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Published on August 18, 2020

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Understanding the Timeline of Breast Cancer

No woman wants to wait when it comes to learning about the results of a mammogram or breast imaging.

The global pandemic that continues to unfold may have led some women to postpone screening mammography appointments. But COVID-19 did not interrupt cancer care overall. Delays of any sort – between exam and diagnosis, or from diagnosis to treatment – require some understanding of the way these cancers work.

“Breast cancers do not just ‘occur.’ In many cases, when a tumor is found via mammography, it may have been growing for two to five years,” said Tricia Merrigan, MD, breast surgeon with Avera Medical Group Comprehensive Breast Care. “In March and April, we did not have any patients who were not seen when they needed it. But the timeline can create worries for patients. We understand that – but we reassure them that devising the best-possible plan may require time.”

Cancer Growth Rates

The facts on breast cancer shed light on the pace at which treatment unfolds.

“Some cancers are more aggressive and grow faster, but the average rate at which tumors double in size is about 220 days,” Merrigan said. “The fastest known case was doubling in about 44 days.”

Every woman’s biology differs. So too does the biology of the tumor itself.

“Generally a patient who has an abnormal mammogram will get the call and we’ll ask them to come back for more imaging,” she said. “That’s usually the first step, and this occurs in about seven to 10 days.”

If a tumor is identified, biopsy would follow the additional imaging. If needed, surgery would take place about 2-4 weeks after the biopsy procedure – but each case is different.

Enhancing and Coordinating

Whether it’s MRI, breast ultrasound or contrast-enhanced mammograms, additional imaging reveals more information about the abnormality. In some cases, additional images may rule out the possibility of cancer, bringing a conclusion to the journey.

“Advanced imaging can help us chart the next necessary steps, and allows me and others on our team to coordinate,” said Merrigan. “I can go over to radiology and ask them for recommendations, or speak with our medical oncologists, radiation oncologists or plastic and reconstructive surgeons as we prepare the best possible plan.”

In many cases, a genetics consult will be a part of the decision-making. All the reviews come together so that when Merrigan and the patient meet, every option available is known.

Treatment Timeline

Cancer experts provide support to one another throughout the process, and use that information to give the patient the facts they need to make good decisions.

If your mammogram was delayed due to COVID-19, now’s the time to reschedule.

Rescheduling a mammogram is easy and there are many sites where these screening exams can take place. It’s better to find a possible tumor earlier on a mammogram than to find it later as a lump in a self-exam,” Merrigan said. “Most delays of a few weeks will not lead to problems. When patients realize the reality of tumor growth, they can better understand that developing the optimal plan for treatment may take time – and taking this time will not put their health in jeopardy. We use that valuable time carefully and proceed as the biology of the patient and the tumor dictate.”

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