First Clues: Yours and Theirs

Since everything we know about breast cancer leads us to know that early detection is
the real secret to successful treatment, what are our first clues? How do we first know
that we may be one of the eight? Is it pain? A lump? An irregular mammogram?
Peas and Marbles: Finding a Lump
Since only rarely does a woman feel any pain with breast cancer, the American Cancer
Society and others have emphasized breast self-exams (BSEs). We’re told to examine
ourselves monthly, preferably in the shower. For some women, the hype about BSE
makes them feel guilty. Guilty because we forget on the first of the month to do the
exam. Guilty because we haven’t joined a buddy system to remind each other to do
the exam. Guilty because we tell the doctor we do it when we really don’t.
Okay, so quit the guilt trip. Do it! Women regularly
discover lumps in their breasts in just this way—
a routine monthly BSE. After all, you know your
body better than anyone else. Why wait for some-
one else to poke and prod just once a year? Truth
be known, however, some women don’t discover
the lump themselves. Their husbands or lovers find
it. Kathy Dockery, administrator of the Deaconess
Breast Center told me, “We hear this more than any
other story, that their husbands found the lump,
and that they may not have noticed it otherwise.”
Then what if you—or someone—finds something?
If you find a palpable lump, no matter its size—pea
or marble—there’s no need for panic. The good
news is that roughly 80 percent of all lumps are be-
nign. That is, they are not malignant. They have no
cancer cells in them.
The bad news is that you must—absolutely must—call your doctor immediately. The
doc will check you over to see if you have a problem. Maybe you will hear “I think
it’s just a cyst.” To validate what he thinks, he will likely aspirate it. Cysts are mostly
fluid-filled, and aspiration is a simple, generally pain-free procedure in which the doc-
tor deadens the tissue with an anesthetic, inserts a needle into the lump, and tries to
draw out fluid. If he can withdraw fluid, you have a cyst, and cysts are most often,
but not always, benign. In cases where the results of the aspiration are inconclusive,
your doctor will have a pathologist take a look at the fluid and/or cells withdrawn.