What is a breast lump?
A lump in the chest is, in medical terms, a breast lump: a lump or tumor in the breast, palpable and that can be painful. It is a very frequent reason to consult the general practitioner or the specialist. Most of these lesions in the breast are discovered by the woman herself, often accidentally in routine self-examination, or when she has glandular discomfort and is explored. Other times, however, they are a finding in medical examinations or routine periodic reviews.
How does it manifest?
The first clinical manifestation is usually the appearance of one or more tumors in one or both breasts. Sometimes that or these tumors can be painful or accompanied by a feeling of swelling or signs of inflammation, deformity of the breast, nipple retraction or even secretion of it.
How is it diagnosed?
In the case of a patient presenting with a breast nodule, the fundamental basis for the initial approach is to perform an adequate clinical history. It is important to ask the patient about her risk factors, personal and family history of illness and especially breast cancer, medications, previous gynecological and obstetric history, the reason she goes to the consultation and the context in which The visit takes place.
The next step in the study of this disease is the physical examination in which an attempt will be made to collect as much information as possible on the breast nodule: number, location, size, shape, consistency, delimitation, mobility, date of onset or detection and Its modifications with the menstrual cycle, other accompanying signs, etc. The lymph nodes in the armpits and those above the clavicles and in the neck will also be examined.
Finally, we will use certain complementary examinations that will help to diagnose the tumor and, especially, to clarify the benign or malignant nature of the same one:
- Ultrasound, which will inform us if the nodule has solid or cystic features.
- Needle aspiration with fine needle for cytology.
When should the patient come to the specialist?
The first place a woman with a breast problem is usually her family doctor, which is why they should know these pathological abnormalities and the way they act with respect to them.
In many cases, the primary care physician will be able to handle the problem, at least initially, especially:
- In other cases, which we explain below, the patient should be referred to the hospital for specialized study.
- In young women with nodules more sensitive to pain (or with mild or moderate degrees of pain) that have no palpable lesions.
- In women under 50 years of age who have discharge from the nipple without other associated problems and in which the possibility of being a side effect of a drug, for example, is suspected.
How are breast lumps treated?
The treatment will depend on the diagnosis made after an exhaustive study of the breast nodule. Treatment may range from medications (eg, antibiotics if a breast abscess or certain hormonal drugs are diagnosed in the case of cystic breast disease) to various surgical procedures (lumpectomy or simple removal of the tumor by preserving the breast in case of benign tumors , Until mastectomy or removal of the whole breast, in case of cancer).
Breast nodule in the male
Although less frequently, men may also have breast nodules that require a study and treatment, in many cases similar to that for the breast nodule in women. The presence of any symptom or the finding of changes in the breast of the adult male should make one think of the possibility of a malignant tumor.
The majority of patients who present with this problem have a mammary tumor below the areola, hard and painless, of 1 to 2 cm, that adhere to the skin and causes phenomena of retraction or deviation of the nipple.
If after the appropriate studies the existence of a breast cancer in the male is confirmed, the treatment is equally surgical, with the removal of the breast.
Breast examination, performed by the patient herself, reveals alterations in the consistency of the mammary gland, nodules and even more subtle alterations such as skin retractions. The great advantage of breast self-examination is that the woman learns to know her breasts.
Many patients go to their family doctor in the first instance when they have a problem in their breasts. This should guide the problem, solve it if you are qualified or send the woman to the specialist when the situation requires.
The retraction of the nipple, associated with eczema of the same and / or tumor behind the areola, should make suspicion of breast cancer.