissue around the tumor and the lining over the chest 

muscles below the tumor). Also called breast-conserving surgery.

calcification: Deposits of calcium in the tissues. Calcification in the breast can be seen on a

mammogram, but cannot be felt. There are two types of breast calcifications, macrocalcification

and microcalcification. Macrocalcifications are large deposits of calcium and are usually not

related to cancer. Microcalcifications are specks of calcium that may be found in an area of

rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer.

calcium: A mineral needed for healthy teeth, bones, and other body tissues. It is the most

common mineral in the body. A deposit of calcium in body tissues, such as breast tissue, may be

a sign of disease.

cancer: A term for diseases in which abnormal cells divide without control and can invade

nearby tissues. Cancer cells can also spread to other parts of the body through the blood and 

lymph systems.

chemotherapy: Treatment with drugs that kill cancer cells.

clinical breast exam: A physical exam of the breast performed by a health care provider to

check for lumps or other changes. Also called CBE.

clinical trial: A type of research study that tests how well new medical approaches work in

people. A clinical trial tests new methods of screening, prevention, diagnosis, or treatment of a

disease. Also called clinical study.

connective tissue: Supporting tissue that surrounds other tissues and organs. Specialized

connective tissue includes bone, cartilage, blood, and fat.
33

core biopsy: The removal of a tissue sample with a wide needle for examination under a

microscope. Also called core needle biopsy.

cryoablation: A procedure in which tissue is frozen to destroy abnormal cells. This is usually

done with a special instrument that contains liquid nitrogen or liquid carbon dioxide. Also

called cryosurgery.

cyst: A sac or capsule in the body. It may be filled with fluid or other material.

DCIS (ductal carcinoma in situ): A noninvasive condition in which abnormal cells are found

in the lining of a breast duct. The abnormal cells have not spread outside the duct to other

tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues,

although it is not known at this time how to predict which lesions will become invasive. Also

called intraductal carcinoma.

dense breasts: See breast density.

diagnosis: The process of identifying a disease, such as cancer, from its signs and symptoms.

diagnostic mammogram: X-ray of the breasts used to check for cancer after a lump or other 

sign or symptom of breast cancer has been found.

digital mammography: A technique that uses a computer, rather than x-ray film, to record

x-ray images of the breast.

duct: See breast duct.

excisional biopsy: A surgical procedure in which an entire lump or suspicious area is removed

for diagnosis. The tissue is then examined under a microscope to check for signs of disease.

false-positive test result: A test result that indicates that a person has a specific disease or

condition when the person actually does not have the disease or condition.

family medical history: A record of the relationships among family members along with their

medical histories. This includes current and past illnesses. A family medical history may show a

pattern of certain diseases in a family. Also called family history.

fat necrosis: A benign condition in which fat tissue in the breast or other organs is damaged

by injury, surgery, or radiation therapy. The fat tissue in the breast may be replaced by a cyst or

by scar tissue, which may feel like a round, firm lump. The skin around the lump may look red,

bruised, or dimpled.

fibroadenoma: A benign (not cancer) tumor that usually forms in the breast from both fibrous

and glandular tissue. Fibroadenomas are the most common benign breast tumors.

film mammography: The use of x-rays to create a picture of the breast on a film.

fine-needle aspiration biopsy: The removal of tissue or fluid with a thin needle for examination

under a microscope. Also called FNA biopsy.

general anesthesia: A temporary loss of feeling and a complete loss of awareness that feels like

a very deep sleep. It is caused by special drugs or other substances called anesthetics. General 

anesthesia stops patients from feeling pain during surgery or other procedures. 

gland: An organ that makes one or more substances, such as milk, hormones, digestive juices,

sweat, tears, or saliva.
 

34

glandular: See gland.

grade: A description of a tumor based on how abnormal the cancer cells look under a

microscope and how quickly the tumor is likely to grow and spread. Grading systems are

different for each type of cancer.

hormonal therapy: Treatment that adds, blocks, or removes hormones. For certain conditions

(such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or

stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or 

other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed

to remove the gland that makes a certain hormone. Also called endocrine therapy, hormone

therapy, and hormone treatment.

hormone: One of many chemicals made by glands in the body. Hormones circulate in the

bloodstream and control the actions of certain cells or organs. Some hormones can also be

made in the laboratory.

implant displacement views: A procedure used to do a mammogram (x-ray of the breasts) in

women with breast implants. The implant is pushed back against the chest wall and the breast

tissue is pulled forward and around it so the tissue can be seen in the mammogram. Also called

Eklund displacement views and Eklund views.

in situ: In its original place. For example, in carcinoma in situ, abnormal cells are found only in

the place where they first formed. They have not spread.

incisional biopsy: A surgical procedure in which a portion of a lump or suspicious area is

removed for diagnosis. The tissue is then examined under a microscope to check for signs of

disease.

infection: Invasion and multiplication of germs in the body. Infections can occur in any part

of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or

fungi. They can cause a fever and other problems, depending on where the infection occurs.

