1. Fine-needle aspiration biopsy (FNA) - using a small needle is inserted through the skin of the breast andthe tip of the needle, tissue samples taken then to be examined. FNA is usually used for taking tissue samples or solid lumps filled with fluid (cyst). If true cyst, it will be deflated after all the liquid is taken. If no fluid, another type of biopsy will be performed.
2. Core needle biopsy - uses a larger needle with a special tip shape. The needle is inserted, through the skin up into lumps, and tissue samples taken about the size of a pencil tip. Biopsy of this type can also be done using a vacuum unit that will slowly take the example of a larger network.
3. Stereotactic biopsy -
using a special type of X-rays with the same needle type with acore needle biopsy. This technique can find a lump that can not be felt by palpation, but looks at the examination by mammogram or breast ultrasound. Small incision made ​​in the skin of the breast to facilitate the needleinto the breast with X-ray guidance Stereotactic biopsy is only applied to specific cases and onlyspecialist that allows doing this biopsy.
4. Open biopsy -slicing open the skin biopsy and take part or the entire lump. If the doctor can not feel a lump, a needle or a special cable will be inserted into the suspected area during a screening mammogrambefore surgery. Figure needles or wires will help physicians determine the area where the bump occurred and determine the surgical incision should be made ​​to take these lumps.

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Cause
The cause is unknown, but there are some risk factors that cause a woman to be more likely to suffer from breast cancer.

Risk Factors
Some of the factors that influence risk are:

1. Age. About 60% of breast cancers occur in over 60 years. The greatest risk found in women aged over 75 years.
2. Ever had breast cancer.  After the affected breast removed, then the risk of breast cancer ina healthy increase of 0.5-1% / year.
3. Family history of breast cancer.  Women who are mothers, sisters or children suffering from cancer, had a three times greater risk for breast  cancer.
4. Genetic and hormonal factors.
5. Had suffered from non-cancerous breast disease.
6. Menarche (first menstruation) before age 12 years, menopauseafter age 55 years, first pregnancy after age 30 years or had never been pregnant.
7. Use of birth control pills or estrogen replacement therapy.
8. Obesity after menopause.
9. The use of alcohol.
10. The use of alcohol more than 1-2 cups / day can increase the risk of breast cancer.
11. Chemicals.  Several studies have mentioned the chemical exposure that mimicestrogen (which is contained in pesticides and other industrial products) may increase the risk of breast cancer.
12. DES (diethylstilbestrol).  Women who took DES to prevent miscarriage have a higher risk ofbreast cancer.
13. Irradiation.

Here are some types of lumps that can be found in the breast.

FibroadenomaFibroadenoma is a round shaped mass, demarcated, rubbery,which arise due to excessive growth of glandular tissue andconnective tissue.
These lumps are benign and usually painless. Lump fibroadenomacan be moved or be shifted if the breast is pressed.
Fibroadenoma responds to hormonal changes and tend to enlargeduring pregnancy and shrink after menopause.
Any woman can suffer from fibroadenoma, but usually most often found at the age of 20 to 30 years.
Fibroadenomas can not be definitely diagnosed only by physical examination alone.
Mammography and breast ultrasound can help make a diagnosis,but the only way to ensure a fibroadenoma is by biopsyexamination, which is taking a bit of tissue with a needle andexamined under a microscope.
Fibroadenoma may disappear spontaneously.
But if you persist, or the more enlarged, or the patient is veryworried about these lumps, it can be done surgically.

Breast abscessBreast abscess usually occurs as a complication of breast infection(mastitis). These infections most often occur during breastfeeding,due to the entry of bacteria into the breast tissue.
Breast infections are usually treated by administering antibitiotik. Ifantibiotics are not able to overcome infection or breast abscess,surgical removal can be a breast abscess.

Breast injuryBreast injury due to surgery or an accident for example, may interfere with the so-called fat necrosis.
Fat necrosis may further lead to the formation of lumps of connective tissue demarcated, round, and can be driven. If the injury has long been the case, the lump is usually painless.
But if the injury has just happened, can there is pain and swelling onthe skin over the bumps.
Breast lumps due to fat necrosis usually disappears by itself. But ifthe lump persists, you should immediately see a doctor.

