New Mom Guide: Breast lumps and its solution during pregnancy: ‘’Breast Cancer awareness Month special’’ (By Dr. Akanksha Chikhlikar Aich, Specialist Breast Surgeon)

‘’October month is observed as breast cancer awareness month. During this month, through different activities worldwide, organizations create awareness about this type of cancer, which affects a large population of women. It tries to make people aware of the need for early detection of breast cancer, its treatment options and prevention methods that can help save lives.

According to WHO, there are about 1.38 million new cases and 458 000 deaths from breast cancer each year (IARC Globocan, 2008). Breast cancer is by far the most common cancer in women worldwide.’’

It’s another regular day of your antenatal period, you get up looking forward to your daily chores, everything planned beforehand and then you notice a lump in your breast while bathing …anxiety and fear strikes like a jolt of electric shock. Now what?

Relax, all lumps are not cancer.

Here are some tips and guidance to help you with early detection.

We know we need to check our breast regularly and be on the lookout for unusual bumps you can't remember being there before. If you do find one, don't panic - some women breasts are naturally lumpy, without it being a sign of cancer. But if it's a new lump, feels different from other lumps, or you just want some reassurance, its advisable to visit your doctor.

Breast lumps sometimes develop during pregnancy. The most common ones are:

Cysts (fluid-filled sacs)

Galactoceles (milk-filled cysts)

Fibroadenomas (which develop in the lobules of the breast)

These are benign breast conditions (not cancer).

A fibroadenoma prior to pregnancy may present as a bigger lump during pregnancy.

In early second trimester our breasts starts preparing to nurse our baby, and sometimes a milk duct can get blocked and enlarged during the process. How can you know for sure? Clogged milk ducts are usually hard, red lumps that are tender to the touch and tend to clear up after a few days (they may continue to clog up, same way when you’re lactating).These irritating bumps are a sign that your body is preparing to nourish your baby and if you do choose to breastfeed, it will reduce the chances of breast cancer later in life.

Blocked Duct

To feel better, apply warm compress to the lump regularly (or run hot water on the area during showers) and massage the duct, which should help unclog the milk build up and eliminate the lump. Some experts suggest to use good supportive bras rather than underwire ones. If the lump doesn’t clear up or gets worse, check with your doctor to ensure it’s not infected.

Choose a day each month that will be easy to remember and make breast self -awareness a regular part of your good health routine.

1. Stand before a mirror and look at both breasts. Check for anything unusual, such as nipple retraction, redness, puckering, dimpling or scaling of the skin. Look for nipple discharge. All discharge should be reported to your doctor.

Note the color, whether it came from one or more openings.

2. Next, press your hands firmly on your hips and lean slightly toward your mirror as you pull your shoulders and elbows forward with a squeezing or hugging motion. Look for any change in the normal shape of your breasts.

3. Looking in the mirror, raise your arms and rest your hands behind your head. This allows you to see the underside of your breasts.

4. Place your left hand on your waist, roll your shoulder forward and reach into your underarm area and check for enlarged lymph nodes (small glands that fill with fluid when you have an infection). An enlarged node would feel like a corn kernel or a bean. Also check the area above and below the collar bone. Repeat on the right side.

5. Raise your left arm. Use the pads of three or four fingers of your right hand to examine your left breast. Use three levels of pressure (light, medium and firm) while moving in a circular motion. Check your breast area using a set pattern. You can choose (1)lines, (2) circles or (3) wedges.

i. Lines

Beginning at the outer edge of your breast, move your fingers downward using a circular motion until they are below the breast. Then move your fingers slightly toward the middle and slowly move back up.

ii. Circles

Beginning at the outer edge of your breast, use the flat part of your fingers, moving in circles slowly around the breast. Gradually make smaller and smaller circles toward the nipple. Be sure to check behind the nipple.

iii. Wedges

Starting at the outer edge of the breast, move your fingers towards the nipple and back to the edge.

6. Lie flat on your back with your left arm over your head and a pillow or folded towel under your left shoulder. This position flattens the breast and makes it easier to examine. Use the same motion described in Step 5. Some women like to use body lotion in this step.

Occasionally, breast cancer is diagnosed in pregnancy, and early detection is the key to better outcome. Consultation with a breast specialist, a thorough physical exam, and an ultrasound helps in diagnosis. Nothing to worry about.

Most often we find cysts, without any increased risk of breast cancer. But in about 30 percent of women, excess proliferation is seen which can be cancerous or can be associated with an increased risk of breast cancer in future. We need to be vigilant and consistent with regular follow-ups and appropriate investigations.

A Lump in the Armpit While Pregnant

Swollen Lymph Nodes

Ø Coming across a pea-sized lump in the armpit during pregnancy will leave you all worried and tensed. But there is no reason to stress yourself. Among many other changes that your body goes through during pregnancy, this is one of them.

Ø It is important to note that the lump is also a part of the breast. Yes, it may be strange to hear this since we believe that the breast is usually the portion that is present in the chest region. In reality, the actual section can extend to the armpit as well, reaching the point of division quite easily. The lines that occur when this happens, resembling a valley of sorts, are termed as milk ridges. Breasts undergo expansion during pregnancy and even when lactation sets in after the child has been delivered. This can cause the breast tissue to expand in the area of the armpit as well.

MORE ON BREAST CANCER AWARENESS

Risk Factors: who needs to be more careful

Family History: Women whose mother or sister had breast cancer carry a higher risk of developing this disease.
Breast lumps- Women who have had some type of non-cancerous breast lumps are more likely to develop cancer later on.
Dense breast tissue - Women with dense breast tissue have a higher chance of developing breast cancer.
Age: As women get older, they are at higher risk of breast cancer.
Diet and lifestyle choices: Women who smoke, eat high fat diet, drink alcohol is more at risk of developing breast cancer.
Radiation Exposure: Frequent exposure to X-Rays and CT scans may raise a women's chance of developing breast cancer.
Obesity: Overweight women are at a higher risk of developing breast cancer.
Oestrogen exposure – Women who started having periods earlier or entered menopause later than usual are at a higher risk of developing breast cancer. This is because their bodies have been exposed to oestrogen for longer duration.

Tips for Breast Cancer Prevention

It is important to self-examine your breasts. Women should be aware as to how their breast normally look and feel. If you feel any change, then consult the doctor.

· It is advisable for women who are around 40 and above to get their mammography done. Mammography is a simple radiographic technique which helps in detecting irregularities in the breast tissue.

· Addition of vegetables and fruits in your diet helps in maintaining a healthy body weight.

· For new mothers, it is advisable to breastfeed their child for minimum of one year.

· Don’t smoke or drink alcohol in excess.

NEED OF THE HOUR - awareness about breast examination, beginning from 20 years of age, and regular screening from a qualified doctor, so that it can be detected early and treated successfully.

"Early detection is the key to prevention."