Recently, 2016 January, I had the opportunity to do a breast mass excision on a 49-year-old female suspected of having a recurrent 1-cm fibroadenoma. She had a history of a fibroadenoma excision 20 years ago. She palpated the current breast mass about 3 months prior to the operation. Initial mammogram and ultrasound of the breast showed no signals for malignancy. A needle biopsy showed findings to be consistent with a fibroepithelial lesion (to consider fibroadenoma). On operation, the mass turned out to be a 0.5 cm infiltrating ductal carcinoma.
This incident led me to rethink and reinforce my belief on the value of breast self-examination and breast specialist clinical examination in contributing to the discovery of an early breast cancer. It also led me to review of the stand of the American Cancer Society advocating the use the mammography over the breast self-exam to the point of not recommending the latter.
Here are the statements from the American Cancer Society.
Clinical breast exam and breast self-exam
“Research does not show a clear benefit of physical breast exams done by either a health professional or by yourself for breast cancer screening. Due to this lack of evidence, regular clinical breast exam and breast self-exam are not recommended. Still, all women should be familiar with how their breasts normally look and feel and report any changes to a health care provider right away.”
The mass in the case in point was palpated by the patient. She consulted me. She had mammography and ultrasound of her breasts done with negative signals for malignancy. I did a needle biopsy which showed benign fibroepithelial lesion. My primary diagnosis was fibroadenoma and secondary diagnosis, breast cancer. We decided to do breast mass excision because of the age-related risk for breast cancer. Lo and behold, the mass turned out to be breast cancer, 0.5 cm in size (early stage).
This incident reinforces my belief on the value of breast self-examination and breast specialist clinical examination in contributing to the discovery of an early breast cancer. I will continue to advocate the use of monthly breast self-examination and regular breast specialist clinical examination as a primary screening package for breast cancer.