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A BREAST LUMP IS PAINLESS, DOESN’T MEAN IS HARMLESS

“I had a breast lump, it didn’t hurt, so I didn’t bother…”

Above were the lines of a patient who came to my OPD a few days back with a complaint of pain in her breast. Upon examination we found that she had a big lump that was about an inch in size. When asked if she didn’t notice it before, she replied that she had noticed the lump 5 months back but just because it was painless and did not hurt her before, she did not bother to consult a doctor.

Such is a common situation with women that we come across often in practice. The reasons behind this could be:

  • Lack of awareness
  • “Family First” attitude
  • Reluctance to visit a doctor

Most Indian women tend to ignore their health issues until it really becomes problematic and that is one of the major reasons why cancer incidences in women is higher than men in India which reverses the global trend.

  • Nipple secretions
  • Changes in the nipple’s appearance
  • Nipple tenderness
  • Dimpling or puckering of the skin

About 50% of the malignant lumps develop from the mammary glands or ducts and appear in the upper, outer quadrant of the breast, extending into the armpit, where tissue is thicker than elsewhere. Although all breast lumps are technically referred as a tumor, more than 80% of them end up being benign. However, consulting a doctor is the
key to eliminate the possibility of cancer.

Some common benign lumps that affect women are:

  • Fibrocystic changes
  • Fibroadenomas
  • Papillomas

These lumps generally develop as response against hormonal changes in women aging between 20-50 years.

What should you do? Screening!

The goal of screening tests for breast cancer is to find it before it causes symptoms. Early detection means finding and diagnosing a disease earlier, rather than waiting for the symptoms to start. Breast cancers found during screening exams are more likely to be in early stages and still confined to the breast. As the cancer advances, the tumor spreads and involves lymph nodes in the armpit, neck or chest and also other body parts such as the bones, liver, lungs, and even the brain through metastasis. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis (outlook) of a
woman with this disease.

The general screening guidelines for breast cancer in women are as follows :

  • Age 20 and above: Regular breast self-examination every month.
  • Age 30 and above: Periodic clinical breast examination every 3 years.
  • Age 40 and above: Regular mammograms every year.

It is important to remember that the five-year survival rate for woman whose breast cancers are treated in the early, localized stage is 96% and gradually decreases in proportion to the advancement of the cancer.

TAKE HOME MESSAGE

Experience has verified that 90% of breast lumps are found by women themselves however, only your doctor can determine accurately whether it is benign or malignant. The important thing is to diligently follow the screening guidelines and report any abnormality. The key point is that a woman should always seek medical attention for any concerning lumps in her breasts, even during the coronavirus pandemic

Dr (Prof) Meenu Walia

Senior Director & HOD
Medical Oncology & Hematology
Max Super Specialty Hospitals
Patparganj, Vaishali and Noida

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