Breast lump
Summary/Definition
A lump in the breast is any neoplasm that appears in the breast, and is the most common symptom with which patients go to the hospital for breast—related problems. Approximately 80% of patients have a tumor detected by accident, and the remaining 20% have it detected during examination or medical treatment. Breast neoplasms in women under the age of 40 are almost always benign and are caused by fibroadenoma, fibrocystic changes, fibrosis, etc. However, regardless of age, painless formations in the breast need to be examined to distinguish them from malignant tumors. With age, the process of degeneration of a benign breast tumor into a malignant neoplasm increases, therefore, non-cystic formations in women older than 40 years should be considered malignant, regardless of clinical data. Other causes of the formation of tumors in the breast include mammary hamartoma, fibrocystic changes, intra-flow papilloma, abscess due to mastitis and atypical hyperplasia.
Symptoms
Usually, seals in the chest are felt when their size is 2 cm or more, as well as depending on the size of the seal, location or depth. However, even in healthy women with hormonal changes, the breast may seem compacted. Since a woman’s breasts increase during menstruation and then decrease again, the best time to check for seals is 5-7 days after the end of menstruation. If you feel a seal whose size does not change depending on the menstrual cycle, or if you feel a seal after menopause, you should immediately go to the hospital for an examination. As a rule, with benign formation, there are no skin changes, the seals are soft, mobile when probed. For comparison, malignant formations are solid and immobile when probed. However, since it is very difficult to distinguish a benign tumor from a malignant one with palpation, X-ray examinations (mammography and ultrasound of the breast) are necessary.
Diagnostics
First, using questionnaires, we will study the risk factors for breast cancer, for example, breast palpation, whether the size of the formation changes depending on the menstrual cycle, whether it continues to grow, whether pain is felt, whether there are changes in the shape of the nipple, nipple discharge, family history of breast cancer, birth history, hormone treatment and oral contraceptives. We will also check skin changes, breast symmetry, nipple discharge, inflammation, the presence of nipple retraction and examine the entire breast, including the nipple, areola circumference and armpit. However, since it is difficult to distinguish a benign tumor from a malignant one during palpation, it is necessary to conduct X-ray examinations (mammography and ultrasound of the breast). In addition, if a solid formation is felt, all three procedures are performed: breast examination, imaging tests (mammography or ultrasound of the mammary glands) and fine needle aspiration biopsy. If a malignant neoplasm is suspected during all three procedures, surgical removal is required.
Treatment and course of the disease
Treatment of mastopathy is selected depending on the type of compaction in the chest. Common benign tumors do not need treatment, but if they increase in size, it is necessary to pass additional tests. In the case of breast cysts, the diagnosis is carried out using a fine needle aspiration biopsy, and in about 80% of cases, one procedure is sufficient to treat the tumor, preventing recurrence. Simple cysts can recur in less than 20% of cases, and in less than 9% of cases they can recur even with repeated aspiration. Fibroadenoma is a benign tumor and does not require special treatment, but if it increases in size, its removal is recommended. Depending on the degree of progression of breast cancer, surgical treatment, radiation therapy and chemotherapy are performed.
