When Amanda Radcliffe and Sharon Seal each found a lump in their breasts, they both spent anxious weekends wondering if they would be joining the nearly 200,000 other women in America who develop breast cancer every year.
"There's just no words to describe the feeling when you find a lump," Radcliffe recalled. "It was sheer terror."
Both women were relieved to learn the lump was not cancerous. But a new study published today in the New England Journal of Medicine shows that even a benign growth may be cause for worry.
Dr. Neil Friedman, the cancer expert at Mercy Hospital in Baltimore who treated Seal, said findings confirm something that has long seemed apparent to doctors: Women who have had breast lumps in the past are at a greater risk for developing cancer.
Researchers have learned not all benign tumors are created equal. Some are merely an overgrowth of normal cells, called a proliferative lesion. But sometimes these cells take on strange shapes. This condition, called atypia, is often a precursor to cancer.
The new study found that women whose benign lump showed signs of proliferation and atypia were about 400 percent more likely to develop breast cancer in their lifetimes.
While these numbers sound scary, Dr. Marisa Weiss, who founded breastcancer.org, cautions against overreacting. For instance, Weiss explained that if you had a 1 percent chance of developing breast cancer and that chance rose by 400 percent, you would now only have a 4 percent chance of getting the disease.
So when studies say that having a benign lump increases your risk by 50 percent, Weiss says women have to think through the numbers carefully. "Yes, your risk increases by 50 percent. But that doesn't mean that your risk [of getting cancer] is 50 percent."
About 20 percent of all American women will have a breast biopsy at some point in their lives, but for most of them, the results will be good news. Eighty percent of women with a benign lump will never develop cancer. But when women who are older than 50, who are overweight or who have a family history of the disease find a benign lump, the odds stack in favor of the cancer.
After receiving the good news that her breast lump was benign, Seal began to take much better care of her body.
She followed her doctor's advice to get more exercise, eat well and give herself monthly breast examines.
So Seal was worried when she felt a part of her breast was thicker than usual. At first the doctors chalked it up to Seals's added muscle, but she insisted, "No, I know the way my breast feels. I want you to check it."
The mass turned out to be cancer. In 2002, Seal underwent chemotherapy and radiation and she is now healthy and cancer-free.
In Radcliffe's case, Weiss had taken care of Radcliffe's mother when she had breast cancer. According to the study, family history of breast cancer increases a woman's risk even further, sometimes as high as 85 percent. So when Radcliffe called to tell Weiss she had found a lump, Weiss arranged for her to have a mammogram first thing the next morning.
But Radcliffe was lucky. She did not have the cancer that took her mother's life just a few months before.
It's too soon to tell for Radcliffe, who only found her lump this past February. She says she worries about the risk, but only to a point, "I'm doing everything I can. And beyond that, it's in God's hands."