When the body’s natural defense system is strong, it can often fight the germs and prevent

infection. Some cancer treatments can weaken the natural defense system.

intraductal papilloma: A benign (not cancer), wart-like growth in a milk duct of the breast. It

is usually found close to the nipple and may cause a discharge from the nipple. It may also cause 

pain and a lump in the breast that can be felt. It usually affects women aged 35-55 years. Having a

single papilloma does not increase the risk of breast cancer. When there are multiple intraductal 

breast papillomas, they are usually found farther from the nipple. There may not be a nipple

discharge and the papillomas may not be felt. Having multiple intraductal breast papillomas may

increase the risk of breast cancer. Also called intraductal breast papilloma.

LCIS (lobular carcinoma in situ): A condition in which abnormal cells are found in the lobules

of the breast. LCIS seldom becomes invasive cancer; however, having it in one breast increases

the risk of developing breast cancer in either breast. 

lobe: A portion of an organ, such as the breast, liver, lung, thyroid, or brain.

lobule: A small lobe or a subdivision of a lobe.

local anesthesia: A temporary loss of feeling in one small area of the body caused by special

drugs or other substances called anesthetics. The patient stays awake but has no feeling in the

area of the body treated with the anesthetic.
35

lumpectomy: Surgery to remove abnormal tissue or cancer from the breast and a small amount

of normal tissue around it. It is a type of breast-sparing surgery.

lymph: The clear fluid that travels through the lymphatic system and carries cells that help fight 

infections and other diseases. Also called lymphatic fluid.

lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective

tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood

cells). They are located along lymph vessels. Also called a lymph gland.

lymph vessel: A thin tube that carries lymph (lymphatic fluid) and white blood cells through

the lymphatic system. Also called lymphatic vessel.

lymphatic system: The tissues and organs that produce, store, and carry white blood cells that

fight infections and other diseases. This system includes the bone marrow, spleen, thymus,

lymph nodes, and lymph vessels (a network of thin tubes that carry lymph and white blood 

cells). Lymph vessels branch, like blood vessels, into all the tissues of the body.

lymphocyte: A type of immune cell that is made in the bone marrow and is found in the blood

and in lymph tissue. The two main types of lymphocytes are B lymphocytes and T lymphocytes.

B lymphocytes make antibodies, and T lymphocytes help kill tumor cells and help control 

immune responses. A lymphocyte is a type of white blood cell.

macrocalcification: A small deposit of calcium in the breast that cannot be felt but can be seen

on a mammogram. It is usually caused by aging, an old injury, or inflamed tissue and is usually not

related to cancer.

mammogram: An x-ray of the breast.

mammography: The use of x-rays to create a picture of the breast tissue.

mass: In medicine, a lump in the body. It may be caused by the abnormal growth of cells, a cyst,

hormonal changes, or an immune reaction. A mass may be benign (not cancer) or malignant

(cancer).

mastectomy: Surgery to remove the breast, or as much of the breast tissue as possible.

mastitis: A condition in which breast tissue is inflamed. It is usually caused by an infection and

is most often seen in nursing mothers.

medical oncologist: A doctor who specializes in diagnosing and treating cancer using

chemotherapy, hormonal therapy, and biological therapy. A medical oncologist often is

the main health care provider for someone who has cancer. A medical oncologist also gives

supportive care and may coordinate treatment given by other specialists.

menopause: The time of life when a woman’s ovaries stop working and menstrual periods stop.

Natural menopause usually occurs around age 50. A woman is said to be in menopause when

she hasn’t had a period for 12 months in a row. Symptoms of menopause include hot flashes,

mood swings, night sweats, vaginal dryness, trouble concentrating, and infertility.

menopausal hormone therapy: Hormones (estrogen, progesterone, or both) given to women

after menopause to replace the hormones no longer produced by the ovaries. Also called

hormone replacement therapy and HRT.
 

