Wednesday, October 7, 2009

Becoming Breast Aware

It is important to be proactive and seek more information when you discover a lump on your breast. Breast self-examination is a good practice but self-diagnosis is definitely not.
The most common causes of a single breast lump are:
- Fibroadenoma – A benign solid tumor formed by glandular and fibrous tissue
- Fibrocystic changes – benign breast changes
- Cysts – Benign, smooth discrete fluid-filled sacs
- Non-invasive cancers – Ductal carcinoma in situ (DCIS)
- Atypical hyperplasia – Fast-growing abnormal cells
I just came back from an ultrasound scan. I was advised to take evening primrose oil when I spotted a lump on my right breast (classified as fibroadenoma) on January this year. When I went for a follow-up check today (after 6 months), the lump on my right breast is no longer detectable. But now, there is another small lump on my left breast (classified as the same - fibroadenoma) - which the doctor said nothing to worry.

I had few questions which I clarified with the doctor and radiographer. How does the ultrasound scan reveal whether the lump is cancerous or not? Is my breast dense? (Lumps or other changes are more difficult to detect via mammogram if you have a dense breast - which then calls for ultrasound scan). What is the difference between ultrasound scan and mammogram - which one is better? Mammogram is only recommended for women above 35 years of age. Besides seeking clarification from the experts, I believe that ultimately you are the expert of your own body - and I should continue paying attention to any changes in the breast and go for a follow-up check.

Ignorance is certainly not a bliss when it comes to health matters. The best thing to do is taking action and seek as much information as you could. As Dr. Oz said, "If you aren't sure, explore some more".

Here is what you should be paying attention to:
  • Size and Symmetry – Breasts come in all shapes and sizes; from AA to DD and beyond. As weight is lost or gained, particularly during pregnancy, the breast will vary in size. Normal breasts can be unequal in size and shape. What you are looking for is an unusual increase in the size one breast and if one is more pendulous than the other.
  • Nipples – When examining the nipple you are looking for changes in appearance, direction (pushed inward) and if there is any discharge other than breast milk. You are also looking for skin peeling around the nipple.
  • Skin – Here you want to see if there is any dimpling, puckering, ridges, redness, rash, scaling on the skin, areola, or nipple. Note any prominent vein patterns.
  • Nodularity – This is the part that gets tricky. Monthly hormonal changes during menstruation can cause the tissue to become tender and nodular. What you are looking for is a new lump or thickened area, which may or may not be painful or tender. You want to note the shape (round, oval, or irregular), margins (defined or irregular), texture (rubbery, soft, firm, hard) and if it is movable or fixed.

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