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Don’t Ignore That Painless Lump

Times of India
22 October 2011
By Kounteya Sinha

Don’t Ignore That Painless Lump
Alump on her underarm had been bothering interior designer Sonia Singh (47) for months, and though painless, it was growing in size. Finally, Sonia decided to visit Dr Pankaj Garg at Fortis Hospital, Chandigarh. A clinical examination, imaging and needle test confirmed that she was suffering from advanced breast cancer.

“I asked her why she came to us so late when the lump has been around for months?” Garg asked. To which she had replied, “It was painless, so I didn’t think it was harmful.”

Garg who conducted a study of over 1,000 women in Chandigarh to understand their perception of breast cancer found that over 82% didn’t know that early breast cancer was painless. “Most think that a painless lump in the breast is harmless. Women should report all types of lumps to their doctors; this will help in early diagnosis and possibly even a complete cure,” he said. Garg’s study found that over 80% patients didn’t think that a lump in the armpit was a sign of early cancer.

Over one-third thought that breast pain was the important symptom of early cancer. The misconception that “pain is an important sign” is prevalent in India, and is evident in the fact that 70% of breast cancer cases are detected late as compared to developed nations, where late detection is 20%. Dr Siddharth Sahni, HoD of breast cancer surgery at BLK Super Speciality Hospital says breast cancer, if detected in Stage 1, has a nearly 98% cure rate.

“A lot depends on the type of tumour. The average size of a breast cancer tumour in London is 1.1cm, but in New Delhi it is 3.9cm. Here we deal with tumours in Stage 2 or 3,” he said.

Screening mammography to check for cancer in a woman who is asymptomatic is recommended every one-two years for women once they reach 40 years, and every year once they turn 50. In India especially in rural areas, regular clinical examination and mammography is not feasible due to shortage of skilled clinicians, lack of X-ray machines and prohibitory costs.

Don’t Ignore That Painless Lump
According to the WHO’s latest World Health Statistics (WHS), less than 5% Indian women, aged 50-69, underwent screening by mammography between 2000 and 2003. WHO says there is significant evidence to show that mammography screening among women in this age group reduces mortality by 15% to 25%. Garg’s study also showed that 71% women had no clue about mammography.

Dr Geeta Pandya of Jaslok Hospital, Mumbai said that often, women feel awkward about approaching doctors for breast examinations. “Another factor is the inherent fear that she may have cancer, and so she avoids going for a check-up.”

Catch it Early
Early detection of breast cancer improves a woman’s chances of total recovery. Experts say the size of the tumour at the time of starting treatment is directly related to the ultimate result

Growing Numbers
WHO predicts that by 2020, India will be at par with the US and Europe in the number of incidence of breast cancer–one in seven women. Today, an estimated one lakh Indian women are diagnosed with breast cancer every year

Stages of Cancer
Stage 0 | Cancer in site, where only few cells have started multiplying
Stage1 | The lump is no larger than 1cm and is inside the basement membrane
Stage2 | The lump is between 1-2cm and has spread to the lymph nodes Alternatively, the lump is larger than 2cm, but has not spread to the lymph nodes
Stage 3 A | The lump is larger than 2cm and has spread to the lymph node
Stage 3 B | It has spread to the skin, chest wall, ribs, muscles and inner lymph nodes
Stage 4 | The lump has spread to several parts of the body like the other breast, bone, lungs, liver or brain

Don’t Ignore That Painless Lump
Symptoms of Breast Cancer?
In its early stages, breast cancer usually has no symptoms
  • A lump in the breast or underarm that persists after your menstrual cycle.
  • Though lumps are usually painless, if you feel pain or tenderness in the breast, consult a doctor. In some instances, you may feel a prickly sensation
  • Swelling in the armpit can be a sign
    Other Changes to look for include
  • Size or shape
  • Skin texture such as puckering or dimpling
  • Appearance of the nipple
  • Discharge of Get a blood-stained liquid

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