36

menstrual cycle: The monthly cycle of hormonal changes from the beginning of one menstrual 

period to the beginning of the next.

menstrual period: The periodic discharge of blood and tissue from the uterus. From puberty

until menopause, menstruation occurs about every 28 days, but does not occur during

pregnancy.

metastasize: To spread from one part of the body to another. When cancer cells metastasize

and form secondary tumors, the cells in the metastatic tumor are like those in the original 

(primary) tumor.

microcalcification: A tiny deposit of calcium in the breast that cannot be felt but can be

detected on a mammogram. A cluster of these very small specks of calcium may indicate that

cancer is present.

microscope: An instrument that is used to look at cells and other small objects that cannot be

seen with the eye alone.

MRI (magnetic resonance imaging): A procedure in which radio waves and a powerful magnet

linked to a computer are used to create detailed pictures of areas inside the body. These pictures

can show the difference between normal and diseased tissue. MRI makes better images of organs

and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI

is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones.

Also called NMRI and nuclear magnetic resonance imaging.

mutation: Any change in the DNA of a cell. Mutations may be caused by mistakes during cell

division, or they may be caused by exposure to DNA-damaging agents in the environment.

Mutations can be harmful, beneficial, or have no effect. If they occur in cells that make eggs or

sperm, they can be inherited; if mutations occur in other types of cells, they are not inherited. 

Certain mutations may lead to cancer or other diseases.

needle localization: A procedure used to mark a small area of abnormal tissue so it can be

removed by surgery. An imaging device is used to guide a thin wire with a hook at the end

through a hollow needle to place the wire in or around the abnormal area. Once the wire is in the

right place, the needle is removed and the wire is left in place so the doctor will know where the 

abnormal tissue is. The wire is removed at the time the biopsy is done. Also called needle/wire

localization and wire localization.

nipple: In anatomy, the small raised area in the center of the breast through which milk can

flow to the outside.

nipple discharge: Fluid coming from the nipple that is not breast milk.

noninvasive: In cancer, it describes disease that has not spread outside the tissue in which

it began. In medicine, it describes a procedure that does not require inserting an instrument

through the skin or into a body opening.

oncologist: A doctor who specializes in treating cancer. Some oncologists specialize in a

particular type of cancer treatment. For example, a radiation oncologist specializes in treating

cancer with radiation.

outpatient: A patient who visits a health care facility for diagnosis or treatment without

spending the night. Sometimes called a day patient.
37

pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope.

perimenopausal: Describes the time in a woman’s life when menstrual periods become irregular

as she approaches menopause. This is usually three to five years before menopause and is often

marked by many of the symptoms of menopause, including hot flashes, mood swings, night

sweats, vaginal dryness, trouble concentrating, and infertility.

personal medical history: A collection of information about a person’s health. It may include

information about allergies, illnesses and surgeries, and dates and results of physical exams,

tests, screenings, and immunizations. It may also include information about medicines taken

and about diet and exercise. Also called personal health record and personal history.

premalignant: A term used to describe a condition that may (or is likely to) become cancer.

Also called precancerous.

premenopausal: Having to do with the time before menopause. Menopause (“change of life”) is

the time of life when a woman’s menstrual periods stop permanently.

radiation oncologist: A doctor who specializes in using radiation to treat cancer.

radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons,

protons, and other sources to destroy cancer cells and shrink tumors. Radiation may come from 

a machine outside the body (external-beam radiation therapy), or it may come from radioactive

material placed in the body near cancer cells (internal radiation therapy). 

radiologist: A doctor who specializes in creating and interpreting pictures of areas inside the

body. The pictures are produced with x-rays, sound waves, or other types of energy.

raloxifene: The active ingredient in a drug used to reduce the risk of invasive breast cancer in

postmenopausal women who are at high risk of the disease or who have osteoporosis. It is also 

used to prevent and treat osteoporosis in postmenopausal women. It is also being studied in 

the prevention of breast cancer in certain premenopausal women and in the prevention and 

treatment of other conditions. Raloxifene blocks the effects of the hormone estrogen in the

breast and increases the amount of calcium in bone. It is a type of selective estrogen receptor 

modulator (SERM).

risk factor: Something that may increase the chance of developing a disease. Some examples of

risk factors for cancer include age, a family history of certain cancers, use of tobacco products, 

certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing

agents, and certain genetic changes.

