Women's Services

Breast Cancer

We at TriHealth understand your journey with breast cancer and strive to offer a care team that makes all the difference.

What is Breast Cancer?

Cancer begins when the body starts to produce abnormal cells. Our bodies typically create new cells whenever they are needed, but sometimes the cells grow out of control and look unlike normal cells. They form a mass called a tumor. If the cells in the tumor are like regular healthy cells, the tumor is called benign. If the cells are unlike regular healthy cells, they are called malignant

As in all cancers, the body site where these abnormal cells come from gives its name to the cancer. So if you have breast cancer, the abnormal cells started in your breast. Just as other cancers, these cells can invade other areas and create new tumors. This spread is called metastasis.

You’ve probably heard this statistic: One in eight women will get breast cancer.

For women, breast cancer is the second most frequent cause of death for women in the U.S., following lung cancer. Skin cancer is the most frequently diagnosed cancer among American women. Men can get breast cancer, too, although it’s not very common.

Breast Cancer Risk Factors

The Role of Genetics in Breast Cancer

Among all individuals with breast cancer, about 5 to 10% were born with a genetic risk for the disease. Genes are very small pieces of DNA that govern how cells work, including how and when they divide and grow. We inherit one copy of each gene from our mothers and one from our fathers. A mutation is a change in a gene that make it work differently than it should. Individuals with breast cancer may have one of these mutations.

Genetic Testing for Breast Cancer

Genetic testing can determine whether a hereditary gene mutation is present in an individual. This can help determine whether someone who has already been diagnosed with breast cancer has a higher risk of getting a second breast cancer, or other cancers.

Learn more about cancer genetic counseling at TriHealth.

Diagnosing Breast Cancer

Scientists are still grappling with whether breast cancer can be stopped before it ever occurs in the body. We do know that some things can help protect against breast cancer, including:

Regular aerobic exercise

Research has shown that women who exercised frequently and with vigor were only half as likely to get breast cancer. (These results were in studies with mostly younger, pre-menopausal women.)

Exercise can also help those who have breast cancer deal with side effects of treatment and recover more quickly after surgery. Regular exercise can also positively affect survival.

Diet and nutrition

Fats in the diet may raise the risk of developing breast cancer, while vegetables, fruits and grains may help lower the risk. Such results have been found in other countries, but so far no lessening of breast cancer risk has been found as a result of eating a low-fat diet.

Drinking alcohol has been associated with a rise in the risk for breast cancer. Studies have shown that women who consume 2 1/3 to 4 ½ bottles of beer a day, 2 ½ to more than 5 ½ glasses of wine daily or 2 to 4 shots a liquor per day have an increased incidence of breast cancer. It is recommended, therefore, that women restrict their intake of alcohol.

Diet by itself is not enough, however, to outweigh other breast cancer risk factors. Eat a healthy diet AND practice such prevention approaches as getting a regular mammogram. Here’s what you need to know about a mammogram. 

The wisest way is to find cancers as early as possible and get treatment for them. Review with your doctor these approaches to preventing cancer or detecting it early:

  • Each year, get a thorough checkup and a screening mammogram beginning at age 40 (earlier if you have a family history of breast cancer.) Discuss with your doctor when to begin.
  • Review the use of birth control pills with your doctor.
  • As you near menopause, talk to your doctor about hormone replacement therapy (HRT). Research suggests that HRT, particularly when estrogen and progestin are combined, can raise breast cancer risk.
  • If you are at high risk for getting breast cancer, speak with your doctor about the risks of specific medications, such as tamoxifen and raloxifene, which show promise in reducing breast cancer risk.

Screening Mammogram

What it is: A screening mammogram is for women who have no symptoms of breast cancer. In this test, an x-ray of the breast is taken from top to bottom and side to side. Radiologists look at the mammograms to determine if further attention is necessary.

The American Cancer Society recommends that women have once-a-year screening mammograms beginning at age 40.

What if the screening mammogram finds something unusual?

Between 6 to 8% of these screening mammograms identify something that may need further attention, including:

  • Physical examination of the breast
  • Further mammography
  • Ultrasound
  • Needle biopsy

When further evaluation is completed, most women whose screening mammogram located a potential abnormality will be found to have nothing wrong.

