Frequently Asked Questions About Breast Cancer
BREAST PAIN. IS IT DANGEROUS?
Most women experience pain in the breast at some time in their life. The pain may be related to the menstrual cycle, or not, and be diffuse or focal.
Usually the cause is benign and only 10% is malignant.
Suspicious symptoms are pain unrelated to the menstrual cycle and located in a certain area, but also a palpable mass as well as bloody nipple discharge. Once malignancy is excluded, the patient needs to put her mind to rest. Of course, in a percentage of 15% the pain is so intolerable, that it prevents daily activities.
The pain that is related to the menstrual cycle usually feels like heaviness or sensitivity upon palpation. It is frequently located at the external part of the breast and it can reflect to the ipsilateral upper extremity (inner surface of the arm). Many times, recommendation of vitamin E and interruption of caffeine consumption may help. Evening primrose oil is first line treatment, while derivatives of testosterone are administered in advanced cases.
The non-circular pain appears in premenopausal as well as postmenopausal women. It is usually described as ”burning”, ”stabbing” or ”pulling” and it is located around the nipple or towards the sternum. The treatment is similar to the one described above, while local infusion of xylocaine / cortisone may be indicated. Finally, removal of the area where the pain originates has a successful result in 50% of cases.
PAIN IN THE NIPPLES OF BREASTS. DANGEROUS OR NOT?
Pain in the nipples of breasts may be due to an injury of the area from breastfeeding or from intense physical activity without a brassiere (e.g. during exercising) or due to a brassiere that does not fit well and generally, in cases where friction is exerted in the area.
Pain in the nipples can also be due to pathological condtions, mainly inflammation, such as mastitis or an abscess (frequent conditions in women who breastfeed).
Finally, there is also a rare form of cancer, the so-called Paget disease, which causes inflammation and pain in the area.
The symptoms, therefore, that should make you seek immediate medical care are:
- erosion of the skin of the area
- redness
- warmness
- local edema (swelling)
- pain on one side (either left or right)
- shiver
- fever
- GENERALLY, A SWELLING OF THE BREAST
- Nipple discharge unrelated to breastfeeding or bloody discharge
Finally, if the pain persists or generally if it makes you worry, you should visit a doctor.
WHEN SHOULD I BEGIN HAVING A MAMMOGRAPHY?
Mammography begins at 40 years old. In certain cases it can also begin at 35 years in order to have a basis of screening. If there is a known mutation in the BRCA gene, it begins at the age of 25-30. In women with a strong family history but without a defined gene mutation, the mammography begins 10 years before the age of the youngest relative who had the disease and, definitely, before the age of 40.
NIPPLE DISCHARGE. WHAT DOES IT MEAN?
Nipple discharge that is not related to breastfeeding can be due to certain medicines or a prolactinoma, which is diagnosed through measurement of prolactin (blood test). It can also be due to a benign intraductal papilloma, duct ectasia or fibrocystic changes, conditions which often are not obvious in mammography, while ultrasonography depends significantly on the skills of the radiologist. Normal discharge is usually non-bloody, from many lactiferous ducts (openings at the nipple) and breast pressure is required for the fluid to be discharged. Pathological discharge is usually either bloody or automatic (without pressure), from only one side (either right or left) and from one lactiferous duct.