BREAST CLINIC

Breast Self-Examination(BSE)

Breast self-examination (BSE) is a screening method used in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling.

An pictorial example of breast self-examination in six steps.

Steps 1-3 involve inspection of the breast with the arms hanging next to the body, behind the head and in the side.
Step 4 is palpation of the breast.
Step 5 is palpation of the nipple.
Step 6 is palpation of the breast while lying down.

 

Breast Cancer Symptoms and Signs

If you notice any of the following changes in your breasts, notify your doctor as soon as possible. Possible signs and symptoms of breast cancer include:

Changes in the nipple:

• Tenderness
• Change in appearance
• Nipple that is slightly depressed inward (retracted)
• Scaly
• Reddened
• Any discharge
• Rash

Changes in the appearance of the breast:

• A new lump or lumps in the breast (not all lumps are cancerous)
• Unexplained change in the size or shape of the breast
• Dimpling or puckering on the surface skin of the breast
• Unexplained swelling or shrinking of the breast
• Unexplained pain in one spot that will not resolve
• Redness, warmth, or scaly skin on the breast
• A hard lump, knot, or thickening inside the breast or underarm
• Itchy or scaly skin on the breast.
  
  

Breast Pain

Breast pain (mastalgia) is the most common breast related complaint among women; nearly 70% of women experience breast pain at some point in their lives. Breast pain may occur in one or both breasts or in the underarm (axilla) region of the body. The severity of breast pain varies from woman to woman; approximately 15% of women require treatment. Though breast pain is not normally associated with breast cancer, women who experience any breast abnormalities, including breast pain, should consult their physicians.

Evaluating Breast Pain

Women should report all complaints of persistent breast pain to their doctor. Physicians will evaluate the pain, taking into account the woman's personal history, family history, the area of pain, the intensity and duration of the pain, and the extent to which the pain interferes with her lifestyle.

Physicians will also perform clinical breast examinations, and if necessary, order additional breast imaging exams (such as mammography or ultrasound) to help determine whether the pain is related to another breast condition or possibly cancer. If no breast abnormality is indicated, the physician and woman should decide together whether drug treatment is necessary.

Breast Lump

Breast lumps are localized swellings that feel different from the surrounding breast tissue. It is a symptom/sign for a variety of conditions. As approximately 10% of breast lumps ultimately lead to a diagnosis of breast cancer,it is important for women with a breast lump to receive appropriate evaluation.

Breast lumps are often discovered during a breast self-examination or during a routine check-up. Upon noticing an unusual lump in the breast the best course of action is to schedule an examination with a physician who can best diagnose the type of breast lump and strategy for treatment.

Patients should make sure that the medical records of any breast-related illnesses are retained,as this facilitates diagnosis in case of recurrence or follow-up.

Nipple Discharge

Nipple discharge refers to any fluid that seeps out of the nipple of the breast. Nipple discharge in a woman who's not pregnant or breast-feeding isn't necessarily abnormal, but it should be evaluated by a doctor. Nipple discharge in a man under any circumstances could be a problem and needs further evaluation.

There are many different types of discharges. Some associations include:

• cloudy white color—most common, can be galactorrhea
• clear or light white—pregnancy
• red—contains blood—most often due to breast infection or intraductal papillomas, but can be breast cancer
• whitish-yellow, yellow, or green—pus due to infection

CA Breast

Breast cancer is cancer that develops from breast tissue. Breast cancer develops from a cancerous cell which develops in the lining of a duct or lobule in one of the breasts.

Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, or a red scaly patch of skin.In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin.

Breast Cancer Symptoms

Other symptoms which may be noticed in the affected breast include:

• Changes in the size or shape of a breast.
• Dimpling or thickening of some of the skin on a part of a breast.
• The nipple becoming inverted (turning in).
• Rarely, a discharge occurring from a nipple (which may be bloodstained).
• A rare type of breast cancer, causing a rash around the nipple, which can look similar to a small patch of eczema.
• Rarely, pain in a breast. Note: pain is not a usual early symptom. Many women develop painful breasts (mastalgia) and this is not usually caused by cancer.

The first place that breast cancer usually spreads to is the lymph glands (nodes) in the armpit (axilla). If this occurs, you may develop a swelling or lump in an armpit. If the cancer spreads to other parts of the body then various other symptoms can develop.

Evaluation of breast cancer includes the following:

• Clinical examination
• Imaging
• Needle biopsy

Physical examination

The following physical findings should raise concern:

• Lump or contour change
• Skin tethering
• Nipple inversion
• Dilated veins
• Ulceration
• Paget disease
• Edema or peau d’orange

If a palpable lump is found and possesses any of the following features, breast cancer may be present:

 

• Hardness
• Irregularity
• Focal nodularity
• Fixation to skin or muscle

Screening

Early detection remains the primary defense in preventing breast cancer. Screening modalities include the following:

 

• Breast self-examination
• Clinical breast examination
• Mammography
• Ultrasonography