Breast Lumps and Breast Cancer

Breast cancer remains the commonest cancerous cause of death amongst women in Australia, and one in every nine women will get breast cancer at some time in their lives.

Because of this breast checks are an essential part of a woman's health check. We believe that all women should practise self breast examination. Follow the link for more information about breast self examination. As well as breast self examination, all women over the age of 20 should have an annual breast check out their doctor.

At least 20% of women have what is called fibro-cystic breast disease. In this common benign condition multiple cysts develop in the breasts. The cysts may become painful or more sensitive, especially in the week before periods. If you have fibro-cystic breast disease, we believe it is especially important to practise breast self examination, so as you can get used to the feel of your breasts and are more likely to notice when any significant change or a new lump begins to occur.

Fibro-cystic breast disease may sometimes improve when treated with natural progesterone. This may lessen both the cysts and the discomfort of the fibro-cystic breast disease. The risk of breast cancer is not significantly greater in those women who have fibro-cystic breast disease, but the fibro-cystic breast disease may make and breast cancer harder to find amidst the cysts. Because of this, it is wise to discuss with the doctors having regular breast ultrasound is as well as mammograms if you have fibro-cystic breast disease.

In Australia the government pays for women to have regular two yearly mammograms when they over the age of 50. Latest research however, indicates that it may well be worth while starting having mammograms from the age of 40. Mammograms significantly increase the rate of breast cancer detection in women.

The risk of breast cancer actually increases the older you are. Women have a lifetime risk of approximately 11% of contracting breast cancer. This means that about one in nine women will have breast cancer at some time in their life.

Breast cancer runs much more strongly in some families than others. This is because there is actually a gene for breast cancer. If you are in a family where a lot of the women have had breast cancer, this gene can be checked for at either Royal North Shore Hospital or Westmead Hospital and other major Sydney hospitals. If you have this gene is more important than ever to have regular breast checks, mammograms and ultrasounds. It is wise also to consider going on the anti-cancer diet and considering the supplements which may decrease the risk of breast cancer. In addition to the supplements DIM & IC3, the drug known as Evista which is primarily for osteoporosis, is also a serm and helps protect against breast cancer, though it may also increase the risk of blood clots.

What to do if you find a breast lump.

The first and most important thing to do if you find a breast lump is to make an appointment with your doctor as soon as possible. Your doctor will examine you and may refer you for a mammogram and ultrasound. Remember, 9 out of 10 breast lumps are totally benign. The doctor will perform a full breast examination and check and your underarms to see if any glands can be felt.

Your doctor will assess the lump in your breast to see if it feels hard or soft, and to see whether it is mobile, all fixed to either the skin or the underlying tissues. This is called tethering. A hard craggy tethered lump with dimpling in the skin over it is much more likely to be a cancer than a fairly soft mobile lump, which is not tethered to the skin or underlying tissues.

The commonest breast lump is called a fibroadenoma or mor commonly a "Breast mouse". Fibroadenoma are highly mobile and may be up to 1 cm in size. They are not tethered to either the skin or underlying tissues. Fibroadenomas are always benign.

If the doctor is still suspicious about your breast lump, you will be referred for a mammogram and often an ultrasound as well. The mammogram and ultrasound will further identify whether your lump is likely to be benign.

If the mammogram and ultrasound are also suspicious you will be referred to a breast surgeon. The breast surgeons in Australia generally see patients with new lumps very quickly. They will often refer you immediately for a fine needle aspiration of the lump. This involves putting a fine needle into the lump and removing a small amount of tissue which is sent to the pathologist to be examined under the microscope. If this test is positive for cancer or if the surgeon is still suspicious that the fine needle biopsy may have missed the cancer, the surgeon will often perform a lumpectomy.

If the lumpectomy is positive cancer, the surgeon will discuss the best course of action for you. Often they will inject dye which spreads through the lymphatic glands and the they can determine what is called a "Sentinel node". The sentinel node can then be biopsied to determine whether the cancer has spread as far as this. This helps the surgeon to decide which glands, if any, should be removed from under your armpit. Surgical options apart from lumpectomy are usually segmental mastectomy or mastectomy with or without removal of the glands from the axilla.

After surgery you will be often referred by the surgeon for both radiotherapy and chemotherapy. All this is of course is very traumatic to both you and your family. Having a supportive family system and network all friends is very important at this stage as is the support of a good family doctor. During this time, it is really important that you reprioritise your life. Patients having chemotherapy fare much better if they just consider the time of the chemotherapy as a time for them to go through stop. That is a goal for this time be looking after themselves, and getting through the chemotherapy as best as they can. If you try and carry on with normal goals that is being the best mother of all the best professional person as well as having the chemotherapy the likelihood of stress making you sick goes up a great deal.

After that you may has been removed, it will be checked to see if it is "hormone positive" war "hormone negative". A hormone positive breast cancer is sensitive to oestrogen. This means that oestrogen specially oestradiol and OESTRONE, can make the tumour growth faster and increase the likelihood of it spreading to other parts of your body. Tamoxifen is in the class of drugs known as SERMS. Serms are antioestrogen in the nature alter the way oestrogen bind to receptor sites. IC3 and DIM may change the way oestrogen is broken down into its byproducts. These are normally mainly 16 hydroxy oestrogen and 4 hydroxy oestrogen. These are known as "bad oestrogens" because they are potentially carcinogenic. There are also good oestrogens, these are 2 hydroxy oestrone and 2 hydroxy oestradiol and in turn these are broken down to 2 methoxy oestrodiol and 2 methoxy-oesterone. All these four substances are protective and help slow the spread of breast cancer.

Generally after breast surgery and radiotherapy and chemotherapy, patients are prescribed Tamoxifen for five years. However lately, another drug called Arimidex has proved to be more effective than Tamoxifen. Lifestyles changes to become more healthy such as stress reduction, stopping smoking, limiting drinking, and the anti-cancer diet are all useful during this critical five years. Specific anti breast cancer supplements can also be taken.

Many patients alleged to have breast reconstruction surgery following mastectomy. This is usually scheduled about six months after the chemotherapy finishes. Breast reconstructive surgery is very effective and can to a lot for a patient’s self-esteem after breast surgery.