Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Ms. G. is a 40-year-old woman with two small
children. Like most women, she is concerned about her chances of developing
breast cancer. She asks her doctor about her risks.
Although breast cancer is a worry for most women, Ms. G. is especially worried because of a
family history of breast cancer. Her mother and sister had breast cancers that were diagnosed
at young ages.
A woman with a family history of breast cancer
has a lot of concerns. Among other things, she is thinking of her job, children,
and husband, as well as how her medical insurance and health team will be able
to serve her needs in the future should a crisis arise.
What are the facts about families that have multiple members with breast cancer?
Inherited breast cancer disorders account for a
small minority of breast cancers overall. Genes are the "messages" in
each cell of the body that determine the ultimate design of our bodies.
The breast generally refers to the front of the chest
and medically
specifically to the mammary gland.
(The word "mammary" comes from "mamma," the Greek and Latin word
for the breast, which derives from the cry "mama" uttered by infants
and young children, sometimes meaning "I want to feed at the
breast.")
How is the mammary gland designed?
The mammary gland is a milk-producing structure that is composed
largely of fat cells (cells capable of storing fat). The fat deposits
are laid down in the breast under the influence of the female hormoneestrogen. Just as
the surge of estrogens at adolescence encourages this process,
androgens, such as testosterone, discourage it.
Within the mammary gland there is a complex network of
branching ducts (tubes or channels). These ducts exit from sac-like
structures called lobules.
The lobules in the breast are the glands that can produce milk in
females when they receive the appropriate hormonal stimulation.
The breast ducts transport milk from the lobules out to the
nipple. The ducts exit from the breast at the nipple.
Picture of the anatomy of the breast
How are human breasts different from those
of other primates?
Human breasts function somewhat differently than those
of other primates. In other primates, the breasts grow only when the female is
producing milk (lactating). When the non-human primate female has weaned her
young, her breasts flatten back down. In humans, the breasts develop at
adolescence usually well before any pregnancy has occurred and the breasts stay
enlarged throughout the remainder of life.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Cysts are saclike structures that can occur throughout the body and usually contain a semisolid, liquid, or gaseous substance. Infections, tumors, genetic conditions, chronic inflammatory conditions, and wear and tear can cause cysts. Though some cysts may be palpable, others may not produce any symptoms. Treatment depends upon the location and cause of the cyst.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
Pregnancy symptoms vary from woman to woman. There are some symptoms that are more frequent in some women. These symptoms include a missed period, nausea, vomiting, bloating, weight gain, headaches, food cravings, and mood changes.
Fibrocystic breast condition (sometimes called fibrocystic breast disease) is characterized by lumpiness and usually discomfort in one or both breasts. The condition is very common and benign (not malignant). Fibrocystic breast condition is the most common cause of "lumpy breasts" in women. A common symptom of fibrocystic breast condition is breast pain or discomfort. There are two types of fibrocystic breast condition, cysts and fibrosis, and Hyperplasia and atypical hyperplasia of breast cells.
Breast lumps in women can have a variety of causes such as breast inflammation, infection, injuries, cancer, and non-cancerous growths. Breast lumps in women are diagnosed with physical exam, mammogram, ultrasound, MRI, and biopsy. Treatment of breast lumps in women depend on the cause.
Male breast cancer accounts for 1% of all breast cancers, and most cases are found in men between the ages of 60 and 70. A man's risk of developing breast cancer is one in 1,000. Signs and symptoms include a firm mass located below the nipple and skin changes around the nipple, including puckering, redness or scaling, retraction and ulceration of the nipple. Treatment depends upon staging and the health of the patient.
Prolactinoma is an adenoma (benign tumor) of the pituitary gland. Causes of many prolactinomas are unknown. Symptoms in women include changes in menstruation and infertility, decreased libido, or painful intercourse due to vaginal dryness. The most common symptom in men is impotence (erectile dysfunction). Treatment of prolactinomas are medication or surgery.
The time when boys and girls begin the process of sexual maturation is called puberty. During this time, both sexes undergo a series of biological changes that include a rapid increase in height, bone growth, weight increase, the growth of pubic hair, breast development and the onset of menstruation in girls, and testicle, penis, and muscle enlargement in boys.
It's important to know whether you will breastfeed or bottle-feed your baby prior to delivery, as the breasts' ability to produce milk diminishes soon after childbirth without the stimulation of breastfeeding. Breast milk is easily digested by babies and contains infection-fighting antibodies and cholesterol, which promotes brain growth. Formula-fed babies actually need to eat somewhat less often since formula is less readily digested by the baby than human milk. This article explores the advantages and disadvantages of both forms of feeding.
Inflammatory breast cancer is an accelerated form of breast cancer that is not usually detected by mammogram or ultrasound. Symptoms of inflammatory breast cancer include pain in the breast, skin change in the breast area, bruise on the breast,sudden swelling of the breast, nipple retraction or discharge, and swelling of the lymph nodes.
Lymphedema is a common chronic, debilitating condition in which excess fluid called lymph collects in tissues and causes swelling in them. It is common after a mastectomy, lumpectomy or breast cancer surgery and radiation therapy.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
Lifestyle changes, a healthy antioxidant-rich diet, exercise, and weight reduction can help reduce a woman's risk of developing breast cancer. It's important to be aware of how risk factors such as family history, lifestyle factors, breast conditions, radiation therapy, and hormonal factors may influence your chances of developing breast cancer. Mammography and breast self-examinations are crucial steps in breast cancer prevention.
Pregnancy can bring challenges like weight gain, stretch marks, varicose veins, heartburn, constipation, hemorrhoids, problems sleeping, and wondering if it is safe to have sex while pregnant. Learn how to manage and move through these challenges during pregnancy.
As breast cancer is the most diagnosed non-skin cancer in American women, it is important to know your breast cancer risk. Risk factors include age, age at menarche, age at first live birth, history of breast abnormalities, breast biopsies, race, and history or breast cancer among first-degree relatives.
1. What is preventive mastectomy, and what types of procedures are used in
preventive mastectomy?
Preventive mastectomy (also called prophylactic or risk-reducing mastectomy )
is the surgical removal of one or both breasts in an effort to prevent or reduce
the risk of breast cancer. Preventive mastectomy involves one of two basic
procedures: total mastectomy and subcutaneous mastectomy. In a total mastectomy,
the doctor removes the entire breast and nipple. In a subcutaneous mastectomy,
the doctor removes the breast tissue but leaves the nipple intact. Doctors most
often recommend a total mastectomy because it removes more tissue than a
subcutaneous mastectomy. A total mastectomy provides the greatest protection
against cancer developing in any remaining breast tissue.
2. Why would a woman consider undergoing preventive mastectomy?
Women who are at high risk of developing breast cancer may consider
preventive mastecto...
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