sclerosing adenosis: A benign condition in which scar-like tissue is found in a gland, such as

the breast lobules or the prostate. A biopsy may be needed to tell the difference between the

abnormal tissue and cancer. Women with sclerosing adenosis of the breast may have a slightly 

increased risk of breast cancer.

screening: Checking for disease when there are no symptoms. Since screening may find diseases 

at an early stage, there may be a better chance of curing the disease. Examples of cancer 

screening tests are the mammogram (breast), colonoscopy (colon), Pap smear (cervix), and PSA

blood level and digital rectal exam (prostate). Screening can also include checking for a person’s

risk of developing an inherited disease by doing a genetic test. 

screening mammogram: X-rays of the breasts taken to check for breast cancer in the absence 

of signs or symptoms.
 

38

side effect: A problem that occurs when treatment affects healthy tissues or organs. Some

common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood 

cell counts, hair loss, and mouth sores.

sonogram: A computer picture of areas inside the body created by bouncing high-energy sound

waves (ultrasound) off internal tissues or organs. Also called an ultrasonogram.

specific: See specificity.

specificity: When referring to a medical test, specificity refers to the percentage of people who

test negative for a specific disease among a group of people who do not have the disease. No 

test is 100% specific because some people who do not have the disease will test positive for it

(false positive). 

stage: The extent of a cancer in the body. Staging is usually based on the size of the tumor, 

whether lymph nodes contain cancer, and whether the cancer has spread from the original site 

to other parts of the body.

stage 0 breast carcinoma in situ: There are 2 types of stage 0 breast cancer: ductal carcinoma

in situ (DCIS) and lobular carcinoma in situ (LCIS). DCIS is a noninvasive condition in which

abnormal cells are found in the lining of a breast duct (a tube that carries milk to the nipple). 

The abnormal cells have not spread outside the duct to other tissues in the breast. In some

cases, DCIS may spread to other tissues, although it is not known how to predict which lesions

will become invasive cancer. LCIS is a condition in which abnormal cells are found in the lobules

(small sections of tissue involved with making milk) of the breast. This condition seldom

becomes invasive cancer; however, having LCIS in one breast increases the risk of developing

breast cancer in either breast. Stage 0 breast cancer is also called breast carcinoma in situ.

surgeon: A doctor who removes or repairs a part of the body by operating on the patient.

surgery: A procedure to remove or repair a part of the body or to find out whether disease is

present. Also called an operation.

surgical biopsy: The removal of tissue by a surgeon for examination by a pathologist. The

pathologist may study the tissue under a microscope. 

tamoxifen: A drug used to treat certain types of breast cancer in women and men. It is also used

to prevent breast cancer in women who have had (DCIS) ductal carcinoma in situ (abnormal

cells in the ducts of the breast) and women who are at a high risk of developing breast cancer. 

Tamoxifen is also being studied in the treatment of other types of cancer. It blocks the effects of

the hormone estrogen in the breast. Tamoxifen is a type of antiestrogen. Also called tamoxifen

citrate.

tumor: An abnormal mass of tissue that results when cells divide more than they should or

do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also

called neoplasm.

ultrasound: A procedure in which high-energy sound waves are bounced off internal tissues or

organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine,

forming a picture of body tissues called a sonogram. Also called ultrasonography.
39

vacuum-assisted biopsy: A procedure in which a small sample of tissue is removed from the

breast. An imaging device is used to guide a hollow probe connected to a vacuum device. The

probe is inserted through a tiny cut made in numbed skin on the breast. The tissue sample is

removed using gentle vacuum suction and a small rotating knife within the probe. Then the tissue

sample is studied under a microscope to check for signs of disease. This procedure causes very

little scarring and no stitches are needed. Also called VACB and vacuum-assisted core biopsy.

white blood cell: A type of immune cell. Most white blood cells are made in the bone marrow

and are found in the blood and lymph tissue. White blood cells help the body fight infections 

and other diseases. Granulocytes, monocytes, and lymphocytes are white blood cells. Also

called leukocyte and WBC.

wire localization: A procedure used to mark a small area of abnormal tissue so it can be

removed by surgery. An imaging device is used to guide a thin wire with a hook at the end

through a hollow needle to place the wire in or around the abnormal area. Once the wire is

in the right place, the needle is removed and the wire is left in place so the doctor will know 

where the abnormal tissue is. The wire is removed when a biopsy is done. Also called needle

localization and needle/wire localization.

x-ray: A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by

making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.
NIH Publication No. 09-3536

Printed September 2009