Breast Lumps

Yes indeed, an odd topic for a blog post, I suppose, and if it makes you uncomfortable, it won’t offend me if you don’t read it. :) But I have talked to so many sweet women lately who are terrified and feel so alone, and I am starting to realize that it’s because this is something that we just don’t talk about enough. So I’m going to talk about it! If it makes one woman feel less alone and more informed, then I’ll be happy! :)

I have a lot of experience in this area, and would just like to put down some of my thoughts and knowledge that I have gleaned…definitely not to be taken as medical expertise or advice.

  • Why don’t we talk about it? I think it’s because so many of us are too embarrassed. Hey, a few years ago, I was, too. I would sit through women’s health night at church and squirm and wiggle till it was over. I would avidly avoid any mention of my breasts at the doctor. Not that I had a problem with their intended purpose…I was all for breastfeeding, but talking about it was just really uncomfortable. I notice that most women won’t even use the word “breast,” but would rather use another term, something a little less embarrassing to say. So that said, it’s a part of you. It’s something that is so very important to be mindful of, too!

Well all the breast awkwardness changed for me when I was 24. I found a small lump which I was scared of, but just knew it couldn’t actually be a lump, and dismissed it as a milk duct (I was nursing at the time). I didn’t even do a breast self-exam for the next two months. One day I did and found that the lump was about an inch in diameter.

  • Why don’t we do our breast self exams regularly? It’s definitely not pleasant. That’s one reason we put it off. Also, many of us, like me, think we are too young for it to happen to us. We also just have that mentality that it’s something that happens to other women. That’s pretty normal. But it is SO important to do that BSE at least monthly. I can tell you that now from experience. Monthly sounds like such a frequent thing to some ladies…it isn’t. I have had many lumps appear in the course of a month, and I’ve sometimes had them double in size in 2-3 weeks. Don’t put it off! Changes actually do happen from month to month. If you are checking every month, you’ll be more sure of what to expect. Women who check often can find them when they are small. If you put it off, even for a couple of months, the growth can be very rapid and you may not even know, just like me. I check every 1-2 weeks now.

So I had a lump. It was pretty good sized, and I was pretty scared. I was pregnant with my 3rd baby. I was frantic for information. I of course turned to the internet, and the conflicting information overload was horrible.

  • Stick to reputable sites like WebMD and the Mayo Clinic. They’ll usually give pretty factual, well-researched information. However, no site can diagnose cancer or any other type of tumor. In my opinion, stay away from sites with astronomical claims. And above all, do what you really don’t want to do…CALL YOUR DOCTOR IMMEDIATELY.

That call to the doctor was really hard for me. I had to say the word “breast” over the phone to someone I didn’t even know. As silly as it sounds to some women, that was really hard for me, and I know it’s really hard for a lot of women. Have your husband hold your hand like mine did. But CALL as soon as you find it!

Then came the doctor visit. It was difficult for me, because my doctor was extremely concerned. He had done an exam on me just 2 1/2 months earlier and hadn’t felt anything, and now I had a large lump. The doctor can’t tell for sure just by examining you what the lump is. There are lots of possibilities, the most common of which are:

  • Cysts (Fluid-filled sacs in the breast. They usually feel smooth and rubbery and move around under the fingers. They can be painful at times. They are generally harmless and can be easily aspirated by your doctor in his office.)
  • General Breast Lumpiness (Okay, that name had to be created by a man–so logical and descriptive, not at all an attractive name, lol :) GBL feels like a lot of tiny little bumps, or like some parts of the breasts are thicker or denser than others. It is especially noticeable before your period. It used to be called fibrocystic breast disease and was considered abnormal. They have now decided it is quite common and nothing to be concerned about. The good news is it usually disappears after menopause.)
  • Benign Tumors (most common of which are called fibroadenomas. These are abnormal growths in the breast, usually in the glandular tissue. They can happen anywhere in the breast tissue, even under the arms, and usually feel round and firm. You may be able to move them a bit. Though they are tumors, they are not related to breast cancer.)
  • Breast Cancer (Breast cancer usually feels rigid and hard. It usually feels fixed in place and usually has irregular edges. It rarely hurts.)

So what happens next? The doctor cannot make a determination in his office. My doctor sent me to get an ultrasound of the lump. All of the doctors that I have seen have wanted ultrasounds. I have always been blessed to have very compassionate and capable people performing the ultrasounds. I have never gone to the hospital closest to me for them…I have been willing to drive further away. This is an important thing to me. You need to go where you feel cared for and that people are competent and have compassion. Don’t settle, especially when it comes to such an important part of your health.

The ultrasound can tell you basically if it is a tumor or a cyst. (Some radiologists will also make a guess as to whether they think it’s cancer or not. In my opinion, they really shouldn’t do this. They usually really can’t tell.) If it’s a cyst, you can get it aspirated and that’s that. If not, you have more options ahead of you. In my case, it was not a cyst. It was definitely a tumor, so my OB sent me to a surgeon.

I love my surgeon. He has been compassionate and kind, and sensitive to how difficult this has been for me. He has also let me make the decisions. That is so important.

  • If you don’t feel your doctor is providing the care you want, fire him. Get a different one! It’s not worth messing around. I had a dear friend die from breast cancer. Her surgeon refused to remove her tumor, even though she begged him to. He didn’t think it was actually cancerous, and it metastasized and spread through her entire body. It isn’t worth sticking with him if he’s not listening to you.

My surgeon offered to do a needle-core biopsy and see what things looked like. We asked if he could just remove it. I couldn’t stand it growing inside me, even if it was benign. I felt like I was under a horrible black cloud. He quickly understood and agreed. Since I opted for that, there was no reason to expose me to the possibility of infection twice, especially since I was pregnant, so I did not get the needle-core biopsy. I had to wait for a few weeks for the baby to be further along before we could do the procedure and find out for sure what the tumor was.

