2013-10-03

I encourage all women to perform self breast examinations regularly. It is very important to be familiar with your own breasts; knowing exactly how they appear and how they feel. This way, you can detect subtle changes at an early stage, and then see your doctor for further investigations if necessary.

A large percentage of the patients I’ve seen with breast cancer detected a lump or other abnormality themselves. They were able to notice a subtle change in their breast, which enabled a tumor to be detected at a very early and treatable stage.

Please read this simple explanation of how a breast self examination should be performed.

Women who menstruate perform a breast self exam after their menstruation has ended. Post menopausal women can do it any time of the month.

Of course, breast self examination cannot detect all tumors, because some are located deep within the breast, and also some types of tumors do not form lumps. But what if you do find a lump?

Nine out of ten breast lumps are not cancerous, that’s the good news.  If you or your doctor has detected a lump in your breast during a physical exam, the lump will be one of the following:

Cyst

This is a benign (non-cancerous) fluid filled sac of tissue.  A cyst will feel smooth and squishy and if you press on it, it will move like a water filled balloon.  A cyst can move around and it will typically change size during the menstrual cycle.  Cysts can be found close to the surface of the breast or deep down, close to the chest wall.  Cysts typically diminish in size or disappear altogether immediately after menstrual bleeding, therefore when conducting a breast self exam it is best to do it a few days after your menstruation has finished.  Breast cysts are common in menstruating women of all ages, but are rare in post-menopausal women.  Your doctor can aspirate the cyst, that is remove the fluid it contains with a syringe, which deflates the cyst.

Fibroadenoma

This is a benign cyst that is made of fibrous and glandular tissue.  This cyst feels like a round hard lump. It moves around during a breast physical examination. These lumps are usually found near the surface of the breast, therefore can be easily felt. To confirm that the lump is a harmless fibroadenoma, a doctor can perform a biopsy to analyse what type of cells it contains. Fibroadenomas are common in teenagers and women in their 20s and 30s; they are uncommon in post menopausal women. Women with fibroadenomas in their breasts are at increased risk of developing breast cancer. Deficiencies of vitamin D, selenium and iodine may raise the risk of forming fibroadenomas.

Pseudo-lumps

Pseudo means false. These are benign lumps made of scar tissue, or fatty tissue, hardened silicone (in women with breast implants), or may be due to a rib bone pressing into the breast tissue and compressing it. Pseudo-lumps may move around during a physical examination or remain fixed; they do not change size during a menstrual cycle.  A mammogram, ultrasound or biopsy can identify a pseudo-lump.

Breast cancer

This is a malignant lump made of abnormal breast cells. A malignant lump usually has an irregular lump shape, rather than being perfectly round. It usually feels very hard and can occur near the surface of the breast, deeper inside or in the armpit. An ultrasound and mammogram will be performed to identify the lump, but a biopsy provides the clearest view of the kind of cells the lump contains.

What is Breast Cancer?

A number of different cell types in the breast can change form and become cancerous.

The most common breast cancer types include:

Ductal carcinoma: Makes up 70 to 80 percent of all breast cancer.  The cancer cells resemble the ducts of the breast.

Lobular carcinoma: Makes up five to ten percent of breast cancer.  The cancer cells resemble breast lobules.

Mucinous carcinoma: Makes up one to six percent of breast cancer cases.

Medullary carcinoma: Makes up one to five percent of cases.

Tubular carcinoma: Makes up two percent of cases.

What are breast calcifications?

Breast calcifications are tiny calcium deposits in the breast tissue that appear as white spots on a mammogram.  Breast calcifications are common, and most women have at least one.  In most cases they are not cancerous; however in some cases they may indicate breast cancer.

There are two main types of breast calcifications:

Macrocalcifications: These appear as large white dots or dashes on a mammogram and are almost always not cancerous.

Microcalcifications: These appear as very fine white specks on a mammogram.  In a small percentage of cases they may be cancerous, for example if they form tight clusters with irregular shapes; additional tests will be required to rule out cancer.

The most common causes of non-cancerous breast calcifications are:

Calcium inside the fluid of a benign breast cyst.

Previous injury to the breast.

A dilated milk duct.

Mastitis (inflammation of the breast).

Calcifications in a fibroadenoma (a non-cancerous breast lump).

Previous radiation therapy for breast cancer.

Calcification of the arteries within the breast.

Residues of deodorant, powders or lotions applied topically to the skin, or dermatitis on the skin of the breasts.

For more information about breast cancer, see our book The Breast Cancer Prevention Guide.

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.

The post Should you worry if you find a breast lump? appeared first on Liver Doctor.

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