Tumor FillodesFillodes tumor is a breast lump that is not pain due to excessivegrowth of connective tissue.
Fillodes tumors generally are benign, although some of them may be malignant.
Often, medical practitioners is difficult to distinguish between tumorand fibroadenoma fillodes - even after the imaging examinations(mammography or breast ultrasound) and fine needle aspirationbiopsy.
One sign that the lump was a tumor fillodes is growing very fast andlarge size.
Fillodes tumor treatment include lump removal through surgery. After surgery, the possibility of recurrence is still there.

Breast cancerBreast cancer is a malignant lump is often painless, palpable hard and irregularly shaped.
At the touch, this lump feels different from surrounding breasttissue. If the lump is attached to the chest muscles, the lump can not be driven.
Skin over the lump may be interested and reddish.
Another feature of breast cancer, among others, is a discharge ofclear fluid or blood mixed spontaneously from the nipples, nipplesappear to be interested, change size and shape of the breast, andbreast skin like orange peel.
Breast cancer treatment depends on the type of cancer, cancer staging, and description of the cancer cells look under amicroscope.
Treatment options may include surgery, radiation, chemotherapy,or hormone therapy.
Keep in mind that breast cancer is discovered at an early stage, chances for successful treatment of breast cancer greater than thatfound in an advanced stage.

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There are three techniques that can be used to detect breast cancerearly.
By using ultrasound, mamotome system, and sentinel lymph bipsi.

1. Ultrsound used in hospital is part of the examination of additional clinical breast examination. The tool is very important in determining the characteristics ofbreast mass that clear or not clear. The use of ultrasound is also useful to distinguish a cyst that exist in the breast, both benign and malignant. As an illustration, the cancer will be detected from the sound wavesreleased by ultrasound. Gelombagn voice will be higher withabtasan irregular.By ultrasound examination at the time of the consultation will makethe problems experienced by patients can be treated quickly. Cystor lump found in breast can also be biopsied with minimal incisionsfor later analysis.This of course will reduce patient anxiety. Mengurangibiaya coursewill also perform when compared with open surgical biopsy.
2. Mammografi digital (digital mammography), dan dalam beberapa kejadian, magnetic resonance imaging (MRI).
3. One of the more sophisticated biopsy techniques were mamotome.
With this bipsi system allows doctors to take exactly the amount ofbreast tissue with local anesthesia and surgery tapa. Biopsy results are generally quite accurate, especially for earlystage breast cancer. For the record, the procedure is done quickly and only a little pain. Even the incision was quite small. "Only about 4 mm, so it does notneed stitches," said Dr.. Joy. She can run the activity again as soon as the procedure done. Approximately one million procedures performed each yearmemotome and become standard practice in many health care services. Even so, it takes great skill and experience to perform the procedure. Biopsy memotome three times more accurate than the usualneedle biopsy using.

Levels of breast cancer

Stage 3A
According to data from the MOH, 87% of breast cancers are foundat this stadium. Cancerous lump is larger than 5 centimeters and has spread to lymph glands.

Stage 3B
Cancer has spread to all parts of the breast, even reaching the skin, chest wall, ribs and chest muscles. In addition, the spilloverhas invaded lymph kalenjar thoroughly. If you already so there is noalternative other than removal of the breast.

Step of treatment for stage 3 are:
- Removal of the breast,
- Chemo or radiotherapy
- Body immune therapy
- Hormonal therapy

The next step is chemotherapy, it is very important to kill the cancercells.
Because if left too long will the cancer cells grow faster.
Business Chemotherapy combined with surgery, would improve the chances of life expectancy in patients with breast cancer.

Side effects of chemotherapy are nausea, there are some patientswho experienced muntah2, hair loss, lack of appetite. Above side effects are also influenced by patient endurancemasing2.
During the post-chemo and afterwards can be combined withherbal treatments to reduce the risk of side effects from the chemoitself.

Take steps who are scientifically and appropriately in treatingcancer.
Do not spend time and money for treatment who are notmeaningful.

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* Standing in front of the mirror with her ​​hands placed on the side of the body.
Raise both arms and observe carefully the skin on the breast if there are wrinkles, curves, change in size or shape.
See if there is a change of symmetry in both breasts.
Observe also if the nipple or enter into any strange fluid coming out of the nipple.
Now put both hands on the side pingul then observe your breasts.After that put both hands behind your head and do the same.

* Check both breasts while standing in the shower while showering.Do the same when you lie.
Put one hand behind his head, one hand while doing the massagemotion rotate clockwise in the area of ​​breast tissue, nipple, and thetissue under the armpit.
Repeat this on the left breast. When you do the bath, soaps andwater makes the skin smooth up to mampermudah examination.