Diagnostic Mammogram

What it is: A mammogram done for women whose screening mammograms detected some kind of abnormality. Often, magnification views can give a better picture of the area under question.

What if the diagnostic mammogram finds something unusual?

It depends on what was found. Some women may need additional images from mammography. Others may need additional mammograms and ultrasound.

3D Mammogram (Tomosynthesis)

TriHealth is proud to have brought the first 3D digital tomosynthesis to the public in Greater Cincinnati.

What it is: A revolutionary screening approach that produces a series of high resolution pictures, giving doctors the ability to view the breast layer by layer. This approach can reveal information that goes unseen in standard mammograms.

  • Among the many benefits of 3D mammograms:
  • Improved views of breast tissue
  • Increased cancer detection by up to 40%
  • Fewer (15%) call-back rates for further tests
  • Less anxiety for patients

How Accurate are Mammograms?

Mammograms are accurate in 85 to 90% of the cases. They help detect abnormal tissue before it is large enough to be felt. Still, it is possible that you could feel a lump that might not be visible on a mammogram. Tell your doctor anything you feel while examining your breasts!

How Does an Abnormality Appear on a Mammogram?

Something that needs further attention might be called a mass, lump, density, distortion or nodule. This might appear as:

  • A mass with a smooth, well-defined border. This is often benign. Ultrasound can determine what is inside the mass. If it is fluid, the mass is called a cyst.
  • A mass with an irregular border or a starburst appearance. This may be cancerous. The physician will probably recommend a biopsy.
  • Small amounts of calcium, called microcalcifications, most of which are noncancerous. The physician can classify them as benign, suspicious, or indeterminate. She or he may recommend additional mammogram studies, possibly followed by a biopsy.

“What if They Think They See Something on my Mammogram?”

This is a common question. The majority of abnormal findings from a mammogram are found either to be normal breast tissue or benign (noncancerous) tissue.

Breast Ultrasound

What it is: High-frequency sound waves (inaudible to humans) are transmitted through the breast. Echoes produce pictures of the breast and can zero in on a small area of concern. These ultrasound images can help specialists identify an array of conditions and diseases, including breast cancer.

Your provider may use ultrasound by itself or with other diagnostic tests.

An ultrasound can help determine:

  • Whether a lump in the breast is a solid mass or a cyst (sac containing fluid). If it is a cyst, a needle is often used to aspirate – remove— fluid. If the fluid that is removed is clear and the mass vanishes, your physician may decide that no further testing is needed.
  • The specific location of a tumor that is known to exist but cannot be felt. Knowing the specific location, the physician can guide the needle to that precise spot during a breast biopsy.

Other Breast Procedures

  • MRI (Magnetic Resonance Imaging) of the breast creates detailed pictures of the breast and the tissues around it. MRIs can add helpful information to mammograms but are only recommended in certain instances.
  • Breast biopsy is a procedure that takes a small amount of tissue from an area of the breast with abnormal-looking tissue identified by a physical exam, mammogram or other means. The tissue sample is then investigated to see whether cancer cells are present.
  • Fine needle aspiration breast biopsy is a procedure in which the doctor puts a thin needle into the suspicious-looking area and draws out fluid and breast tissue that are then examined. This is the simplest type of breast biopsy and is used mostly for lumps that are felt in the breast.

What Does it Mean if I Have Dense Breasts?

My Mammogram Letter Says I Have Dense Breasts. What Does That Mean?

The Ohio legislation passed a new law concerning breast density as it relates to mammography results. This new law requires TriHealth to include the following statement on reports for our patients who have heterogeneously or very dense breasts:

Your mammogram demonstrates that you have dense breast tissue, which could hide abnormalities. Dense breast tissue, in and of itself, is a relatively common condition. Therefore, this information is not provided to cause undue concern; rather, it is to raise your awareness and promote discussion with your health care provider regarding the presence of dense breast tissue in addition to other risk factors.

What is Breast Density and Why is it Important

Breasts are made up of a mixture of fibrous and glandular tissue and fatty tissue. Your breasts are considered dense if you have a lot of fibrous or glandular tissue but not much fat. Density may decrease with age, but there is little, if any, change in most women.

