Q1. What is a breast lump?
A breast lump is a swelling or an area which feels a little thicker than the rest of the breast tissue.
Q2. What should I do if I feel a lump in my breast?
First of all, don’t panic. Not all breast lumps are cancerous. You just need to visit your family doctor or gynaecologist and tell him or her about the lump.
Q3. What do I expect when I visit my doctor regarding the breast lump? Will I be subjected to an invasive procedure?
Your doctor will ask you about the lump, like since when you have noticed its presence, is it painful etc. He /she will also enquire about your family history -whether any of your close family members had breast cancer. After this, the doctor will examine you. You will then be advised some investigations to determine the exact type of lump. Not all investigations are invasive, so don’t worry.
Q4.What are the usual investigations advised for breast lumps?
Following are the usual investigations advised to a patient of breast lump:
1.Mammography– This is an X-ray of the breast.
2.Ultrasound-tells us whether the lump is cystic or solid, which is helpful in differentiating various types of lumps.
- Fine needle aspiration cytology (FNAC)-for this, a needle is inserted into the lump and the liquid is aspirated and cells present in it are examined under a microscope to know more about the type of lump.
- Magnetic resonance imaging(MRI)-may also be advised for evaluation of small lumps.
5.Biopsy- core needle biopsy, excisional biopsy, stereotactic biopsy may be advised to diagnose the type of lump.
Q5.What are the types of breast lumps?
Lumps in the breast may belong to either of the two categories- benign / non-cancerous or malignant /cancerous.
Q6.What are the types of benign breast lumps?
Benign or non-cancerous lumps may be of following types:
Fibrocystic breast disease: It is a benign condition which is the result of hormonal changes during the menstrual cycle, due to which there is the formation of fibrous lumps or fluid-filled cysts in the breast.
Fibroadenoma: it is a benign lump which is made up of fibrous and glandular tissue. This tumour is very common and is seen in the form of a freely mobile, usually painless lump.
Mastitis: It is a swelling commonly seen in breastfeeding women and is the result of clogging of a milk duct, which then gets infected resulting in the formation of a painful lump.
Papilloma: A papilloma is a small wart like growth in the line of a mammary duct near the nipple. It usually leads to discharge from the nipple which may be clear or blood-stained.
Traumatic fat necrosis: This is the result of an injury which causes fat to form round, firm lumps.
Sclerosing Adenoma: This condition is characterised by small, firm lumps which may be painful.
Benign Phyllodes tumour: the word ‘phyllodes’ means leaf-like, which refers to the appearance of the cells of this tumour under a microscope. These are painless lumps which are benign but 1/4th of these may be cancerous.
Duct-ectasia: this condition is characterised by a lump caused by blockage of a duct under the nipple. It may lead to blood-stained discharge.
Q7.What are the warning signs of breast cancer?
1.New lump in the breast or armpit.
2.Redness or flaky skin in the nipple area or around it.
3.Pulling in (inversion) of nipple or pain in nipple.
4.Nipple discharge whether clear or blood-stained.
5.Any change in size or shape of the breast.
6.Pain in any area of the breast.
7.Dimpled, puckered skin of the breast.
Q8.What are the treatment options if I have a lump in the breast?
Treatment depends on the cause.
Fibrocystic breast disease: since the condition is usually painful, pain-killers can relieve the pain and discomfort. A well-fitting supportive bra and hot or cold compresses also help.In some patients essential fatty acid supplements also reduce the symptoms.
Fibroadenoma: If the fibroadenoma is small, it doesn’t need to be removed. However, if it is increasing in size or is bothering you, you may go for its removal.
Mastitis: This condition is treated with antibiotics and pain-killers. If it is severe, an incision and drainage may be required.
Papilloma: the lump is removed along with the milk duct on which it is lying.
Traumatic fat necrosis: It usually doesn’t require any treatment.
Sclerosing adenoma: Pain- killers may be required for the pain, otherwise no treatment is required for this condition.
Phyllodes tumour: It is removed surgically because it may develop into cancer.
Duct-ectasia: usually no treatment is required. If the nipple is inverted or the discharge from the nipple is copious, the blocked duct may be removed.
What is the treatment of breast cancer?
The treatment of breast cancer depends on several factors, most important being the stage of cancer, type of cancer, and the hormonal status . Various options are:
Surgery: may involve removal of the lump-lumpectomy (breast-conserving surgery) or removal of the whole breast(mastectomy), depending on the stage, or the type of breast cancer.
Radiation: This involves the use of high energy waves to destroy cancer cells.
Chemotherapy: It is the use of various drugs to kill cancer cells.These medicines have side effects like vomitings, loss of hair, premature menopause etc.
Hormone therapy:The growth of cells of some cancers is supported by hormones, especially estrogen. In such cases, drugs like tamoxifen are useful.
Targeted therapy: this involves the use of drugs which prompt the immune system of the body to destroy cancer cells e.g Abemaciclib.
Immunotherapy: It is the use of the immune system to target cancer e.g Atezolizumub.
