Breast Pain: Should I worry it could be Breast cancer?

Definition

Mastalgia is breast pain. There are two types of mastalgia or breast pain: cyclic and noncyclic. Cyclical breast pain is most often associated with menstrual periods. Noncyclical breast pain is not related to the menstrual cycle.

Causes

Mastalgia can be caused by:

  • Hormonal changes associated with the menstrual cycle
  • Pregnancy
  • Trauma to the breast
  • Mastitis
  • Thrombophlebitis
  • Stretching of breast ligaments
  • Pressure from a bra
  • Hidradenitis suppurativa
  • Certain medications, such as hormone medications, antidepressants, or certain heart medications

Risk Factors

Factors that may increase your risk of having mastalgia may include:

  • Having a history of breast surgery or breast injury
  • Having large breasts

Symptoms

Symptoms of mastalgia may include pain in the breast area. Pain may be mild or severe. It may occur in both breasts or just one. It may be painful only in one spot or all over the breast.

When Should I See a Doctor?

Call your doctor right away if you have any signs of infection, such as redness, tenderness, fever, or chills.

Call your doctor if you notice any other changes in your breasts, such as:

  • Change in the size or shape of your breast
  • Discharge from your nipple
  • New lumps or masses felt in the breast
  • Other changes to the skin on your breasts, such as crusting, dimpling, or puckering

 Call your doctor if your breast pain persists, interferes with your daily routine, or is in one specific area of your breast.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. The diagnosis is most often done with history of pain.

Your doctor may order further testing to look for any suspicious changes. These tests may include:

  • Mammogram
  • Ultrasound
  • Breast biopsy

Treatment

Talk with your doctor about the best treatment plan for you. Treatment may be based on what is causing your breast pain. General treatment options include:

Medications

Topical nonsteroidal anti-inflammatory drugs (NSAIDS) may reduce the pain associated with mastalgia. Other medications may be prescribed to help reduce cyclical mastalgia.

If you are taking hormones, such as estrogen or progesterone, your doctor may make changes to your medications to reduce pain.

Other Treatments

Your doctor may suggest some changes depending on the cause of your breast pain. These might include:

  • Wearing a properly fitting bra that has good support
  • Avoiding caffeine
  • Eating a low-fat diet
  • Using a hot or cold compress

Prevention

There are no current guidelines to prevent mastalgia.


Breast Mass: Do I have Breast Cancer? What You Need to Know

Breast mass is a firm, sometimes tender, area within the breast tissue. Many women notice a breast mass at some point in their lives. There are many ducts and nodules within breast tissue and these can change with hormones and age. These changes are normal but you should not assume so until confirmed by a doctor. A breast mass can be scary when you do not know the cause, but there are many reasons for a breast mass to occur. The majority of breast masses are not cancer.

Treatment depends on the cause of the mass.

Lifestyle

  • Apply a warm, moist compress to the breast area as needed but make sure your mass has been seen by a doctor
  • Place a towel between the compress and your skin.
  • Try gentle massage of the affected area only if the mass is not cancerous.
  • Wear well fitting bra. Make sure it is comfortable.

Keeping Track of Your Breast Mass

Your doctor may ask you to keep track of your breast mass. Some things to pay attention to include:

  • Do you feel pain or tenderness? Is it getting worse or better?
  • Do you notice the mass during your menstrual cycle or at other times?
  • Does the mass change size with your menstrual cycle or does it stay the same?
  • Has the mass grown or increased in size over time?
  • Is there any redness or discolouration in the skin above or around the mass?
  • Do you have nipple discharge? Notice the colour
  • Is the nipple on the affected breast pulled inwards?
  • Do you see “dimples” on the affected breast?

When Should I Call My Doctor?

Call your doctor if you experience any of the following:

  • New or worsening sings & symptoms
  • Symptom goes on longer than 3 months. This is long enough
  • Signs of infection, including pus, redness, fever and chills
  • Increased pain & tenderness.
  • Discharge of any form from the breasts

 

NB: Breast cancer mass may be painless. It may not be threatening at the beggining. Always get a physician opinion when in doubt. Feel free to call or email us.


Taking Care of Yourself After Mastectomy. What You Need To Know

A mastectomy is surgery to remove part or the entire breast. This is usually done when breast cancer diagnosis indicates the malignancy is not contained in a very small area or when tests show a high risk of developing breast cancer. The incision is closed with stitches. In some cases, plastic drains are placed to drain fluid. They are usually removed in 1-2 days. Recovery time is about six weeks, assuming all normal circumstances

What You Will Need After Mastectomy:

  • Well-fitting support bra
  • Bandages for the incision area

Steps to Take After Mastectomy

Home Care After Mastectomy

  • Keep breast incisions clean and dry.
  • Wash your hands with soap and water for at least 1 minute before changing the bandages.
  • You may have one or more tubes to drain blood and fluids.
  • Empty the drains and measure the fluid. Report bright blood or pus to your doctor.
  • Ask your doctor about when it is safe to shower. Do not bathe or soak in water until completely healed.
  • Wear a well-fitting, supportive bra.
  • Be sure to wear the bra all day and all night. Do this for the first week after surgery.

