One of the most common ailments women suffer from appear as breast disorders. In fact, around 30% of women seek treatment for benign breast disorders at least once in their lifetime.
Breast disorders may present as either benign or malignant (cancerous), which makes proper diagnosis a very important step towards appropriate treatment. Here is what Dr. Amarchand S. Bajaj, Senior Consultant (General, Laparoscopic & Bariatric Surgery) at Sitaram Bhartia Hospital, South Delhi has to say about common breast disorders.
Did you know undiagnosed breast cancer accounts for 1-3% of deaths in developing countries? Factors such as early diagnosis, customized attention and an expert understanding of the disease can help increase the survival rates.
Early diagnosis can be carried out only if you are more proactive with your health!
Periodic breast self-examinations can help you stay abreast of any symptoms that could indicate breast cancer, such as:
- Fast growing lumps or mass in the breasts that feel firm or hard
- Visible changes in skin wherein skin resembles an orange peel (peau d’orange effect)
- Nipple retraction (the nipple sinks back into the breast)
- Formation of ulcers on the breast in some cases
Occurence of breast cancer below 20 years of age is rare. Its incidence rises steadily after that age and is observed more commonly in older women with a family history of breast cancer.
If diagnosed in its initial stages, breast conservation surgery or a lumpectomy will be advised wherein the whole breast does not have to be removed. Smaller tumours can be removed using this method.
Treatment in the later stage should not be a cause of worry either. Although the breast will have to be removed (mastectomy), breast reconstruction surgery is an available option. Make sure you discuss your options in depth with your doctor before you move forward with your treatment.
Non-Cancerous Disorders (Benign)
“Fibroadenoma is a benign breast condition where small, solid lumps of tissue develop in one or both breasts. It is usually not associated with any particular cause,” said Dr. Bajaj.
Studies show that fibroadenomas are, in fact, one of the most common breast disorders diagnosed in women of 15-25 years of age, although it can occur in older women as well.
“Fibroadenomas can be detected during periodic breast self-examinations. Any unusual lumps or irregularities in shape should be immediately reported to your healthcare provider for further diagnosis.”
Most fibroadenomas are painless but some patients complain of tenderness or pain. Certain symptoms can indicate the presence of fibroadenomas:
- Firm or rubbery lumps
- Easily moveable
- Round lumps with distinguishable borders
The lumps can be mistaken for breast cancer but they usually are not. This is why proper diagnosis is key to treating benign breast disorders such as this one.
Along with a physical examination, after a certain age in some cases, you will also be advised to undergo a mammogram or ultrasound for appropriate assessment. If the lumps are small, a diagnosis will be made after further tests and your condition may be observed for a while.
Some fibroadenomas, on the other hand, may grow exponentially and change the shape of the breast, or grow painful. These usually require an ‘excision of fibroadenoma’, wherein a cosmetic surgery is carried out so that the patient is not left with unnecessary scarring.
Another commonly found form of benign breast lumps are known as breast cysts.
You may have developed a breast cyst if you are experiencing the following symptoms:
- Firm round or oval lump anywhere in the breast
- Pain or tenderness around the breast lump
- Nipple discharge in some cases
Due to the fact that cysts are benign, these lumps are not at risk of developing cancer. The presence of cysts does, however, make it harder to detect new lumps or masses that may need immediate attention.
Most cysts do not require surgical treatment.
In some cases, however, the cyst may persist or grow more painful over time. In such a situation, your surgeon may advise you aspirate the cyst in order to drain the fluid. Even after aspiration of the cyst, they may recur. This is why if cysts remain despite repeated aspirations, you may need excision.
Fibroadenosis, also called fibrocystic breast disease, is a common benign breast disorder where lumpy tissues develop in the breasts. It has been observed that many women suffering from fibroadenosis complain of breast pain or a lump in the breast.
Simple lifestyle changes can help you remedy the pain associated with fibroadenosis. Wearing a soft, firm bra and decreasing the intake of excessive fat from your diet can help with the discomfort or pain. Sometimes, your doctor may prescribe medicine.
4. Tuberculosis of Breast
Tuberculosis of the breast is a rare disease that may occur at any age. Women may also exhibit symptoms such as:
- Irregular, hard lumps
- Painful lumps that may move when touched
- Ulcers or abscess on the skin
If you are diagnosed with tuberculosis of the breast, your doctor may advise anti-tubercular therapy as the main form of treatment. Surgery may also be suggested according to the patient’s condition.
5. Duct Ectasia
Most commonly diagnosed in women in their perimenopausal age, mammary duct ectasia is a condition where a milk duct in the breast gets clogged with fluid. Often women do not experience any symptoms in particular, but some may notice:
- nipple discharge
- tenderness or pain in breasts
- swelling or lump around the clogged milk duct
After a physical examination and an ultrasound, the doctor will diagnose you and determine the treatment option best suited to your condition. It is important to note that mammary duct ectasia does not always require treatment. You may be prescribed medication or advised surgical removal of the swollen milk duct in case conservative treatment fails.
6. Phyllodes Tumour
Another diagnosis for benign breast lumps can be phyllodes tumour which sometimes present as a large, messy tumour with an uneven surface that can be detected during your regular breast self-exams.
They may be fast growing in a few cases as well and may mimic breast cancer. As some cases of phyllodes tumour may turn out to be malignant, therefore proper diagnosis and early treatment is key.
Surgery is the only treatment for this condition wherein the entire tumour is excised fully in order to reduce the chances of recurrence. Some women with more severe conditions may be recommended to remove the breast entirely (mastectomy), in which case they will be offered the option of availing a breast reconstruction surgery as well.
“Breast abscesses develop due to pus formation in the breast, usually caused by an infection. They are most usually observed in breastfeeding women suffering from mastitis (an inflammation of the breast), although it can happen otherwise as well.”
Mastitis occurs when milk gets trapped in the breast and causes an infection. If left untreated for too long, the infection worsens and a breast abscess is formed. This condition can also occur in women who aren’t breastfeeding, although it is uncommon.
You could have developed a breast infection or abscess if you notice the following symptoms:
- Severely painful breasts
- Redness over breasts
- Pus discharge at times
- High fever in some cases
An ultrasound may be recommended by your doctor in order to diagnose this condition. A breast abscess is usually treated by making an incision and draining the pus. Some patients can be treated using aspiration as well depending on the patient’s condition.
Approach your surgeon as early as possible because an untreated abscess can lead to further complications in your health.