Breast Pain – What To Do Initially

Breast Pain – What To Do Initially 

A Patient Empowerment Program of ROJoson Medical Clinic

A lot of female persons are experiencing breast pain.

Nowadays, with the breast cancer scare, a lot of female persons who experience breast pain goes into an anxiety, at times panic attack.

Here are my recommendations:

  1. Do a breast self-examination once you feel breast pain.  Look and Feel.  Look for anything unusual, particularly redness and swelling.  Feel for anything unusual, particularly, tenderness (pain on finger pressure) and dominant mass or lump.  The most important signal that there is a problem in your  breast is that there is a palpable dominant mass or lump.
  2. If you are able to palpate a definite dominant mass or lump in your breast, consult a breast specialist (general surgeon) right away.  Do not go for ultrasound of the breast and/or mammography first.  Consult a breast specialist first who will examine you. Wait for him/her to recommend whether an ultrasound of the breast and/or mammography is needed or not.
  3. If you are not certain of your findings, particularly, if there is really a dominant mass or lump in your breast, there are 2 options: 1) consult a breast specialist (general surgeon) right away; 2) watch and wait or observe or monitor with repeated breast self-examinations at daily intervals until you are sure there is or there is no dominant mass.  If with repeated examinations you are sure there is or more likely there is a dominant breast mass, consult a breast specialist (general surgeon) right away.  If with repeated examinations you are sure there is no dominant breast mass, you may opt not to consult a breast specialist right away and just continue to do watch and wait or observe or monitor.
  4. If you are certain there is no unusual findings on breast self-examination after you feel a breast pain and the pain is tolerable, on-and-off, not progressive, and does not wake you up in the evening when you are sleeping, you may opt to do watch and wait stance.  The breast pain is usually a non-specific breast pain, one that is not associated with a breast disease.  The breast pain may also be related to hormonal changes which usually disappear in due time.

Additional tips and information that may be helpful to deciding what to do when you have breast pain:

  • Whatever symptoms (feel) you may on your breasts, the most important signal that there is a problem in your  breasts is that there is a palpable dominant mass or lump.   If there is no palpable dominant breast mass or lump, there is a big chance (as high as 95% based on subjective probability) there is no breast disease or significant breast problem.  If there is no palpable dominant breast mass or lump and there are no associated findings like redness and swelling,  there is a big chance (as high as 98% based on subjective probability) there is no breast disease or significant breast problem.
  • If you are worrying about the probability of breast cancer when there is breast pain, remember that breast cancer is not painful when it is still within the breast substance.  Let this information allay your anxiety or panic attack on probability of breast cancer when you have breast pain particularly when you don’t feel a dominant breast mass.  As a general rule, if there is significant pain and tenderness on a palpable dominant breast mass with no accompanying skin lesion, the subjective probability of the mass not being a cancer is higher.  The painful and tenderness mass is usually an abscess or a macrocyst (big cyst that contains fluid).
  • Dominant breast mass – when palpating the breasts to see if there is a lump or a mass that will be a cause for alarm, look for a dominant breast mass.  One has to differentiate between lumpy or nodular breast surface and a true lump which is represented by a so-called dominant breast mass, in medical parlance.

“Dominant mass” refers to a mass that clearly stands out from the background,  particularly background of normal lumpiness, presumably by its size or its texture on palpation.

“Dominant breast masses” is defined as a three-dimensional abnormality that is different from surrounding breast tissue. (https://www.aafp.org/afp/1999/0215/p1007.html)

“Dominant breast mass” is a palpable breast mass with defined borders or margins.
“Non-dominant breast mass is a palpable mass, thickening of the breast parenchyma with undefined borders.
(http://www.breastdiseases.com/mampro.htm)

“Dominant breast masses” are distinguished from nodular breast tissue by having three dimensions and a texture different from the adjacent normal breast. Comparison with the mirror-image location in the opposite breast is often helpful.

http://what-when-how.com/acp-medicine/approach-to-the-patient-with-a-breast-mass-part-1

“Dominant breast mass” is a three-dimensional distinct mass that is different from the remainder of the breast tissue and from the tissue of the other breast.

https://www.glowm.com/section_view/heading/Diagnosis%20and%20Management%20of%20Benign%20Breast%20Disease/item/17

Look at the diagrams below for more detailed explanations on dominant mass.

palpation_findings_self-exam_rj_18apr16_without_heading

dominant_breast_mass_no_nipple

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