Don’t ignore a lump in the breast, it could be breast cancer!

 

Breast cancer is the most common cancer among Indian women now. The most common presentation of this condition is in the form of a painless lump in the breast. Early diagnosis of this dreaded condition can lead to complete cure. So, don’t ignore a lump in the breast as it could be cancer.

 

Advertisements

Interesting Mammogram #5

41 year old lady with a left breast lump since last 6 years with rapid increase in size since the last 4 months. Patient was concerned that she is suffering from breast breast cancer and therefore got a mammography done and presented to my clinic.


A tru- cut biopsy was done and it revealed it to be a phyllodes tumor, which after resection turned out to be a malignant phyllodes tumor with Liposarcomatous differentiation. 

Case uploaded by:

Dr. Rohan Khandelwal

Breast Cancer Surgeon

W Pratiksha Hospital, Gurgaon 

Interesting Mammogram #4 

47 year old lady with complaints of bilateral breast pain since 3 months. Pain was non cyclical and relieved by oral paracetamol. She had a hysterectomy 6 years back and she was a known asthmatic.

On examination, she has multiple tender nodules in both the breasts, localised in the peri-areolar region. 

Mammogram revealed multiple, well defined, rounded densities in both the breasts with a rim of calcification around them (refer to figures). 

Multiple round densities in the breast


Ultrasound done revealed dense fibroglandular tissue with multiple sub-centimetric cysts in the breasts. 

Differential – 1. Multiple oil cysts with calcification 

2. Cysts secondary to fibroadenosis

Case managed by:

Dr Rohan Khandelwal

Consultant, Department of Breast Diseases and Cancer Care

W Pratiksha Hospital, Gurgaon  

Wire Guided Localisation of Non Palpable Breast Lesions

With the increase in opportunistic screening of Breast Cancer in India, more and more impalpable breast lesions are being detected. Wire guided localisation is one method to surgically deal with these lesions.

This video highlights the operative steps of wire guided localization and also the use of a specimen mammogram.

 

Dr. Rohan Khandelwal

Consultant, Breast Onco-surgeon

W Pratiksha Hospital

Mondor’s Disease

Mondor’s Disease
————————
 
1. Type of superficial thrombophlebitis (inflammation of the veins_  which involves the veins of the anterior chest wall & breast
2. Presents like a painful, cord like structure just below the breast (image)
3. Most commonly involved vein is the lateral thoracic vein. Other veins involved are – thoraco-epigastric & rarely superficial epigastric
4. Clinical features – pain along the lateral chest wall and below the breast. Patients may also complain of a cord like structure. Some patients present with just breast pain and the cord is detected by the breast surgeon
5. Benign, non cancerous lesion, which is self-limiting
6. Management – Consult a breast surgeon and get imaging done to rule out any other breast lump.
7. Treatment involves warm compresses and anti-inflammatory medicines. It usually resolves in 4-6 weeks. 
mondorscords2
Pic Courtesy: http://www.cosmeticsurgeryforums.com

Breastfeeding – a simple way to keep breast cancer at bay!

Breastfeeding has been known to reduce the risk of breast cancer and this effect is more pronounced in pre-menopausal women.

In an analysis of 47 studies, mothers who breastfed for a total duration of more than one year (all pregnancies combined) had a lower chance of developing breast cancer as compared to those who never breastfed.

Mothers who breastfed for more than two years got about twice the benefit as compared to those who breastfed only for one year.

13882665_493573760848034_2093069558171906821_n

Breast Cancer in patients with breast abscesses

In the last week, I have seen two patients who have presented with features of a breast abscess but they ultimately turned out to be breast cancers. Although, inflammatory breast cancers are a known entity and they can present as breast abscesses but this fact is not well known among patients and many general practitioners, which leads to late detection of these cancers.

With this case, I want to highlight some pointers to diagnose these lesions early. A 39 year old, non lactating mother presented to with complaints to swelling in the right breast for the last 3 weeks. She had already taken a course of antibiotics from a general practitioner but did not get relieved of her symptoms. On examination, she had a swelling involving the skin fold below the breast (infra-mammary crease) with swelling and hardness spreading till the lower part of the breast. In addition to this, she had lymph nodes (glands) in the underarm area (axilla) as well.

An USG revealed a lump in the breast associated with fluid collection, which on biopsy turned out to be an invasive cancer. Fortunately for the patient, on further examination, the cancer was found to be restricted to the breast and the underarm area only.

(null)

When should we suspect that a breast abscess can actually be associated with a malignancy (cancer)?

  1. A non healing breast abscess – which is persisting despite antibiotics and surgical management
  2. Breast abscess in a patient who is not lactating. 
  3. Breast abscesses in elderly patients
  4. Breast abscesses associated with hard lumps in the breast

Patients with these symptoms should get an ultrasound and biopsy done to confirm the diagnosis. In India, another entity which should be ruled out is Breast Tuberculosis.