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In this article I’ll cover the topics such as what are breast masses, what are the causes of breast lumps and what to expect from your doctor while you go for the examination.
The lifestyle, dietary changes and environmental factors have resulted in various adverse effects on the human body.
One such change is the presence of breast lumps or breast masses. Breast lump is a localized swelling or a bulge in the breast that feels different from the breast tissue surrounding it or the breast tissue present in the same area or the other breast.
Apart from hereditary causes multiple other factors also results in the formation of breast lumps.
Not only in females they can be seen in males which can be as simple as gynaecomastia or the severe form i.e. Breast carcinoma or breast cancer.
There are various causes of breast lumps such as-
· Fibroadenoma (females)
· Gynaecomastia (Males)
· Fibrocystic disease of the breast
· Overgrowth of ducts.
· Milk cysts
· Intraductal papilloma
· Fat necrosis
What will the doctor do?
Your doctor will first take your complete personal, medical/surgical and family history.
1. The patient will be questioned regarding the duration of the lump, its size and any associated symptoms such as pain or nipple discharge.
2. Menstrual history of the females will be obtained to rule out the hormonal causes.
3. Medications will be reviewed in both males and females.
4. The patient will also be asked any prior history of trauma that might have provoked the condition.
5. An accurate family history will be obtained. If there is any history of breast, ovarian, colon or prostate cancer in numerous family members, a genetic counseling would be considered in that case.
Then comes the physical examination-
After obtaining the complete history your doctor will proceed to the physical examination.
1. Physical examination includes inspection and palpation of the breast with the patient first seated then lying flat.
2. The breast is observed for any skin dimpling or changes in the contour.
3. Palpation of breast is gentle and circumferential towards the axilla including the nipple, areola and breast tissue.
4. Nipple area is closely examined and evaluated for the presence/absence of any discharge. If discharge is present the doctor notes the character, take an impression on a slide (mostly done by the pathologist) and will further process it for cytologocial examination.A ductal carcinoma usually presents with a sero-sanguinous fluid discharge. For article on nipple discharge click https://www.themicroscopicsight.com/2020/07/nipple-discharge-heres-what-you-need-to.html
5. Then the axillary and supraclavicular area is further examined through palpation for any evidence of mass or enlarged lymph nodes.
Benign nodules have characteristic features such as easy mobility, regular borders, and a soft or cystic feel.
However, only physical examination cannot exclude malignancy there are different diagnostic testing included for confirming the diagnosis and prescribing a proper treatment.
Investigations done –
The doctor might send you to a pathology lab for fine needle aspiration cytology (FNAC) a quick, OPD procedure in which the lump/lumps are examined by the pathologist and a 20 ml syringe which is attached to a 22-23 gauge needle is inserted into the lump and material is aspirated for microscopic examination for diagnosis.
· Women younger than 30 years with a breast mass and no other symptoms can be observed through one menstrual cycle, if it resolves no further investigation is needed and if it persists necessary investigations are conducted on the patient. A dominant nodule is present and remains unchanged throughout the menstrual cycle.
· Women over 30 years would be recommended for a mammogram, ultrasound or MRI.
A biopsy (a small tissue sample) will be sent for microscopic examination for obtaining a definitive diagnosis. The different types of biopsies are-
· Fine needle aspiration biopsy
· Core needle biopsy
· Vacuum assisted biopsy
· Excisional biopsy
· Incisional biopsy
· Stereotactic biopsy
What to expect from your report?
There are different diagnostic categories such as-
1. Negative for malignancy
2. Atypical cytology/features
3. Suspicious for malignancy
4. Positive for malignancy.
Treatment for breast lumps-
First your doctor will find out the diagnosis and then further measures will be taken such as for-
· Infection- antibiotics
· Cyst- drainage of fluid. Some cysts can disappear on their own.
· Cancer- lumpectomy mastectomy, chemotherapy and radiation.
Treatment solely depends on the type of breast lump you have.
Remember, not all lumps are cancerous in nature. So, instead of being afraid or taking stress for the same do visit your doctor for further evaluations so that specific methods of treatment can be implemented on the patient.
Never ever lie to your doctor regarding your personal medical or family history. It plays a very important role in order to quickly reach a diagnosis which will ultimately lead to effective treatment and steps required.
Hope you found it useful.
This article was mainly directed towards breast mass/lump.
I’ll post another article on breast carcinoma awareness both in males as well as females and will also provide a link to my original research study.
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For Q & A on Cervical Cancer Screening click https://www.themicroscopicsight.com/2020/05/cervical-cancer-screening-q.html