Having dense breast tissue may increase your risk of getting breast cancer. Dense breasts also make it more difficult for doctors to spot cancer on mammograms. Dense tissue appears white on a mammogram. Lumps, both benign and cancerous, also appear white. So, mammograms can be less accurate in women with dense breasts.

How do I Know if I Have Dense Breasts

Breast density is determined by the radiologist who reads your mammogram. There are four categories of mammographic density. The radiologist assigns each mammogram to one of the categories.

Imaging Dense Breasts

  • Mammography is still the preferred screening method for breast cancer. Women 40 and over should receive annual screening mammograms.
  • 3D mammography is a newer technology that is superior for women with heterogeneously dense breasts. This technology is now covered by Medicare, but coverage varies between commercial payers.
  • Whole breast ultrasound and breast MRI are both supplementary screening tools for women with extremely dense breast tissue. However, these tests are more sensitive and can identify things that are not cancer, leading to biopsies and other testing that may not be necessary. These tests are also very expensive and often not covered by insurance if not properly justified. For this reason, additional risk evaluation can be a vital part of a thorough risk assessment.

What Does This Mean for You?

If your follow up letter from your recent mammogram notes that you have dense breast tissue, you will fall into one of two categories:

  • Heterogeneously dense breast tissue, or
  • Extremely dense breast tissue

If you have no other risk factors, your best option may be to have a 3D mammography at your next screening mammogram. TriHealth offers this advanced technology at Bethesda North Hospital at the Mary Jo Cropper Family Center for Breast Care and Good Samaritan Hospital.

Risk Evaluation

Whether your breasts are dense or fatty, there may be other factors that can still place you at increased risk for breast cancer. These include:

  • Family history of the disease
  • Previous chest radiation treatment for cancer
  • Previous breast biopsies that show you are high risk

It is important to understand your risk factors and discuss them with your physician. There are several models to assess your risk.

You can determine your risk factors by consulting with your physician, completing a risk assessment or speaking with one of our counselors at the Breast Center.

  • All TriHealth patients are welcome to a free risk assessment through our center by calling 513 862 5160.

Online Breast Cancer Risk Assessment Tool

To further assess your risk for breast cancer, please go to the following website and answer eight simple questions:

This Breast Cancer Risk Assessment Tool is based on a statistical model known as the "Gail model". The model uses the following factors to estimate a woman's risk of developing invasive breast cancer over specific periods of time:

  • Her own personal medical history
  • Her own reproductive history
  • History of breast cancer among her first-degree relatives (mother, sisters, and daughters)

The Gail model has been validated in large populations of white women and performs well in other populations such as African American women with previous biopsies, Asian and Pacific Islanders, but needs further validation for Hispanic women and other subgroups.

The Gail model may underestimate the risk of breast cancer if there is a history of breast cancer on your father's side, relatives who are beyond first degree (e.g., aunt, grandparent, cousin) or if you have a personal history of breast cancer. If your history contains these factors, you should speak with your physician about the appropriate risk assessment and screening plan for you. Patients with extensive family history of cancer (e.g., breast, ovarian, pancreatic, colon, with 3 affected family members or with a diagnosis under the age of 50) can find additional information about genetic counseling here, (add hyperlink) or may request a genetic counseling consultation by calling 513 451 4033, option 1.

After completing the questionnaire, you will be able to print your breast cancer risk assessment and take to your physician for further discussion. Your doctor can help you determine if further screening or testing is necessary. The TriHealth Breast Care team is also available to answer questions and can be reached at 513 862 5160.

Genetic Counseling

The goal of genetic counseling is to provide personalized information about an individual’s cancer risk factors, genetic testing options, and recommendations for cancer screening, treatment and management. The genetic counselor will take a complete family history and medical history. During the risk assessment the patient will learn more about their cancer risk and potential risk to other family members.

For further questions about breast density, risk assessments, or supplementary imaging, please call 513 862 5160 and we will be happy to assist you!

Mammography Scheduling Number
Schedule a mammogram 513 569 6777