Clinical Breast Exam
Instruction in self breast exam is offered during your routine gyn exam, with Dr. Pollycove demonstrating “typical” breast density variations that allow you to feel more confident that you are not missing something important. And for women who do not want to examine their own breasts, reassurance that this is also an acceptable choice in self care, supported by some very large studies on this topic. Dr. Pollycove often says to her patients, “If you can feel the quality of a fabric between your thumb and fingers, feel the difference between a rough burlap sack and a fine silk scarf, you can learn to feel confident when examining your breasts.”
Women who are still having menstrual cycles may notice subtle or profound changes in their breasts according to time in the cycle. Usually the week or 10 days before menstruation starts our breasts are most tender and we find the majority of painful cysts or enlargements. But if such new findings do not disappear when the period is over, please call the office to be examined by Dr. Pollycove. Although this is not an emergency by medical/surgical standards, such lumps can feel like emotional emergencies and are treated promptly to maximize resolution and minimize anxiety.
The optimal standard of breast care in all women at increased risk and all women over 50 includes a twice annual clinical breast exam, the careful exam of the breasts performed by clinician with interest and expertise in breast health. In addition I recommend a baseline mammogram at age 35 and annual mammograms for women over 40. Sometimes a sonogram of the breast is done to further evaluate a lump or mass that is felt on exam, especially in younger women. These ultrasound imaging tests are very helpful in assuring a benign cause of the lump or the rare cancer that is found on self or clinical breast examination. MRI is a highly sensitive method for assessing the biologic activity of an area of the breast, usually guided by changes seen on a mammogram. In some instances, periodic MRI is the optimal imaging technique to clarify benign from potentially pre-cancer or subtle invasive breast cancer as detected by mammography or ultrasound. Tiny “core biopsies” may be taken at the breast center to give specific microscopic details of an imaging finding. These are more common as our detection techniques become more detailed and clinical research correlates better outcomes with accurate early detection of abnormalities in the breast.
Serving on the Board of Trustees of the American Society of Breast Centers, followed by years on the Board of the National Consortium of Breast Centers, NCBC, in 2018 Dr. Pollycove was awarded the title of Fellow, signifying her unusual deep experience in breast care. Her research interest prior to medical school centered on immunology and the breast cancer causing virus, MTV, at the Cancer Research Genetics Laboratory of University of California at Berkeley. From those early days to the present, expertise in all areas of breast cancer: early detection with screening, details of diagnosis, clinical care options and survivor care continue to be areas of great interest and expertise.