Diet After Mastectomy:

  • Ask your doctor if you can resume your normal diet.
  • It is important to avoid alcohol and concentrated sweets.
  • East a healthy well balanced diet with lots of fruits and vegetables.
  • If you are diabetic, keep close monitoring on your blood sugar levels. The goal is blood sugar levels less than 150mg/dl

Physical Activity After Mastectomy:

  • Ask your doctor when you can return to work and drive.
  • Avoid heavy lifting and other strenuous activity.
  • If you had lymph nodes removed or total radical mastectomy:
    • Avoid tight clothing on the affected arm.
    • Do not carry anything heavy using the affected arm.
    • Elevate your affected arm as much as possible.
    • Report excessive swelling to your doctor.
  • Ask your doctor about physical therapy. You may have to do exercises to help you regain shoulder and arm mobility.
  • In most cases, you can resume normal activities in six weeks.

Lifestyle Changes After Mastectomy:

  • Mastectomy is a life changing surgery. Work with your doctor will plan lifestyle changes that will aid in your recovery.
  • Light weight breast prosthesis can be work a month after surgery.
  • You can be fitted for a more permanent prosthesis after your incisions have healed.
  • Talk to your doctor about reconstruction surgery options

If you had lymph nodes removed, you take the following steps even after the recovery process:

  • No blood pressure, injections or blood draws on the affected arm
  • Avoid wearing anything tight on the affected arm.
  • Wear gloves when doing dishes, yard work, or any household scrubbing.
  • Avoid carrying anything heavy with that arm.
  • Always use an electric shaver when shaving your armpits.
  • Moisturize the skin on that arm.
  • Use sunscreen to prevent sun damage.

When to Call Your Doctor After Mastectomy:

After you leave the hospital, call your doctor if any of the following occurs:

  • Signs of infection, including fever and chills, redness or pus
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Cough, shortness of breath, chest pain or anxiety
  • Nausea or vomiting that you cannot control with the medicines you were given after surgery.
  • or Nausea/vomiting which persist for more than two days after discharge from the hospital
  • Redness, warmth, swelling, stiffness, or hardness in the arm or hand on the side of the body where the lymph nodes were removed
  • New, unexplained symptoms of any nature
  • Lumps or skin changes in remaining tissue on mastectomy side
  • Lumps, skin changes, or nipple drainage in remaining breast
  • Depression

 


Screening Mammograms: How to Teach Patients & Promote Compliance

What Is Patient Teaching about Breast Cancer Screening – Mammography?

  • Patient teaching about breast cancer screening mammography (SM)  can defined in simple terms as the process of providing helpful information to patients before, during, and after mammography. This is to increase their knowledge of the procedure and enhance their ability to cope with the procedure and related results.
    • What Patients need to know about screening mammograms:

      screening mammogramPatient teaching about Screening Mammogram involve: –

      • Teaching patients about the purpose of breast cancer screening
      • The risks involved and benefits of screening mammograms
      • How to prepare for mammography
      • What to expect during the procedure
      • Strategies for coping with the screening mammogram procedure and findings.
      • Screening mammogram is the single most effective method for early breast cancer detection because it can identify breast cancer several years before physical signs and symptoms are apparent.
      • Lack of screening mammograms and infrequent  screening mammogram are widely recognized as major factors contributing to increased breast cancer mortality
    • How to teach patients about screening mammograms:

      First time experience can be uncomfortable to many women but with correct teaching, compliance can be achieved. Teaching and motivational activities like face-to-face instruction, written materials, video presentations and pre-visit tours can be utilized to teach and support patients in learning about mammography and breast cancer screening

      • Make teaching and learning an ongoing process by using combination strategies like sending a reminder letter, providing a pamphlet about screening mammograms & discussing concerns about discomfort during mammography. This has been shown to be more beneficial than face-to-face instruction only
      • Use of informed decision-making process is important when promoting health screening such as screening mammogram. In educated population, research has shown that use of leaflets with decision aids appear to increase knowledge and participation in breast screening and have a positive impact on reducing decisional conflict.
    • Where does teaching about screening mammograms occur?

      Patient teaching about breast cancer screening mammograms typically begins in primary care, but can also be introduced at any time of clinic or hospital visit. Public education has shown to yield the best results about screening mammograms.

      • Every possible effort should be made to promote seamless delivery of patient teaching throughout the course of care and after screening mammogram.
      • Conflicting information about breast cancer screening mammograms should be avoided to reduce frustration and confusion and increase
    • Who is the best to teach about breast cancer screening mammograms:

      Patient teaching about breast cancer screening mammogram can be given by healthcare professionals like physicians and nurses and should not be delegated to assistive clinical staff or none clinical staff.

      • Research has shown that the most effective educators of women undergoing mammography are those who individualize information to specifically address their learning needs – women just like them