Taking Your Lumps Seriously

Though the majority of unusual masses in the breast are not cancer, women, and men, should always have them examined

October 18, 2007|By Meredith Cohn | Meredith Cohn,SUN REPORTER

She wasn't looking for it, but there it was. A new and mysterious lump.

Theresa Harris found it in her breast one Friday when she was changing her clothes for bed at home in Damascus. And it wasn't just any day. It was the day in July that her sister underwent a double mastectomy to remove her breast cancer and prevent new tumors.

Shocked, Harris wondered how much one family should have to endure within 24 hours.

But a trip to her gynecologist three long days later and follow-up tests confirmed Harris' lump was not cancer. It was an ordinary cyst.

Like most people, she didn't know that the majority of strange lumps and bumps women, and some men, find in their breasts are not cancer. They're benign growths that don't always even require treatment - though they all need to be checked.

Harris and her doctors say the experience should sap the fear many women have about doing self-exams and going for regular checkups. In the smaller percentage who do have the disease, most professionals agree that early detection and new treatments are reducing the rate of death from the disease.

"Get checked, because odds are it won't be bad news," Harris said. "Finding out was such a relief."

October is Breast Cancer Awareness Month, and groups like the American Cancer Society and Susan G. Komen for the Cure are urging women to be vigilant.

While the lumps are not always tumors, breast cancer remains the most common cancer among women after skin cancer, according to the cancer groups. Among those with the disease, only lung cancer is more deadly.

Close to 178,500 women will be diagnosed with breast cancer this year and 40,460 will die.

Men can also get breast cancer, although the rate is far lower - 1.5 cases per 100,000 men in 2003 versus 124 per 100,000 women, according to the Komen group.

And, contrary to popular belief, a family history is not required, or even typical, in those who get the disease, say doctors such as Nazanin Khakpour, director of breast surgery and of the breast multidisciplinary cancer program at the University of Maryland Medical Center.

She said there are four steps to good breast health: Do self-exams monthly so you know what your breast feels like and if there is a change. Get a breast exam yearly from a professional. Starting at 40 years old, get an annual mammogram. And have abnormalities that show up on the mammogram checked or biopsied.

Many lumps don't need any treatment, such as cysts that tend to come and go, she said.

If the lump is cancer, a patient's prognosis is a lot better than someone who comes in with a large tumor that has already spread to lymph nodes or bones, she said.

"Cancer is a very scary word," she said. "It may deter women from getting a lump checked. But we don't like to sit and watch them grow."

Getting a good picture is the first step in naming the kind of lump, said Deirdre Coll, director of breast imaging at the University of Maryland Medical Center.

A mammogram is a set of images that are taken by squeezing the breast a bit uncomfortably between two plates. Coll said the squeezing part goes quickly and the whole process takes about 15 minutes.

The Maryland center recently replaced its mammogram machines with new digital technology that Coll said gives her clearer pictures of the breast.

Often, an ultrasound, or a more focused picture of the lump taken with a probe rubbed atop the breast, still is necessary to determine if it is fluid-filled and not cancerous, or solid and possibly cancerous. A MRI is an even finer picture of the lump and sometimes needed.

Using a needle to tap the mass, or a biopsy, is also done in the doctor's office to determine the substance of the lump.

The lump could be several noncancerous things, Coll said. Among the most common are fibroadenomas, which are rubbery and move around but are totally benign and don't need to be removed.

Also common are cysts, which fill with fluid and are soft. They can come and go and usually don't need to be drained unless they hurt.

A papilloma is less common. It's a tiny growth in the milk duct near the nipple. It typically has to be surgically removed. A fat necrosis is a scar left after a trauma like a car accident and is not usually removed. And an infection from breastfeeding can also occur when bacteria creep in through a break in the skin. It usually needs to be drained and the patient is given antibiotics.

Coll said these lumps shouldn't scare people.

"I see those first two every day, multiple times," she said. "I go into the room and say it's a cyst and they look at me in horror. I say, `This is great.'"

Harris, 42, who had a cyst, couldn't agree more.

She knew she'd have her family to lean on if it was cancer, including her sister, Susan Granata, who is a year older and lives in nearby Olney. She said Granata had been "superwoman" for how well she dealt with pain, treatment and surgery of her cancer.

But Harris' lump wasn't cancer.

She'll need to be checked again in six months, and then annually. Her sister still will need care.

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