Breast Lump Does Not Always Mean Breast Cancer

May 10th, 2010 healthwiki

Breast lump or swelling in the breast is a complaint frequently encountered by general surgeons. It is a common reason for the female patients to seek surgical consultation.

In my surgical practice the most common question that I face from the patient — “Is it cancer?” Breast lump has become synonymous with breast cancer. The fact is only 20 percent of breast tumours turn out to be malignant or cancerous!

Commonest benign (non-cancerous) breast lump is called fibroadenoma which is typically found in young women. It is generally smooth, spherical, painless and very mobile without any attachment to skin or surrounding breast tissue. More than one lump may be present. It gradually increases in size and may eventually fill the whole. During pregnancy fibroadenoma may increase in size, but returns to the original size after delivery of the baby.

Fibroadenoma is usually treated by surgical removal. It is a minor operation commonly done under short general anaesthesia. It is possible to plan the cut in the breast skin in such a way that there is almost no post-operative scar marks. In case of unavoidable large cuts, it is placed in such a way that the scar is hidden under the clothing.

The other common breast lump is due to an abnormality in female hormone level. In this condition, multiple lumps of various sizes are found in the breast. Typically both breasts are involved, although patients may complain about one breast only. Lump size maybe somewhere between a size of grain to 3-4 cm. The breasts are painful and tender. The pain may become intense at or near the time of menstruation. The pain may radiate to the arm or back, and may be so severe to interfere normal life.

In most patients it is the pain that brings them to a surgeon and not the lump. There may be nipple discharge in the form of clear sticky fluid.

The disease called Fibroadenosis is a disease of the reproductive age. It may be self-limiting, usually disappearing after the first pregnancy. In most patients the disease is of mild form and simple painkiller with adequate explanation usually brings about a relief.

More resistant cases are treated with hormone therapy. Surgery is reserved for extreme cases. A particularly painful cyst or lump is removed under general anaesthesia. As in fibroadenoma, it is possible to plan the skin cut to provide best cosmetic results. The most important point to remember from the patient’s point of view is the possibility of recurrence, and more than one operation may be required.

A breast lump is particularly a concern in women with risk factors. Risk factors include age, family history, early onset of menstruation, late menopause, late first pregnancy, obesity, hormone replacement therapy etc. More than 66 percent of women with breast cancer are above the age of 50 years and 80 percent are at least 40 years old. The chances of developing cancer are two to three times higher in case of women with a close female relative (mother, sister) who had breast cancer.

Early diagnosis is the key to effective treatment for breast cancer. Most breast cancers are detected by the patient herself. This is why, self-examination by the patient is important.


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