Q   Recently I felt a lump in my left breast, which is worrying me. I have not seen a doctor yet. Are all swellings (lumps) in the breast cancerous?

A.   No, they are not all cancer but they need to be evaluated to rule out cancer by doing mammogram or Ultrasound. It is advised that you see a doctor for the examination of your breasts. After taking the history and the full check up, the doctor will be able to reassure you at the end of the consultation. Following that you will need a mammogram or Ultrasound then the doctor will talk to you again the same day to explain the report and further plan. Most of the time that is all is required.

Q. What is the treatment once the suspicious lump is found?

A. Usually the surgeon, depending on the findings will explain to you the details of next step after the mammogram report. Initially needle biopsy or excision biopsy is done to see the histology report. The histology report tells us whether the lump is cancer or just a benign lump. Most of the times lump is not cancerous in such case nothing more is needed.

If the lump is cancerous then the detail management is discussed with the patient. If the patient requires surgery then there are two types of surgery breast saving surgery (lumpectomy) or breast removing surgery (mastectomy). In serous cases more systemic treatment is required.

Q. What age women get cancer? Can it happen to young woman like me?

A. Breast cancer can occur at any age. The average age of women is older age group. The risk of breast cancer increases gradually as a woman gets older. However, the risk of developing breast cancer is not the same for all women. Research has shown that there are some main factors associated with an increased risk of developing this disease .Some of them are:  As mentioned above the older a woman is, the greater her chance of developing breast cancer. When there is a family history of breast cancer (mother, sister, or daughter have a history of breast cancer).The woman who never had any children. Woman who started period before the age of 12yers.Women who take hormone replacement therapy for a long time   

Q.  Is breast cancer hereditary?

A.  As mentioned before Family history of breast cancer plays a significant role. These women should be more vigilant about their breast examination and breast cancer awareness.

Q. Can I get pregnant if I have Breast cancer?

A. Yes if you get breast cancer at younger age and you want to have children you can plan pregnancy. The time period following treatment will depend according to the type of cancer and the type of treatment. Certain reproductive events have been demonstrated to have protective effects (such as a full-term pregnancy). In some cases it can increase the risk of developing breast cancer (for example, early age at first pregnancy. Each woman case will have different criterias that is why it is important to seek professional advice as soon as possible.

Q. Is mammogram 100% diagnostic?

Q  What are the breast changes that I should seek advise from my doctor?

A.

• Lump in or near your breast

• Thick or firm tissue

• Nipple discharge or tenderness

• A nipple pulled back (inverted) into the breast

• Itching of or skin changes such as redness, scales, dimples, or puckers.

• A change in breast shape or size

Q. What is a screening mammogram? When I should have one? Is it 100% diagnostic?

 A. A mammogram is an x-ray of the breast that is given to a woman who has no signs or symptoms of breast cancer. A mammogram can find cancer when it is small – up to tow years before you can feel a lump I your breast. Controlled trials show that mammography reduces breast cancer related deaths in women  older than 50 years of age. The results are inconsistent with women below this age. Today a mammogram uses 1/40 the amount of radiation required 20 years ago. It is clear that the benefits far outweigh the risks which are negligible.

At the age of 40 years and above mammogram will be done every 1 to 2 years, but will be done earlier for women with strong family history of breast cancer.

The quality of mammography has significantly improved over the last few years. Mammogram in conjunction with the breast ultrasound and physical examination gives 98% of accuracy. It is the best tool available for breast cancer screening.