It was an excruciating time. It was Christmas. I was terrified. I had two babies and another one on the way. I remember sitting and rocking every night in the girls’ room in the dark, waiting for Matt to get home and praying with all my heart that Heavenly Father would let me stay.

It was a very dark time in some ways. It was also one of the best times of my life, because everything became so incredibly clear…. I could see so easily what mattered in life and what didn’t. Dumb things didn’t bother me at all any more. All that mattered was my family and the love we shared. More than any time in my life, I became fervently grateful for my knowledge of eternal families. I knew it was true and I was so comforted by it, but I still couldn’t imagine anything more horrible than being away from them. I prayed with all my heart! Every second with my husband and daughters was precious.

Finally, it came time for my lumpectomy. Though it had only been a few weeks, the lump had doubled in size. It was now two inches in diameter. I was pretty scared, and very anxious to have it over with. When they do a lumpectomy, they remove the entire tumor and some surrounding breast tissue, to ensure that they have everything. Often, they can do some immediate tests that will give some preliminary results that are usually pretty accurate. They send the lump to a lab and get a full diagnosis on it. The procedure usually takes about an hour. If you are pregnant or breastfeeding, the area will be even more vascular than normal, and bleeding can be an issue and something to be very careful about. Some women don’t experience too much pain, and some experience quite a bit of pain. I, unfortunately, experienced a great deal with my first lump, but it was largely due to the size and the amount of tissue that they removed.

After the surgery, I was very sore but thrilled to find out that the tumor was a fibroadenoma. The world was much brighter!! :) I am thankful every day, even years later.

So what happened next? To be honest, I was pretty dumb again. After it was removed, in my overwhelming relief, I thought a major trial of my life was over. I didn’t do any self-exams for a few months, to be honest. Partly because I was so sore for a long time, but also partly because I thought it was over. I went to the doctor after I had my baby and he told me that he had a little feeling to do a breast exam. Well, since the entire city had seen me by now, it wasn’t such a big deal to me this time, until he said he found another good-sized lump.

  • Do your self-exams.

A couple of months later I had my next lumpectomy. Since I was breastfeeding, it was a challenging and painful experience, but it was over. This time I kept doing my exams. (At least I was learning, right?) Well, not long after that site scarred over, maybe a month or so later, there was another lump growing fast right where they had just taken one out. So I had to get another lumpectomy right on top of the old one.

Since this newest lump was growing pretty close to the surface, the surgeon offered to do the procedure in his office to save us some money. I agreed…I was pretty used to the procedure by now.

  • In-office lumpectomy. Not something I would recommend. There is nothing quite like it…I will definitely spare you most of the details. I had no sedative whatsoever. Maybe some offices offer it, but mine didn’t. So I was very alert for the entire thing, and I have a surgeon who loves to show you everything he is doing. Also, as I was breastfeeding, the area was extremely vascular and there was a tremendous amount of blood. I would recommend highly doing that procedure in an operating room. The cost is much higher, but the experience is not so gruesome. If they do offer a sedative of some kind so you don’t see the whole thing, it might not be such an issue. :)

So, this story goes on and on. I have had three lumpectomies so far. I have about 15-20 more breast lumps awaiting removal. (And yes, every time I find one I get a bit scared.) You don’t have to get benign tumors removed if you don’t want to. But I personally hate having them in there. I don’t like something growing inside me that isn’t supposed to be there. Plus, mine all tend to grow pretty quickly.

For a long time I wouldn’t talk to almost anyone about this. I was self-conscious about it and it was just so personal to me and not many people seemed to understand. (I am so grateful, by the way, for kind family during that time.) But one day after a couple of years of going through this, I talked with a couple of other women who were absolutely terrified and going through it for the first time and I realized that maybe we wouldn’t all be so terrified if we all talked to each other a little more, and were all a little better prepared. A woman I knew who died shortly after was extremely kind to me and talked to me when I needed to know some information and just didn’t feel like I had any. I am trying to be better at talking to others about it.

What has been recommended to me? I have been counseled to get a full mastectomy once I am completely done with breastfeeding and such. I just keep getting lumps and it doesn’t seem to have an end in sight at the moment. I am pondering it, and we’ll kind of see what happens. It has its appeal to me these days…I hate the lumps but I am getting pretty tired of lumpectomies. I have some time to decide, though.

  • What options are available for benign tumors? :
    • Lumpectomy
    • “Wait and see” approach: just keep an eye on it and see if it grows
    • Cryoablation (new technology that “freezes” the breast lumps! They freeze, die, and get gradually reabsorbed by the body)
    • “Natural” remedies (there are many natural remedies offered out there. I have personally never felt too comfortable with any of them, because they are hard to regulate and I’ve always been pregnant or breastfeeding during this process and I have felt that it hasn’t been only my body I have been dealing with. Some people do feel comfortable with them, though, and see them as a pleasant alternative to surgery.)
  • There are options available…you have to find what feels best for you and then actively pursue it.

The key is to be proactive. Do your breast exams. Find a doctor you feel comfortable with before something like this happens. But if it is happening to you, make sure you are feeling comfortable about your care. If you aren’t, talk to people and find someone else!! It’s your health and your life!

If you forget to do your exams, make a reminder for yourself. I send out a monthly reminder to all of my friends and family, and if you’re not on my list and want to be, let me know. The key is just to remind yourself somehow!! It is SO important. I have been so fortunate that nothing has been malignant so far, but I am humbled to think of what could have happened if it were, as I was not being as proactive about my breast health as I should have been.

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