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Evaluation of Breast Problems That Women Can Do at Home

Author: Dr. Rashi Verma - Women's Health  

For females, an easy way to assess their breast problems is the need of the hour. A female should do a simple checkup at home. If they notice any change then they should bring it to the doctor's attention immediately.

Symptoms:

Majority of women who come to the surgical outpatient department complain of either pain or lump in the breast or discharge from the nipple.

Lump: If there is a lump, then duration, size and rate of growth of the lump has to be considered. A long duration and slow growth is a benign condition. Whereas, short duration and fast growth could be a malignancy.

Pain in Breast: Breast cancer is a painless condition. Pain is the main complaint of acute mastitis. Pain associated with menstruation is seen with fibroadenosis.

Discharge from Nipple: Bloody discharge could either be a duct papilloma or cancer. Greenish discharge may be associated with duct ectasia.

So, how should a woman proceed with a breast problem?

Breast Self-Examination:

The steps of breast self-examination (BSE) that every woman should do every month are as follows.

  • Start the BSE by standing in front of the mirror and looking at your breasts. Keep your shoulders straight and your arms on your hips. Inspect your breasts for any change in size, color or texture of skin on the breasts. Look for any swelling.
  • Next, raise your arms and look for the same changes as mentioned above.
  • Look for dimpling, puckering of skin, redness, swelling or any unusual finding.
  • While inspecting, also look at the nipples. Check for any signs of fluid coming out of one or both nipples.
  • Now, palpate your breasts while lying down, using one hand to feel the opposite breast. Similarly use your other hand to feel the other breast.
  • Palpate the breast with the palmar surface of the finger with hand flat. Make sure you cover the entire breast. Do not forget to palpate behind the nipple too as sometimes there may be a lump behind the nipple and no other abnormality in the nipple.
  • Similarly, repeat the above step in standing and sitting position as well.

Special Investigations Done by a Doctor:

  1. Aspiration.
  2. Mammography.
  3. Ultrasound.
  4. Biopsy.

These are mainly done to differentiate breast cancer from other benign condition, to detect an early cancer and finally to know the stage of cancer.

Differential Diagnosis - What Could It Be?

1) Acute Mastitis: This is infection of the breast which is commonly seen in lactating women. Symptoms are pain in the breast with redness. Breast is warm to touch. Treatment is by antibiotics and if no relief is seen, a simple procedure to drain the pus formed is done.

2) Fibroadenosis: It is the most common breast disease. It is an estrogen dependent condition where pain increases just prior to menstruation. Treatment is not usually required. Evening primrose oil is used in cases of moderate pain.

3) Fibroadenoma: It is a benign tumor seen in females below 30 years. It presents with painless swelling in one area of the breast. Treatment is removal of the tumor if large, multiple or recurring. Otherwise it can be left alone with regular follow up.

4) Duct Ectasia: It is associated with greenish discharge from the nipples which may be associated with pain. It is common in smokers. Treatment involves antibiotics and removal of the affected duct.

5) Ductal Papilloma: Blood stained discharge from the nipple is common. It can be premalignant so further investigations are needed. Treatment is to remove the affected duct.

6) Breast Cancer: The most common symptom is a breast lump. But 90% of the breast lumps are not cancers. However it is important to evaluate a case of breast lump since earlier the detection, better the survival. The second most common presentation is nipple discharge.

Breast self-examination plays a major role in early detection and intervention process. Hence, should be done monthly by all women ideally. Triple assessment is done by the doctor who includes clinical assessment, radiological imaging and biopsy analysis. Treatment is a combined approach involving surgery, radiotherapy, hormone therapy and chemotherapy.

For doubts, queries and clarifications regarding breast problems, consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Last reviewed at: 07.Sep.2018

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