Not Every Breast Symptom Means Cancer

Note by Dr Suraj Manjunath: This is a guest post by Dr Sapna Mallikarjun. It is about women who worry excessively that they have breast cancer when they actually don’t. Dr Sapna recently completed her medical training and had a short posting in our Department of Surgical Oncology. Apart from being an enthusiastic and committed doctor, Dr Sapna is also a budding author.

Breast cancer is the most common cancer in Indian women, having overtaken cervical cancer as per recent statistics of newly registered cases and reported deaths.

Today’s women have access to different sources of information. Hence, it is understandable that for many of them, breast cancer is a deadly nightmare.

With high awareness, expertise, and advanced technologies, it is now possible to detect breast cancer at a very early stage, and treat it with high rates of cure.

But this article is not really about that.  This article is about how it is also important to understand, accept and reassure yourself when you are paranoid about breast cancer, but don’t actually have it.

During my surgical oncology posting, we saw a 28-year-old woman, who walked in with her husband with complaint of breast pain. After detailed history taking, clinical examination and an ultrasound scan, we reassured her that she did not have cancer, and she had no increased risk of getting breast cancer compared to the rest of the population. We spent time to probe why she was worried about cancer, and  made her understand about the frequency of breast cancers, the statistics, the symptoms, risk factors associated with it and who are most prone to get the cancer.

That’s not all about it. She came the next day with her mother and asked why a mammogram or MRI was not advised.  This time her mother revealed that ever since someone they knew got breast cancer, her daughter was constantly worried about getting it herself.  We again made her and her mother understand who needs these tests, and why they are not required for her.

When your doctor evaluates you to see if you have breast cancer or not, there are many factors that go into the evaluation:

  1. Age.
  2. Symptoms, duration of symptoms, and persistence of symptoms.
  3. Family history.
  4. Menstrual history.
  5. Obstetric history.
  6. History of medications, especially hormone treatments.
  7. Physical examination of breasts and armpits by an experienced doctor.

Most of the time, these are sufficient to rule out the presence of breast cancer.  Sometimes, a simple test like mammogram (for older women) or ultrasound (for younger women) may be required.  Even more rarely, an MRI scan, or a biopsy (if a lump is present) has to be done.

When your doctor tells you you do not have cancer, and explains the reasons why, it is important to understand and accept it.  Spend as much time with your doctor as required to be convinced.  Sometimes you may even need a second opinion to be reassured.  But sometimes, no amount of explanations can help satisfy your questions. My take home message for you is, what’s more important is, it’s not us reassuring you but it’s more about us helping you reassure yourself.

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