A lump in the breast? Should I be worried?
A patient of mine noticed a small lump on her left breast, but could not consult a doctor due to her busy schedule. She kept on putting off the visit as she had no pain. She visited the OPD after about a month and it was diagnosed as cancer of the breast, which had advanced locally and into the axilla. If she had consulted earlier, she could have had a better outcome. Many women tend to ignore these early signs of cancer due to ignorance or their busy lifestyle.
Breast cancer has become a major health concern across Urban India, especially in the metropolises, as it accounts for more than a fourth of all cancers in women. The incidence rates in India begin to rise in the early thirties and peak at ages 50-64 years. In India, 1 in 28 women is likely to develop breast cancer during her lifetime. With the rising incidence of breast cancer, it is imperative that you do regular medical checkups.
Why must I see my Doctor for a Breast examination?
Breast diseases/ problems occur in women of all age groups- from school going girls to older women. These problems present with symptoms such as breast pain, a lump in the breast, nipple discharge (blood, watery, purulent, milk), nipple retraction, skin changes over the breast, asymmetrical enlargement of one breast, sudden massive enlargement of both breasts (in pubertal age group), breast infections and abscesses etc.
Once a woman notices any of the symptoms described above she must see her doctor immediately. A thorough clinical checkup and appropriate investigations will help to diagnose the condition, and also differentiate between cancer and non-cancerous state. It is important to remember that more than 90% of these may turn out to be non-cancerous, and of these lesions few may require reassurance only, few may be treated medically and only a few require surgical management. Around ten percent of these will turn out to be cancer.
In another instance, a middle-aged female patient noticed a painful lump in her left breast with swelling and redness, as well as a bloody discharge. Fearing that it was cancer, she went to the doctor after three days, when the swelling and redness had increased and a fever developed. The physician started her on antibiotics and painkiller. A week later as the symptoms did not regress, the physician referred her to a breast specialist for further management. On further investigation, the breast specialist diagnosed it as Periductal Mastitis – a non-cancerous condition, which can be treated and cured with medications.
Many of these symptoms are distressing to the women and also cause fear. The cause for concern is that most of these symptoms are similar in both breast cancer and non-cancerous conditions. Hence women are advised not to panic in such situations but to consult a breast specialist at the earliest.
There are 2 types of check-up:
- Consultation: When you have symptoms
- Screening: Getting checked even if you do not have any symptoms
See your doctor as early as possible when you have any of the symptoms described earlier. This will help to diagnose early and treat the condition appropriately. Most non-cancerous conditions are treatable with medications, in fact some may require only reassurance and maybe follow-up.
2. Screening for breast cancer:
- Self-breast examination/Breast self-awareness
- Regular clinical breast examination by the doctor
- Regular mammography after 50 years of age (earlier may be required in patients “at Risk” as per the risk stratification)
The goal of screening is to catch cancers early. Early-stage cancers are easier to treat than later-stage cancers, and the chance of survival is higher. In fact one may say screening and early detection when breast tumors are still small, helps to save the life and the breast of the woman.
Ramaiah Memorial Hospital runs a Breast clinic for screening and treating all breast diseases on every Thursdays from 2 pm to 5 pm. I advise all women to not ignore any breast symptoms, as well as to get routinely screened for breast cancer as recommended by their doctor.
Consultant, General surgery
Ramaiah Memorial Hospital