Are breast nodules a precursor to cancer and must be operated? Experts say that breast nodules suggested by ultrasound are more common, and generally speaking, nodules assessed as BI-RADS grade IVa or above are recommended for biopsy, while nodules below grade III are mostly recommended for regular observation.
It’s all about the nodules. “Breast nodules are actually cystic hyperplasia of the breast, which can easily lead to breast cancer if effective treatment measures are not taken in time.”
”Surgery is recommended. The purpose of surgery is to check the pathology and exclude malignant lesions (breast cancer).”
After reading these paragraphs on the Internet, Ms. Wang, who lives in Zhengzhou Economic Development Zone, was in a bad mood these days.
The matter originated from the annual physical examination of the unit. This year’s physical examination is not in the hospital, but in a medical examination center. More than half a month after the physical examination, Ms. Wang received the physical examination report: “A hypoechoic area is seen in the left extramammary gland layer, with clear borders, size of about 0.7 × 0.7 cm, blood flow is not abundant. What is seen on examination: left breast nodule.”
Ms. Wang did not know what a nodule was, so she went online and pulled up information related to breast nodules, but instead of being puzzled, she became more depressed: is a breast nodule a precursor of cancer? Do I have to have surgery?
Most breast nodules
Ultrasound-indicated breast nodules are more common and are generally evaluated as BI-RADS
Nodules with grade IVa or higher are recommended for biopsy, while most nodules below grade III are recommended for regular observation. Since this physical examination report does not provide a specific assessment, it is recommended that Ms. Wang first go to a regular hospital for a breast ultrasound examination to be analyzed and judged by a professional doctor.” Liu Hui, chief physician and postgraduate instructor of breast department of Henan Cancer Hospital, suggested.
If the ultrasound examination suggests BI-RADS
grade III breast nodules with malignancy rate of 0.5%~2%, there is usually no major problem and the principle of treatment is regular observation. If the patient has significant local pain symptoms or excessive anxiety, surgery may also be considered. In addition, if the nodules increase in size or change in shape during regular follow-ups, timely surgery is also needed. However, Liu Hui reminds that since ultrasound results have a great deal to do with the standard of the operating doctor, a comprehensive evaluation by a professional doctor at a regular hospital is needed.
Many patients who have had breast ultrasound or mammogram and see the BI-RADS classification in the report are often unaware of the findings.
The purpose of BI-RADS is to standardize breast examination reports, to comprehensively assess the risk of malignancy of breast lesions found in imaging examinations, and to help clinicians make reasonable choices about lesion management.
Hyperplasia is not a disease, so you should not take drugs indiscriminately
Mammary gland hyperplasia is sometimes manifested as breast nodules. So, how should breast enlargement be treated?
Liu Hui said that usually, mammary hyperplasia is a symptom, not a disease, and does not require special treatment, let alone indiscriminate medication. In adolescent or young women, many people have breast pain before menstruation, and sometimes the pain can spread to the back of the shoulder. After the menstrual period, breast pain relieves itself, and only some thickening of the breast can be touched, without obvious nodules, which is a physiological change, not a disease, and generally does not require treatment. For the more painful and long-lasting enlargement, you can adjust your living condition and take some oral Chinese medicines such as “Prosperity Pill” and “Breast Fetish Elimination” to relieve the symptoms.
A positive attitude towards life, a healthy and reasonable diet structure, and a scientific and regular work and rest schedule can help prevent breast diseases such as breast enlargement and breast nodules.
Try moxibustion for mammary gland hyperplasia
Chinese medicine believes that the two meridians of the liver and stomach are most closely related to the breast. The liver and qi stagnation, emotional and internal injuries have an important impact on the pathogenesis of breast enlargement.
”Moxibustion is applied twice a day for 30 minutes each time.” Lv Peiwan said that when applying moxibustion, the moxa stick is 2 to 3 centimeters away from the area, gently swirling around the breast or sweeping up and down along the meridians. The pain will be painful at the beginning, sometimes here and there, even unbearable pain, but the pain will be reduced or disappear when the amount of moxibustion to a certain number of days, “moxibustion after the breast is soft and no nodules, indicating that the disease is cured. However, those with severe breast enlargement should be reviewed in hospital every 3 months.”
Because moxibustion has a warming effect, mostly for the treatment of cold evidence, so there is actual heat evidence, Yin deficiency produces internal heat of deficiency heat evidence people should not moxibustion, patching. “Before moxibustion, you must go to the hospital to do a physical identification, according to the correct guidance of the doctor line moxibustion will achieve the purpose of treatment.”
In addition to moxibustion, can also be combined with the meridian breast massage. The specific practice: the right hand fingers on the left breast rib space, from the inside of the kidney meridian, slowly push and knead to the outside of the breast spleen meridian, lung meridian. Then the same way massage the right breast, each breast pushed 5 to 10 minutes, twice a day.
There is another method is the foot back massage. The recessed area of the back of the foot when the two or three toes are stretched is the breast point of the foot, regular stimulation and massage here is very beneficial to women’s breast health.
Breast Cancer Danger Signs” Due to the lack of knowledge about breast cancer protection, most of the breast cancer patients are already in the middle and late stages after being detected. In fact, the breast gland is located on the surface of the body and it is easy to detect its abnormalities and is an organ that can detect cancer early compared to internal tumors.” Li Wentao, deputy chief physician and graduate instructor of thyroid breast surgery at Henan Provincial People’s Hospital, said.
Does breast cancer also release danger signals in advance? Based on years of clinical accumulation, Li Wentao provided several “danger signs” for self examination.
1. Painless nodules or lumps without redness or swelling are found in the breast.
2.Hardening and shrinking of the breast and elevation of the nipple should be suspected as hard breast cancer.
3.Women over 30 years old should be alerted to inflammatory breast cancer if their breasts increase rapidly within weeks and are accompanied by skin redness and swelling, but not obvious inflammation.
4.Breast skin shrinks and sinks inward to form “dimple sign”.
5.Breast skin is edematous, rough and “orange peel-like”.
6. Repeated bloody nipple overflow. Nipple overflow refers to the phenomenon of liquid overflowing from the nipple in its natural state outside of the breastfeeding period.
7. Be alert to eczema-like breast cancer when erosion or ulceration occurs on the nipple or areola.
If you find a swelling in the armpit, especially an enlarged axillary lymph node on one side, you should consider the possibility of breast cancer metastasis in the axillary lymph node.
Regular breast examination is important “Regular examination is one of the effective ways to prevent breast cancer.” Li Wentao said that women under 35 years old should go to a regular hospital once a year for breast ultrasound examination; women over 40 years old should go to a regular hospital once a year for breast ultrasound and mammography examination.
For women with high risk of breast cancer, they should be included in the surveillance target from the age of 20, and the clinical examination time should be twice a year, and after the age of 30, they should have breast ultrasound or mammography once a year.
Currently, women at high risk of breast cancer are defined by the following criteria: more than two relatives in the family with breast or ovarian cancer before age 50; one relative with both breast and ovarian cancer; one relative with bilateral breast cancer before age 50; one male relative with breast cancer; women with a history of chest radiation therapy; women with genetic testing or genetic risk assessment identifying genetic abnormalities such as BRCA1; women with a history of women with pathologically confirmed lobular carcinoma in situ or atypical hyperplasia or peripheral intraductal papilloma.
In addition, Li reminded that women’s breast gland will change differently in different physiological cycles, especially before and after menstruation, and the breast gland is obviously engorged with blood, so if you visit the doctor at this time, you will often be mistaken for having a breast lump, which will affect the doctor’s judgment.