Beyond cancerous breast lumps


Published on 11/04/2009

By Dr Brigid Monda

Human beings have retained certain characteristics — like the breast, that are pinnacles of evolution. In ancient times, they symbolised nature’s abundance and nurturing qualities, which are the physical emblems for giving and receiving. The breasts are actually modified sweat glands designed to provide food for babies and sexual pleasure for the woman. They undergo cyclical changes in tune with the menstrual cycle, preparing for pregnancy and breast-feeding just like the uterus does during every menstrual cycle. They are also very sensitive to hormonal changes in the body. A number of things can go wrong with the breast for which women go to see a doctor. They include the following:

Fibrocystic beast disease

This simply means ‘lumpy breasts’ and are just part of the breast changes, which many women undergo through the various stages of their lives. The condition disappears after menopause. Over 50 per cent of women between the ages of 20-50 manifest the condition.

It is thought to be genetic because it occurs in some women and not others. Certain factors such as food, fats, caffeine, and chocolate worsen it. Lumpy breasts may make actual lumps harder to find so it is important that women with such breasts perform regular breast examinations including mammograms. The oral contraceptive pill, vitamins B-6 and E and Oil of Evening primrose are helpful for some women with fibrocystic breast disease.

For some women, cutting out chocolate and especially caffeine also helps to ease the pain.

Breast mouse

Also called a fibro adenoma, is the most common type of breast lump. It is nicknamed a ‘breast mouse’ because of how it moves around in the breast when touched. They are not cancerous and are most common in teenagers and women in their early 20s. Postmenopausal women taking hormone replacement therapy may also develop them. Fibro-adenomas can grow anywhere in the breast tissue. They are smooth, firm, painless and feel rubbery. Most often, the woman will discover them on her own. Because they are not cancerous, doctors prefer to ‘wait and see’ without removing them. But a breast lump brings with it a certain amount of anxiety and if you have any anxiety about it, a biopsy can be done. If you feel that leaving the lump in would cause you too much stress, even if it is not cancerous, then your doctor may skip the biopsy and just remove it.

Breast cysts

A cyst is a fluid filled sac. A breast cyst will form when the glands and ducts of the breasts, which always secrete a little fluid even when they are not producing milk, get clogged up damming this fluid and a cyst is formed. Breast cysts are also very common, are the size of a grape or larger and are painful. They may seem to have popped up overnight and may go away on their own as quickly as they came. The cyst feels like a large blister, smooth on the outside, but fluid-filled on the inside when close to the surface. It feels like a hard lump when it is deeper in the breast tissue and may get bigger and painful just before one’s menses. They are common in women between the ages of 35 to 50 and are also rarely cancerous.

If a lump manifests all the characteristics of a simple cyst on ultrasound, it can be safely left alone or simply drained by putting in a needle to draw out the fluid to relieve any pain. If the fluid is clear or straw coloured with no blood in it, this almost always means the cyst is not cancerous. If the fluid is bloody, then the cyst should be removed surgically because it may mean it is cancerous.

Cysts can recur and the younger the age at which a woman has breast cysts, the more likely it is they will recur. If it does recur, the cyst may be removed or aspirated again. Some women tend to develop new cysts over and over, and some develop so many cysts that it is impossible to try to drain all of them. This is challenging because it makes it hard to decide if there may be a "new" lump hiding in the background of all the cysts. In such cases, it is best to have your breasts checked by a doctor frequently like every three to six months. Having lots of cysts does not increase your chances of having breast cancer though — it just makes it harder to screen for.

Fat necrosis

Injury to the breast could damage the fat cells in the breast tissue forming painless, round, firm lumps, which results in the condition called fat necrosis. They also occur in women with very large breasts and after removal of a breast lump and radiotherapy for cancer. Injury can also rupture tiny blood vessels causing bleeding under the bruise and a collection of blood called haematoma, which is felt as a lump, forms.

Breast infections

These are common in breast-feeding women. When the nipple is injured or cracked or a milk duct gets clogged, bacteria from the surface of the skin invade the area and cause infections. Infections can either be spread out in the breast tissue itself (mastitis) or a deep pocket of pus (abscess). A breast infection is treated with antibiotics and warm compresses that help open up the milk ducts to drain.

Expressing milk from the affected breast or using a breast pump is necessary because it helps decrease the chance of the infection spreading. An abscess of the breast may need draining by a doctor.

 

 

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