Comments on: Is this cancer? http://bernardchan.net/2006/10/20/is-this-cancer/ What's next along this river of life? Wed, 19 Nov 2008 01:49:44 +0000 http://wordpress.org/?v=2.2.1 By: Bernard http://bernardchan.net/2006/10/20/is-this-cancer/#comment-644 Bernard Fri, 27 Oct 2006 15:27:42 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-644 HQ, i would refrain from giving specific advice for specific patients. As a general rule, however, all lumps should be assessed in three ways: <ol> <li>clinically, by history and examination. </li><li>radiologically, i.e. an imaging method, either by mammography or ultrasound. </li><li>pathologically, by needle or excisional biopsy. </li></ol> An assessment based on all three aspects together would be 99% accurate. Noteworthy points, however, are that: <ol> <li>The presence or absence of pain does not help to differentiate between cancer and benign lump.</li> <li>Small lumps may be just part of a "lumpy" breast. A biopsy would be the way to go if there really is a discrete lump instead of a "lumpy" breast. Otherwise, a "watch and see" policy may be adopted. Either way, steps 1 and 2 should be taken as well.</li> </ol> I hope this helps. HQ, i would refrain from giving specific advice for specific patients. As a general rule, however, all lumps should be assessed in three ways:

  1. clinically, by history and examination.
  2. radiologically, i.e. an imaging method, either by mammography or ultrasound.
  3. pathologically, by needle or excisional biopsy.

An assessment based on all three aspects together would be 99% accurate.

Noteworthy points, however, are that:

  1. The presence or absence of pain does not help to differentiate between cancer and benign lump.
  2. Small lumps may be just part of a “lumpy” breast. A biopsy would be the way to go if there really is a discrete lump instead of a “lumpy” breast. Otherwise, a “watch and see” policy may be adopted. Either way, steps 1 and 2 should be taken as well.

I hope this helps.

]]> By: Hijackqueen http://bernardchan.net/2006/10/20/is-this-cancer/#comment-620 Hijackqueen Fri, 27 Oct 2006 01:11:46 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-620 My sister had something like a lump in her breast too. Can't remember the scientific name. She said it is like the size of kidney bean. Doc just ask her to hold on. Lately she felt some pain and doc said it's the muscle that is pressing against the lump. The lump is there for about a year plus now. Do you think we should wait longer for the worst to come? Oh, doc said it's not cancerous. My sister had something like a lump in her breast too. Can’t remember the scientific name. She said it is like the size of kidney bean. Doc just ask her to hold on. Lately she felt some pain and doc said it’s the muscle that is pressing against the lump. The lump is there for about a year plus now. Do you think we should wait longer for the worst to come? Oh, doc said it’s not cancerous.

]]> By: Bernard http://bernardchan.net/2006/10/20/is-this-cancer/#comment-614 Bernard Thu, 26 Oct 2006 15:58:13 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-614 The results of the pathology is back... it's giant fibroadenoma. That's benign. Good for her. The results of the pathology is back… it’s giant fibroadenoma. That’s benign. Good for her.

]]> By: Bernard http://bernardchan.net/2006/10/20/is-this-cancer/#comment-573 Bernard Tue, 24 Oct 2006 10:17:45 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-573 I don't think she can remember the original shape before the lump appeared. But.. it's fairly balanced when compared the other side. I don’t think she can remember the original shape before the lump appeared. But.. it’s fairly balanced when compared the other side.

]]> By: hoiling http://bernardchan.net/2006/10/20/is-this-cancer/#comment-565 hoiling Tue, 24 Oct 2006 04:52:12 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-565 Err .. the breast size back to original shape after the procedure?? Err .. the breast size back to original shape after the procedure??

