A B C D E F G H I J K L M N O P R S T U V W

BREAST CANCER - BREAST LUMPS

What is Breast Cancer ?

Lumps in the breast may be innocent, but may be due to breast cancer. The three commonest benign or innocent lumps are a cyst, a blocked milk duct, and a benign growth called a fibroadenoma. The commonest malignant lump is breast cancer. You might have discovered a lump by accident, or it may have been picked up by the doctor during routine check-up. It may also have been picked up by breast screening programmes which are now widely available, or as a result of systematic examination of your own breasts. Breast cancer is a serious condition, but if caught early, it often has a good outlook. Any breast lump may or may not be painful: the amount of discomfort is no real guide as to what it actually is. Cancer has an unfortunate tendency to spread. This can be to the lymph glands, usually under the armpit. It can also spread through the bloodstream and affect other organs and tissues. Even at this stage, however there are excellent prospects for treatment. If you find any lump, see your doctor!

How does Breast Cancer occur ?

Benign lumps are due to the breast tissue being sensitive to slight changes in the normal hormones. They can also occur if female hormones are taken in various forms, such as the contraceptive pill or hormone replacement therapy (HRT) in post-menopausal women. Fibroadenomas are common in adolescence just after periods have started. Cysts tend to get more frequent from 35 years of age onwards. They are rarely seen before the age of 30. Cysts commonly disappear after the menopause, but may persist if you happen to be taking hormone therapy. Breast cancer is most frequently found from 50 years of age onwards, but also occurs in the younger age groups. Women whose mothers or sisters have had breast cancer are more at risk of developing this type of growth. Women who have taken female hormone preparations for many years are also at risk. It is thought that breast-feeding gives some protection against breast cancer developing.

Treatment Involved for Breast Cancer

Blocked ducts usually disperse and disappear by themselves if left alone but cysts and fibroadenomas may get bigger. When any lump is felt by a doctor, a needle test may be performed. This is often done under local anaesthetic (if necessary) and involves placing a small needle through the skin into the lump (like a blood test). A cyst will be dispersed immediately by removing the fluid within it. If the lump is solid, cells can be drawn up into the needle and looked at under the microscope by the pathologist. Cysts which are large, tense, painful and easy to feel, may have their fluid content removed by a syringe and needle. They only need to be surgically removed if the same one recurs frequently. Fibroadenomas rarely become malignant and below the age of 25 can be left alone. However, over the age of 25 fibroadenomas are often removed by a small operation, usually done under a general anaesthetic, with the incision as near to the nipple as possible. The lump is shelled out . After inserting stitches, a small tube drain is sometimes put through the skin for 24 hours, to drain away any fluid which collects. Possible malignant lumps need to be assessed very carefully. Commonly, a simple x-ray of the breast (mammogram) is performed to gain further information. A piece of tissue (biopsy) will need to be removed from this lump so that an accurate diagnosis can be made. Once cancer has been confirmed, then appropriate treatment can be recommended. This could be either to remove the lump only or may involve removing all the breast tissue, as in a mastectomy. Each patient is different and the doctor will explain to you which operation he feels would be most appropriate. Further treatment involving x-rays (radiotherapy) or tablets may be recommended.

After Treatment of Breast Cancer

Benign lumps may all come back again, in the same or different part of the breast. This does not mean that they are more likely to be malignant. Nevertheless, further operations are usually done to remove them. Removal of malignant (cancer) lumps always requires careful follow-up. If radiotherapy or chemotherapy is given, these specialists will also need to be visited. Various scans and blood tests will be done over the next few years. These will often find out if any cancer spread has occurred. This may then lead to further operation, radiotherapy, chemotherapy, or other tablet treatment. With the variety of treatments available, the outlook for this condition is mostly good.

If Breast Cancer is Left Untreated

As a rule, benign lumps would not become malignant. However, such a change may occur in some fibroadenomas. If untreated, breast cancer can break through the skin, producing an ulcer. Cancer cells would also be more likely to get into the blood circulation and spread to other parts of the body. This would make the condition more difficult to treat at a later date.

Effects on Family of Breast Cancer

Even benign lumps can cause concern to your family. The doctor's reassurance should put their mind at rest. Cancer and its treatment will bring special problems for those close to you. They will often benefit from contact with one of the support groups mentioned below.