Pain, lumps, and overflow are known as the three major symptoms of breast disease, and most patients who come to the hospital do so because they feel a lump in their breast. At every stage of a woman’s life, adolescence, pregnancy, breastfeeding, middle age, and old age, breast lumps can occur at any stage, and some lumps can even be fatal. The scariest thing is that most breast lumps grow quietly, without pain or itching, without delay in eating and sleeping, without delay in exercising life, thinking that it does not matter, so paralyzed, who knows, when one day, you want to get up to see a doctor, found that it has long been not the “small beans” you found at the beginning “small peanut” is no longer. It has become a hard “big walnut” “big egg”, more unacceptable is that it can still move, but now it seems to have no boundary, growing on the chest wall motionless. The doctor gave a terrible name to this lump – breast cancer.
Lumps are divided into benign and malignant
Case sharing: One morning a month ago, just after opening the clinic, a couple came in. The lady, who was in her 40s, said, “Doctor, last night when I was taking a bath, I inadvertently felt a lump in my right breast as big as a child’s fist, and it was rolling around with a gurgle, which scared me to death. Our doctors are very experienced in this area.
1. from the patient’s symptoms: she had almost never had any discomfort in her breasts and was not aware that she had anything growing on them before.
2. From the patient’s signs: her right breast was obviously larger than the left one, the skin above the nipple was elevated, and a lump could be felt with clear borders, smooth surface, good mobility, and hard and tough texture. The absence of any pain on pressure.
3. Auxiliary examination: a lump of 6*7 cm within the glandular layer of the right breast was seen, with clear borders and an envelope, and no obvious blood flow signal was seen.
The three indicators can initially affirm that the woman has a huge tumor growing in her right breast. Specific management measures.
1.Puncture pathology examination.
2.Send icing during surgery.
3, explain to the family that further stage II surgical treatment is needed if it is malignant.
Fortunately, this woman’s tumor was a benign fibroadenoma. The tumor would not recur in its original location after excision. I was impressed by the fact that the three patients who registered immediately after her told the doctor that they had a single breast mass or multiple breast masses in one or both breasts, and more typically, each of them was found inadvertently “in the shower”.
I. Types of benign lumps, characteristics and treatment
1.Fibroadenoma of the breast
They are usually found in young women between 20 and 30 years old, mostly unintentionally in the shower, with no obvious pain, hard and tough texture, slow growth, good mobility, and ultrasound: hypoechoic nodules with obvious envelope, clear borders and regular shape.
2.Cystic hyperplasia of the breast
Most middle-aged women have onset, no obvious conscious symptoms, occasional yellowish fluid from nipples, breast ultrasound: multiple echogenic nodules are visible. Most of them are caused by endocrine disorders ductal dilation.
3.Mastopexy nodules
They can develop at any age during the reproductive years, and are usually painful regularly with the cyclical changes of menstruation. Generally multiple, occasionally single. The borders are not clear, the mobility is not great, and pain can occur with pressure. Ultrasound shows: hypoechoic nodular shadow with unclear borders and irregular shape.
4.Lipoma of the breast
Benign tumor in the fatty layer of the breast, usually observed and not treated.
5.Mammary malformation tumor
A benign tumor in the breast, which is extremely rare, is usually difficult to distinguish from other benign tumors and requires final pathological diagnosis.
6.Breast tuberculosis
Some patients with breast tuberculosis have a history of tuberculosis and a positive tuberculin test, which is difficult to distinguish from malignant tumors and requires pathological diagnosis.
7.Fat necrosis of the breast
Most of these patients are elderly patients after breast degeneration and have a history of trauma.
8, inflammatory mammary mass
Mastitis is divided into lactating and non-lactating mastitis. Regardless of the type of inflammation, there will always be redness of the skin, breast lumps, increased skin temperature, and other inflammatory manifestations. Benign breast lumps are summarized by the following characteristics: slow growth, good mobility, hard and tough texture, smooth surface, regular shape, clear demarcation from surrounding tissues, partial or complete envelope, no recurrence, and no metastasis. The treatment of benign lumps generally depends on the situation, not urgent to operate immediately can observe the growth of lumps, if found that the recent growth is rapid or the lump is huge, can be solved by surgery.
II. Characteristics and treatment of malignant breast tumors
Most of the malignant masses occur in middle and old age, however, there is now a trend of advancement reported, and most of the malignant masses in China are common among women around 50 years old. They are mainly characterized by painless masses, hard texture, rapid growth, rapid metastasis and recurrence. Adjuvant examination shows indistinct boundaries of the lump, crab foot-like, with calcified spots and abundant blood flow signals, etc.
Several types of breast cancer.
Eczema-like carcinoma of the nipple – itchy itchy itchy nipple with repeated breaking of water is seen.
Inflammatory breast cancer – skin redness and swelling similar to breast cancer during lactation with high malignancy
occult breast cancer – no lump in the breast and metastases are found first
parametrial breast cancer – a mass found in the parametrial breast in the armpit area
Male breast cancer – breast cancer found in men
Secondary breast cancer – cancer from another site metastasized to the breast
Breast cancer from radical surgery – modified radical surgery – total mastectomy – segmental resection plus axillary lymph node dissection (breast conservation). Neoadjuvant chemotherapy, radiotherapy, biologic targeting, endocrine therapy, physical therapy, Chinese herbal medicine, etc. Early detection of breast cancer is obviously more meaningful to the survival of life!
III. Methods of breast self-examination
Most of the breast cancers are found by the patients themselves when they are examined at home. So what is the best way to detect breast problems? Here is how to perform breast self-examination.
1.Facing the mirror, bare your upper body and cross your arms to see if your breasts are symmetrical and if there is no nipple depression or elevation or lowering. Whether there are bulges or dimples on the skin surface.
2 . Put your fingers and palm in a plane to touch the opposite breast. Touch the right breast with your left hand and the left breast with your right hand. Do not pinch and pinch with your hands to avoid mistaking normal breast tissue for a lump.
3, the breast is divided into five areas, outer upper, outer lower, inner upper, inner lower, nipple areola area, in order from outer to inner respectively, touch, pressure, the presence of lumps.
4, the armpit is the part of the breast examination can not be missed, touch the armpit with the fingertips, there is no lump.