Breast lumps? Most of the time, they don’t mean breast cancer. Here’s what to know about the different types of lumps, and what to do if you find one.
What exactly does a breast lump feel like?
“A common complaint from my patients is that their breasts feel lumpy all the time. They want to know how to tell if anything is wrong,” says DR TAN YIA SWAM, a female breast surgeon at Thomson Breast Centre. “There are also some patients who have many small lumps detected on ultrasound, and want to know if they should be worried.”
After all, breast cancer is the most common cancer affecting women worldwide. So, it’s very common for many women to fear it, especially when they don’t know all of the facts, explains Dr Tan. In Singapore alone, almost 200 women are diagnosed with breast cancer each month, according to statistics from the Ministry of Health (MOH).
The good news, she says, is that breast cancer is one of the most treatable cancers, especially when detected at an early stage; and, there are good, effective methods for early detection.
First, though, it’s important to know what’s normal for you. Dr Tan suggests examining yourself on a monthly basis. “The purpose of breast self-examination (BSE) is to empower yourself to be comfortable and familiar with your body. When there are any new, persistent changes, you can detect it earlier.”
This will help you distinguish what’s normal and what’s not for your own breasts.
Dr Tan also says that breast tissue itself has a lumpy quality that tends to get more obvious (and possibly more sensitive) during periods. She tells patients to imagine the following:
- Lumpy breast tissue is like an old cotton pillow
- A benign breast lump is like a round, smooth rubber ball
- A cancerous lump is like an old rolled up handkerchief – hard, irregular, edges are not so clear
Of course, Dr Tan recommends consulting a breast specialist. “With their vast experience, they are able to have good sense of what kind of lumpiness is normal and what is not.”
And, while early breast cancer usually does not have any symptoms (which is why screening is so crucial!), it’s important to consult a doctor if you experience symptoms such as:
- unusual nipple discharge (e.g., bloody/greenish/yellowish fluid; not milk);
- newly retracted nipple;
- persistent rash around the nipple;
- dimpled/puckered skin; or
- swollen/thickened skin.
What other conditions can cause breast lumps?
“While a breast lump is taught to be a sign of breast cancer, the truth is that most breast lumps are benign. They may be due to hormonal changes (fibrocystic changes), or conditions such as fibroadenomas, cysts, lipomas and angiomyolipomoas,” says Dr Tan. “Therefore, if you detect a breast lump, don’t panic! Make an appointment with a breast specialist to get a quick and accurate diagnosis.”
Screening and risk factors
Self breast exams are important. But, keep in mind that lumps less than 1cm will not be felt by our fingers, unless it’s really just under the skin, says Dr Tan. The nerves on our fingertips simply aren’t that sensitive! That’s why mammogram and ultrasounds screenings are so important.
“For breast cancer screening, most countries, including Singapore, recommend mammogram screenings from age 50 onwards. For ladies who are at higher risk, this may start at 40. Some specialists will recommend a supplementary ultrasound as well,” says Dr Tan.
She recommends considering a yearly mammogram with a supplementary ultrasound from the age of 40. And, if you’re above 50, she encourages two-yearly mammogram screenings with a supplementary ultrasound screening.
“For some patients, your doctor may recommend keeping to a yearly schedule if your mammogram shows dense breasts, or there are some minor abnormalities detected.”
If you’re under 40, there are no guidelines on screening. However, she says it’s a good idea to consult a specialist to discuss other modes of screening if you have a first-degree relative with breast cancer (a mother, sister or daughter, for instance) or other risk factors. For women, these may include:
- early onset of menstruation;
- late menopause;
- having your first child after the age of 30;
- having fewer children or never having children;
- being on longterm hormone replacement therapy;
- weight gain, especially after menopause; or
- a personal history of breast cancer, or abnormal biopsy results.
For both women and men (yes, men are at risk of breast cancer, too), risk factors may include:
- a personal history of breast cancer, or abnormal biopsy results; or
- a history of breast or ovarian cancer in the family.
Dr Tan’s preventative tips
For breast cancer prevention, Dr Tan’s general tips include keeping an average weight, and not smoking or drinking alcohol. If you enjoy alcohol, she says to avoid having more than two drinks a day.
“A healthy lifestyle is the best medicine,” says Dr Tan. “A holistic approach, encompassing all aspects of wellness is the key to good health. Eat whole foods, exercise, look after the mental and emotional health, develop strong bonds with family and friends to have good social support. This will reduce the chance of almost all illnesses. Even when a critical illness strike, being strong and fit, physically and mentally, will help you get well faster.”
Sometimes, even with best efforts at prevention, cancer cells can still develop. Then the best protection we have is for early detection. The good news is, early detection can increase your chances of survival. Therefore, every woman aged 40 and above should be screened regularly for breast cancer. Early detection is key!
“For a personal assessment tailored to your individual medical and family history, speak to a breast specialist to understand more and find out which method of early detection is most suitable for you.”
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