* Check if there are lumps that do not disappear or do not change.An abnormal lump can appear suddenly and persist.
These lumps of different shapes and hardness and sometimesfeels hard with irregular edges.
Sometimes the lump is a thickening of the tissue without a clearboundary line. Remember, the cancerous lump is usually painless.

American Cancer Society recommends women undergo clinicalbreast examination as part of routine health examinations, onceevery three years for women aged 20-39 years and every year for women over 40 years.

T 0: not found the primary tumor
Q 1: The size of the tumor diameter of 2 cm or less
T 2: tumor size of 2-5 cm diameter
Q 3: The size of the tumor diameter> 5 cm
Q 4: How tumor size alone, but there have been spread to the skinor chest wall or both, may include ulcers,  edema, or swelling, breast skin redness or a small lump on the skin outside the main tumor

Stadium 0: T0 N0 M0
Stadium 1: T1 N0 M0
Stadium II A: T0 N1 M0 / T1 N1 M0 / T2 N0 M0
Stadium IIB: T2 N1 M0 / T3 N0 M0
Stadium IIIA: T0 N2 M0 / T1 N2 M0 / T2 N2 M0 / T3, N1, M0 / T2 N2M0
Stadium IIIB: T4 N0 M0 / N1 M0 T4 / T4 N2 M0
Stadium III C: every T N3 M0
Stadium IV: every T-M1-N

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In many cases, doctors will work with patients to determine thetreatment plan Although the treatment of each patient will be adjusted by the doctor.
But here are the general steps undertaken in the treatment ofbreast cancer:

* The main purpose of early-stage cancer treatment is to remove the tumor and tissue surrounding the tumor.
So doctors will recommend surgery to remove the tumor. Generally,radiation therapy will then be performed on the remaining breasttissue.
For certain circumstances (eg, patients with serious medicalproblems) radiation can be postponed.
* The following steps in dealing with early stage cancer is to reducethe risk cancer will recur and discard the remaining cancer cells.
When the tumor is large lymph nodes or channels have beenstricken with cancer as well, the doctor will recommend additionaltherapy, among others: Radiation Therapy, Chemotherapy, and / orhormone therapy.
As for the recurrence of cancer, treated with a variety of ways.When planning treatment, doctors will consider several factors:

* Stage and grade of cancer
* Status of the tumor hormone receptor (ER, PR) and HER2/neustatus
* Age of patients and the general health
* Patients have gone through menopause or not
* The presence of gene mutations of breast cancer biology breast cancer condition an effect on the behavior of the cancer and its treatment.
Some tumors are small in size but growing in size fast or big butslow growth.

Treatment usually begins after a thorough assessment of the condition of the patient, which is about a week or more after thebiopsy.
Treatment consists of surgery, radiation therapy, chemotherapyand hormone inhibitors.

Radiation therapy is used to kill cancer cells in the removal of the tumor and the surrounding area, including the lymph nodes.

Chemotherapy (a combination of drugs to kill cells that multiplyquickly or pressing breeding) and drug-hormone inhibitors (drugs that affect the hormones that promote the growth of cancer cells)are used to suppress the growth of cancer cells throughout thebody.

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For the early symptoms include a lump usually feels different fromsurrounding breast tissue, painless and usually have an irregular edge.

In the early stages, when driven by a finger, a lump can be moved easily under the skin.
In later stages, the lump usually adheres to the chest wall or skinaround it. In advanced cancer, can form a swollen lump or breast skin ulcers.
Sometimes the skin over the lump shrank and looked like an orange peel.

Other symptoms that may be found a lump or mass in the armpit,change size or shape of the breast, an abnormal discharge from the nipple (usually bloody or yellow to green, may also be pus), change incolor or texture of the skin on the breast, nipple and areola (dark brown colored area around the nipple), breast looks red, the skin around the nipple scaly nipple interestedin or feel itching, breast tenderness or swelling of one breast.

At an advanced stage may develop bone pain, weight loss,swelling of arms or ulcerated skin.

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Many risk factors can not be controlled. Some diet experts and oncologists believe that changes in diet and lifestyle in general can reduce the incidence of cancer.
Endeavored to make early diagnosis of breast cancer easier to treat and can disembuhan if still at an early stage.
Be aware, clinical breast examination and mammography as a screening procedure is 3 tools to detect cancer early.

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