PETER CHIN
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If a breast lump is found, it usually warrants further investigation to determine the nature of the lump. Breast lumps may be due to a benign condition e.g. simple cyst or fibroadenoma, but adequate triple assessment (described elsewhere) needed to be performed to rule out any sinister pathology. Other breast symptoms that will require assessment or treatment include Nipple discharge (especially if blood stained), nipple inversion, skin retraction and breast asymmetry.
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Breast cancer can often be asymptomatic and can be detected early with screening mammography. It can present as a non-tender firm breast lump and sometimes is associated with skin retraction and nipple inversion. Mammography may also detect microcalcification (calcium) in the breast tissue which is not palpable. Often these are benign (dystrophic calcification) and does not require further investigation. Occasionally, certain types of microcalcification may signify an underlying pathology and will require further investigation.
BREAST SYMPTOMS
Women can develop breast symptoms as a result of changes in the breast fibroglandular tissue. These symptoms may be related to the menstrual cycle and include breast pain, tenderness and nodularity. It is not uncommon to find general lumpiness in the breasts which are symmetrical on both sides. General lumpiness is a normal part of breast change which is often related to the menstrual cycle. However, the development of a new area of persistent lumpiness should be assessed to determine the underlying cause.
Breast pain is another symptom that commonly occurs in women and is often related to the menstrual cycle. This is due to changes in the breast glandular tissue at different periods of the cycle. There are other causes of breast pain which include lateral chest wall pain or pain arising from the cartilage joints of the rib. Although many women with breast pain understandably fear breast cancer, it is not a common symptom of cancer.