]]> By: Bernard http://bernardchan.net/2006/10/20/is-this-cancer/#comment-552 Bernard Mon, 23 Oct 2006 00:44:25 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-552 Sifu George, thank you for your wise answers to my humble question. I agree with the possibilities. Re: I perform FNAC (Fine Needle Aspiration Cytology, for the uninitiated) or core needle biopsy in 2 situations: <ol> <li>It would be useful if the lesion was <em>suspicious</em> of malignancy/cancer to avoid an excisional biopsy just as I had performed in this patient before a proper cancer-clearing operation.</li> <li>If the patient wanted to <em>keep</em> the tumour (as some patients might be undecided about removing it) then FNAC would be useful to rule out a cancer and the patient may be allowed to keep it under watchful eyes.</li> </ol> This young lady's tumour was clinically benign and she was not thinking of keeping it anymore because of the ache caused by the weight. So, excision of the tumour was performed as the first procedure. This <em>avoids</em> an FNAC, the discomfort and the cost, which <em>has</em> to be calculated in private practice. Good reason, sifu? Any comments about that ah? Sifu George, thank you for your wise answers to my humble question. I agree with the possibilities.

Re: I perform FNAC (Fine Needle Aspiration Cytology, for the uninitiated) or core needle biopsy in 2 situations:

  1. It would be useful if the lesion was suspicious of malignancy/cancer to avoid an excisional biopsy just as I had performed in this patient before a proper cancer-clearing operation.
  2. If the patient wanted to keep the tumour (as some patients might be undecided about removing it) then FNAC would be useful to rule out a cancer and the patient may be allowed to keep it under watchful eyes.

This young lady’s tumour was clinically benign and she was not thinking of keeping it anymore because of the ache caused by the weight. So, excision of the tumour was performed as the first procedure. This avoids an FNAC, the discomfort and the cost, which has to be calculated in private practice.

Good reason, sifu? Any comments about that ah?

]]> By: George http://bernardchan.net/2006/10/20/is-this-cancer/#comment-550 George Sun, 22 Oct 2006 16:21:43 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-550 Well here is what sifu uncle George thinks (like it is important) - 2 possibilities: 1. Fibroadenoma 2. Phylloides tumour - how come no FNAC? Sorry to ask Well here is what sifu uncle George thinks (like it is important)

- 2 possibilities:
1. Fibroadenoma
2. Phylloides tumour

- how come no FNAC? Sorry to ask

]]> By: Bernard http://bernardchan.net/2006/10/20/is-this-cancer/#comment-547 Bernard Sun, 22 Oct 2006 15:59:48 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-547 guys and girls, a few things argue for benign disease... ... she's young, but young women with breast cancer is not unknown. ... it's been there a long time, but some less aggressive cancers can be there for quite some time too. ... it's looks well demarcated and encapsulated. That's because I cut it without taking a margin of normal breast. Because I think the probability of cancer is low too. I'm waiting for the pathological examination report, but I'm quite sure it's a benign giant fibroadenoma. A gentle giant of sorts. :-) guys and girls, a few things argue for benign disease…

… she’s young, but young women with breast cancer is not unknown.

… it’s been there a long time, but some less aggressive cancers can be there for quite some time too.

… it’s looks well demarcated and encapsulated. That’s because I cut it without taking a margin of normal breast. Because I think the probability of cancer is low too.

I’m waiting for the pathological examination report, but I’m quite sure it’s a benign giant fibroadenoma.

A gentle giant of sorts. :-)

]]> By: yenjai http://bernardchan.net/2006/10/20/is-this-cancer/#comment-543 yenjai Sun, 22 Oct 2006 02:25:34 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-543 I tend to agree with CSH. Nice demarcation. No break in the capsule. I tend to agree with CSH.
Nice demarcation. No break in the capsule.

]]> By: hoiling http://bernardchan.net/2006/10/20/is-this-cancer/#comment-536 hoiling Sat, 21 Oct 2006 04:44:28 +0000 http://bernardchan.net/2006/10/20/is-this-cancer/#comment-536 Oh my! .. Those "thingss" taken from 1 side of the breast? I wonder she having lopsided size for 2 years? Feel sorry for her. So young. The tumor (am I correct to refer it as tumor?) grown to this size for 2 years and she still alive, my take would be benign. If its cancerous, I think she might be in critical condition, yes? Oh my! .. Those “thingss” taken from 1 side of the breast? I wonder she having lopsided size for 2 years? Feel sorry for her. So young.

The tumor (am I correct to refer it as tumor?) grown to this size for 2 years and she still alive, my take would be benign. If its cancerous, I think she might be in critical condition, yes?

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