| "All breasts are lumpy."
What a wonderfully reassuring fact.
"Eighty percent of all breast lumps turn out to be benign." Even
more encouraging. What really matters -- when it comes right down to it
-- is that you discover a suspicious lump if you have one.
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Far too many women -- for whatever reason -- do not
regularly inspect their breasts at all. Perhaps avoiding the simple breast
self exam (BSE) allows them to maintain the comfortable denial that anything
could be wrong.
According to the Susan G. Komen Breast Cancer Foundation, in 1999 over
175,000 women will be diagnosed with breast cancer -- that’s one
woman every three minutes -- which makes this the most common form
of cancer in women of all ages. And, although often overlooked, |
1,300 men will also be diagnosed with breast cancer this year.
Some women are more at risk than others: those with a mother or sister
with the disease, childless women, women who have their first pregnancy
after age 30, and have either early onset of menstruation or late menopause.
Experts report that more than half of all women discover a lump themselves
or have a "questionable" mammogram result at some time in their lives.
Only twenty percent of these breast anomalies turn out to be malignant.
Breast "geography" changes and may feel differently at different times
of the month. A woman's hormones can also cause breast tissue to fill with
water, making them feel tender as well as lumpy.
Lumps tied to hormonal cycles are sometimes called "fibrocystic disease,"
although some argue that is only a convenient term used to group all breast
conditions that aren't cancer. For many women, being diagnosed with any
disease other than cancer is the branch of hope they cling to.
The important thing is to learn to distinguish the difference between
what is normal and what is not. The only way to do this is to perform monthly
breast self exams and have anything unusual checked out. Ideally, breast
self exams should be performed at the same time each month -- avoiding
examinations in between -- to really get a good "map" of your breasts.
Some women find it is helpful to draw a diagram of their breasts and indicate
the location of any lumps they want to track.
In women between age 30 and 50, smooth, round, soft and somewhat moveable
lumps are very often fluid-filled pockets called cysts. They can
be tiny or larger than a golf ball, but they are usually harmless. The
best way to find out is to have a fine needle aspiration to find out if
the contents of the cyst are fluid or solid, and to have the cells analyzed.
There are other types of benign breast tumors that are sometimes removed
to prevent them from hiding a malignancy in the future. And then, sometimes
that lump is cancer.
Unlike benign lumps -- which can feel like grapes you can push around,
or feel like they are surrounded by a capsule -- cancerous lumps are most
often hard and irregular to the touch and usually can't be moved.
Finding a lump is an unsettling, subjective experience, and sometimes
words are inadequate when it comes to describing "how" something feels.
If you feel something different while performing BSE, think very carefully
about where it is and what it feels like. Is there a matching "lump" in
the other breast? Is it soft or hard, moveable, or painful? Does your breast
look different? Any color changes or dimpling? How about the shape and
symmetry? Do any visible changes occur when you raise your arms over your
head?
Resist the temptation to dismiss any lump as unimportant.
Try to be realistic -- are there changes that don’t go away in a month?
Is the area becoming harder or larger? Is the lump immobile and in only
one breast?
| Whatever shape or texture the lump may be, if it doesn't go away after
your next menstrual cycle, have it checked out by your doctor, who
may recommend an ultrasound, mammogram, or fine needle aspiration based
on your own medical history, age and risk factors. |
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Before ordering additional tests, your doctor will want some pertinent
information, including: the date you found it; the exact location of the
lump (mark it in permanent ink if it is difficult to find); what was the
lump like when you found it and has it changed; describe how it feels as
best you can; and provide information about your family history and your
own personal breast history, if you have one.
Our patients tell us that waiting for the results of the diagnostic
tests is one of the most difficult thing they ever have to do. I think
that most doctors understand that today, and we try to minimize this natural
anxiety by getting the results to you as promptly as possible.
Depending upon the results, a biopsy may be indicated which, in some
cases, can be performed in the doctor’s office. Remember, 80 percent of
the lumps prove to be benign, so a biopsy does not automatically lead to
surgery. In fact, nothing is "automatic;" possible treatment options and
alternatives will be thoroughly discussed along with the results of the
biopsy.
Again, if you do find a lump, don't just worry about it; get it checked.
Here are some facts to consider:
n Only about 5 to 10 percent of women
with breast cancer have the hereditary kind; that means that 90 to 95 percent
of breast cancer does NOT run in families.
n When a malignant lump is discovered
early enough -- when the cancer is confined to the breast -- the 5-year
survival rate is better than 95 percent.
n More than three-fourths of all women
with breast cancer are over 50, and 50 percent of all breast cancer occurs
in women over 65. That doesn’t mean breast cancer cannot occur in younger
women -- it can and it does. It’s just that the majority of breast
cancer patients are over 50.
There are many new successful treatment options for breast cancer today.
When that is the outcome of the diagnostic tests, we urge our patients
to learn as much as possible about the disease, and to become an active
partner with their physicians and specialists in making the important treatment
decisions along the way.
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