Beth Israel DMC Women's Health News

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If you're going in for a mammogram, you shouldn't wear perfume, deodorant, lotion, or powder. Small metal particles in these products can appear on your mammogram and resemble a problem area, says breast imaging specialist Janet K. Baum, MD, co-director of the Beth Israel Deaconess Medical Center BreastCare Program. BI-Deaconess has just finished expanding its mammography services, adding new mammography equipment, radiologists, and technicians. There is now only a two- to three-week wait for a mammogram and, if it is scheduled during regular work hours, you can opt to get your results before you leave.

illustration of woman Discovering a lump in the breast is one of the most frightening things that can happen to a woman. We hear so much about breast cancer that we immediately think the worst. But, far more likely for many women, the lump will turn out to be nothing more serious than a cyst or a benign tumor called a fibroadenoma.

"Women's fears are usually far worse than the reality," says Susan L. Troyan, MD, who co-directs the BreastCare Program at Beth Israel Deaconess Medical Center. "We believe in spending time with patients and educating them."

The BreastCare Program comprises a group of breast imaging specialists, nurses, surgeons, radiation and medical oncologists, and counselors. Physicians evaluate women who find new lumps or who have mammogram abnormalities, nipple discharge, breast pain, or infections. A phone line is available (617-667-2900) for anyone to call with breast-related concerns or to schedule an appointment for further evaluation.

"Most often breast changes are not medical emergencies, but they are psychological ones because they can be so frightening," says Judi Hirshfield-Bartek, RN, the team's clinical nurse specialist who fields questions on the phone line. When a woman calls scared and concerned, Hirshfield-Bartek offers the reassurance she may need until she can be seen and evaluated further by one of the specialists. "It's gratifying to hear a woman say that she was able to sleep for the first time in weeks after getting the answers she needed," she says.

Women who turn out to have breast cancer have the option to be seen in the multidisciplinary breast care program. In a single session, a woman can receive treatment recommendations from the entire team of breast care specialists.

The goal is to help women navigate the healthcare system without ever feeling they will fall between the cracks.

The woman meets first with any one of the three specialists to review her history and get an understanding of her diagnosis. The specialists then confer to discuss her individual treatment options, and review her pathology slides with the breast pathologist and breast imaging with the radiologist. The group next confers and agrees on treatment recommendations. After the conference, the woman meets with the specialists and reviews the plan. The specialists, including Hirshfield-Bartek, are available to answer any questions a woman may have and to assist her as she decides on a treatment option. Hirshfield-Bartek says her goal is to help women navigate the healthcare system without ever feeling they will fall between the cracks.

Breast care services also are available within the CareGroup Healthcare System at the Mount Auburn Hospital Breast Center. The Breast Center is part of its newly renovated and centralized women's health service, which includes gynecology and an expanded Women's Imaging Center encompassing bone densitometry, ultrasound, and mammography. Immediate on-site reading of films, discussion with providers, and informational resources are available in a sequential model of care coordinated by the referring primary care doctor and Breast Center personnel.

"We've decided to organize our care so that a woman can move quickly through the system to find out what the lump or mammographic finding means, but not so quickly that she is overwhelmed and doesn't feel she has a role in the decision-making," says Russ Nauta, MD, chief of surgery at Mount Auburn Hospital. "What is important is that the care is individualized and timely so that the medical question is answered as the anxiety is being allayed."

Breast care does not just mean care of cancers. It also means prevention: being watchful with monthly self-exams, regular mammograms (the American Cancer Society recommends one every year or two after the age of 40 and yearly after age 50), and evaluation of symptoms.

Call the CareGroup Care Connection at toll-free 888-389-CARE (2273) for information about these and other breast care programs in the CareGroup Healthcare System.

Since breast cancer is the most common cancer in women,
any symptom or physical finding in the breast evokes much fear. Most of the time, however,
the abnormalities are not cancer. For example:

Breast pain or tenderness often occurs before or during the menstrual period. Sometimes cysts--fluid-filled sacs--can cause pain. Pain does not mean cancer. In fact, only about 6 percent of women with breast cancer feel any pain in their breasts.
Fibrocystic breasts is a common term used to describe breast pain, cysts, and noncancerous lumpiness. Most women have some lumpiness, usually in the upper, outer portion of the breast. Breast evaluation can distinguish these lumps from cancer.
Lumps can be cysts, which feel soft and can be moved under the skin, or fibrous lumps, which are easy to move and feel like slippery marbles. Neither is cancerous. All lumps, however, deserve evaluation.
Nipple discharge is fluid leaking from the breasts. This is not necessarily abnormal but should be evaluated, as should bloody discharge, which usually is caused by a noncancerous lump in the milk duct.