Understanding breast lumps

Breast lumps are common, and many women may develop one during their lifetime. These lumps can vary in size, shape, and cause, with the most concerning being breast cancer. In Jamaica, the tendency to “watch it” often leads women – and, in rare cases, men – to attribute concerning symptoms to more benign (non-cancerous) conditions. Fear of diagnosis and potential treatment often drives this behaviour, but delaying evaluation can result in later-stage diagnosis and lower chances of cure. Here are some common misconceptions about breast lumps and breast cancer:

1) Pain means cancer, no pain means no cancer

Many Jamaicans believe that if something doesn’t cause pain, it isn’t a cause for concern. Unfortunately, this is far from true. While pain can be an important clinical symptom in diagnosing and treating many conditions, the overwhelming majority of breast cancers are painless. In fact, pain indicating cancer is the exception rather than the rule.

2) Young women don’t get breast cancer

Although most breast cancers occur in older women, research has shown that Black women have a higher incidence of developing the disease at a younger age, and these cancers also tend to be more aggressive. Local data indicate that more than one-third (36 per cent) of new breast cancer diagnoses in Jamaica occur in women under 50, and nearly one-fifth in women under 40.

3) No one in my family ever had it, so I can’t have it

It is true that a family history of breast or certain other cancers can increase a woman’s risk. However, most women do not have such a family history. In fact, about 90 per cent of all breast cancers occur in women with no familial link. Overall, approximately one in 15 Jamaican women will develop breast cancer in their lifetime.

4) Cancer is a death sentence

The fear of a cancer diagnosis predominantly stems from its association with death. The likelihood of survival from any cancer largely depends on how far it has spread from its initial site (i.e., the stage). In the case of breast cancer, this spread typically follows a predictable pattern: Breast, then the armpit (lymph nodes and axillary tissue), and finally other organs.

The further the cancer spreads, the higher the stage and the lower the chance of survival. For early-stage breast cancer, modern treatment and surgery allow more than 95 per cent of patients to survive at least five years and be considered cured. If left unchecked, however, the likelihood of a cure drops sharply. The key message is: the longer you wait, the less likely we can help.

5) Breast cancer means removal of the breast

Many women also fear seeking treatment for breast cancer because they do not want to lose their breasts, which are an important part of their femininity, body image, and sex life.

Although removal of the breast (mastectomy) is a surgical option for some women, it is not always the only choice. Women with smaller lumps may opt for removal of the lump alone, though this usually needs to be paired with radiation therapy to destroy any remaining cancer cells. For those who do undergo mastectomy, there are several options for breast reconstruction. Reconstructive surgery can be performed at the same time as the cancer operation or at a later date, depending on individual circumstances.

6) There is nowhere to get help

I want to stress that not all breast lumps indicate breast cancer, and the majority are benign. However, I strongly urge every woman with a concerning lump to seek medical attention without delay. Most lumps can be evaluated through a simple physical examination combined with breast imaging, typically a mammogram and/or ultrasound. Your doctor may then recommend observation, a biopsy (tissue sampling with a small needle), or referral to a surgeon. Delaying diagnosis only puts you and your family at risk.

If you are diagnosed with breast cancer or have a highly suspicious lump, your surgeon will recommend a treatment plan tailored to you. While it is fine to seek advice from others, remember that plans differ between patients. Some may receive chemotherapy before surgery, others surgery alone, and some only hormone-based treatments.

Help is readily available. Breast surgical consultations are offered at all major hospitals across the island, privately, and through the Jamaica Cancer Society.

Dr Matthew-Anthony Lyew is a consultant general surgeon at Kingston Public Hospital and Island Medical Specialists. Send your questions for consideration via DM on Instagram @drmatthewlyew or email surgicalconsult@gleanerjm.com.