DR. DAWN HARPER

BREAST LUMPS

DR. DAWN HARPER | BREAST LUMPS

DR. DAWN HARPER | BREAST LUMPS 2/3

I see 2 or 3 women every week with breast lumps and to most of them, breast lumps equal breast cancer. Who can blame them? One in 9 women will develop breast cancer (usually later in life) and the disease claims over 15,000 lives in this country every year. But thankfully, 90% of referrals to breast cancer specialists turn out to be benign disease.

It doesn’t have to be a big deal – you can become familiar with your own breasts by looking and feeling in a way that fits in with your life whether it be in the bath or while dressing. All I want from my patients is that they know when something doesn’t feel right – the rest is up to us GP’s. So what are these lumps and how do we tell the difference? The most common breast lumps are fibroadenomas and breast cysts.

As a general rule, fibroadenomas, also called ‘breast mice’ because they can be moved about under the skin, tend to occur in women aged 15 – 30. The younger the woman is when she develops them, the more likely they are to disappear spontaneously. It is extremely rare for fibroadenomas to be linked to any form of breast cancer. Cysts (fluid filled sacs) are more common between 40 and 50. They are often multiple but why they occur is unclear. People have speculated that there may be a slight increase risk of breast cancer but the evidence is conflicting and if there is any risk it is likely to be very small indeed. To the trained clinician there can be differences in the feel of these lumps but to be honest the

only way to be certain is to have a look at some cells or fluid under a microscope. This means putting a needle into the lump and aspirating the tissue. The results are usually available within a few days and the discomfort is a small price to pay for the reassurance that follows in most cases.

Bottom line? Anyone with a new breast lump should see their doctor. Patients often apologise to me for wasting my time when they are given the all clear, but I can’t think of a better way of “wasting my time” than telling someone they don’t have cancer!

BREAST LUMPS

DR. DAWN HARPER | BREAST LUMPS 3/3

Recently I’ve become very concerned about my breasts. When I was little my left breast was slightly larger than my right. Now that they have developed I have noticed that my left breast is larger than the other one. It’s really embarrassing and it’s more than just slightly larger – you can see the difference just by looking at them. I don’t know what to do, please help! Is this normal, and is there anything I can do?

Breast development begins anywhere between 8 and 13 years old and it’s common for them to grow asymmetrically. The development isn’t complete until about 20, so there’s plenty of time for your breasts to even out at your age (14). In fact, we are all slightly uneven and that’s normal. Rarely the asymmetry is quite obvious and then breast reduction or augmentation or a bit of both can correct things, but you really don’t want to entertain that until you know your final shape. In the meantime there are good bras available with optional padding that can hide any lopsidedness very effectively.

I’m only 15 and I’ve found a lump smaller than a pea right next to my nipple and I’m worried if you can get cancer around your nipples whether it might be that or if it’s something to do with my periods. Please help.

This is almost certainly NOT cancer Fiona. At your age it’s much more likely to be something called a fibroadenoma, which is not malignant and has an

extremely low risk of becoming cancerous. A third of fibroadenomas get bigger, a third stay the same and a third go away on their own without treatment. Make an appointment to see your GP – you can request a lady doctor and I’m sure she will put your mind at rest. If it is a fibroadenoma, there is no need to have it removed but some women choose to just so they can forget about it.

I’m not sure what ‘normal’ is for breasts. Most of the month my breasts are quite sore and a bit hard and lumpy. It’s freaking me out. I heard that it’s normal for breasts to have a certain amount of lumpiness, but I don’t know how much is normal. After my period, my breasts are not sore, but still lumpy. What’s happening?

Don’t worry. Everyone’s breasts are different and it’s common for them to change during the menstrual cycle, tending to be more tender and lumpy just before a period. To get to know what’s normal for you, it’s best to try to examine yourself at the same time each month. Your GP or practice nurse will show you how to do this properly so that you feel more confident. Some women’s breasts are persistently lumpy making it more difficult to be sure, but if you are worried about a specific lump, get it checked by your doctor.

Recently there have been stretch marks appearing on my breasts. My breasts are now covered in them. Will they ever go away?

Your breasts can grow rapidly in your early teens making you more prone to stretch marks. As many as 7 out of 10 teenage girls will have them somewhere and fair skinned people seem to suffer more than those with olive skins. When they first develop they are often dark pink or even purple and you are not on your own - I see lots of girls worried about their appearance. The good news is that they fade over time often so much so that they are barely visible, so please don’t worry.

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