Always Check That Lump

When you have noticed a lump in your breast (or in any other part of your body, really), you need to book an appointment with your General Practitioner, so they can refer you to the hospital as quick as they can.

Forget about your fears. There will of course be fear, an intense preoccupation that´ll last for weeks for sure, but you don´t want to take the risk of having a quiet Cancer killing you slowly, or do you?

Once you get your appointment arranged at hospital, go with someone. Even if you are one of those who prefer to do everything on their own. I am one of those, but at the end of the day, you want a friendly and loving hand who holds your sweaty one, while you are doing all the thinking and waiting among ultrasound, mammogram and biopsy (if they have to do all the necessary tests). It will calm down your nerves a bit to have someone with you. I promise.

Don´t be stressed on this day. It won´t help much. I know it is easier to say than to do. If it is 100% clear that you don´t have Cancer (if it is just a cyst), you will know it quite soon, and you will get to go home immediately.

The doctor will always start by feeling the lump with their hands and, then, an ultrasound will be done. If your lump is just a cyst this will be seen in the ultrasound straight away, as these are fluid-filled masses (instead of solid, as tumours are), and the sound waves of the machine will pass through the cyst. So there will not be any doubt for the ultrasound technician, if we are talking about a cyst.

If the ultrasound performer (not necessarily a doctor) see that it isn´t a cyst, a mammography exam will be carried out. A mammogram is a specialized medical imaging that uses a low-dose x-ray system to see inside both breasts. And, yep, everything you heard about it is true: it hurts as hell, so try to think of something nice while having one done. I know, I know, that is just not possible. Then think of how much you would like to slap the technician´s face. A bit aggressive but, hey, anything might help you!

This test won´t tell you if you have Cancer; it will just tell you if there is something suspicious: the machine sees abnormal lesions, lumps, calcifications and dense tissue. However, sometimes it is impossible to say if a tumour is benign or malignant with just a mammogram, especially if you are young or youngish, as the breasts are usually dense, which makes the whole tissue unclear.

There could also be calcifications in the tissue of the breast: small dots of calcium. They are usually not felt with the hands, but they can be seen in the mammogram. If they are big they are usually not associated with Cancer, but if there is a group of little ones together they can be associated with extra breast cell activity, and this needs to be checked in future revisions, as it could develop into Breast Cancer.

So, if at this stage the doctors are still unsure of the nature of your lump, they will always perform a biopsy on you. This is probably the scariest stage of them all, because you know you are going to go home not knowing if you have Cancer or not. Plus the biopsy itself is not really pleasant; I am afraid that it also hurts.

There are several types of biopsy. One involves a fine needle, but this is normally used with lumps that are suspected to be cysts. If the lump is more of a solid mass, and to avoid doing this procedure twice (because a fine needle doesn´t give much information of the tissue collected), you will be practised a core needle biopsy. A radiologist or surgeon will then use a thicker needle to remove tissue samples from the breast mass, using the ultrasound for guidance, to reach well the tumour.

It is a bit painful, but bearable and necessary. Grab someone´s hand (if you are alone, a nurse will probably be there for you), and then shout if you need it. It helps if you are the shouty type like me.

The sample or samples taken will need a few days to be analysed, so if you have Cancer, you will never know on the same day, so, again, there is no point to panic. Of course you will be worried, but you will see that, as days pass and after doing lots of thinking, your nerves get better (OK, just slightly).

Even for private patients the process might take a week in order for you to know the results. For me it took a very long time: sixteen days, and that made me incorrectly think (how innocent I am) that my tumour wasn´t malignant. But that is just the NHS in England. They just have so many people… Pathetic, but true: you are just another number to add to their Cancer list. At the beginning of the process they make you feel like another customer that isn´t paying (when you have indeed, for many years). So they make you wait.

If you complain about it, to make you feel comfy and relaxed they say that tumours do not grow that fast; they kind of change every 28 days, one oncologist told me. But mine was Grade 3, and that is the maximum speed they can grow at. But, again, they considered that I could wait. Not a great system I must say.

So basically it might take you a whole month to know that you have Cancer: from the moment you feel the lump, get your appointment at the GP, are referred to the hospital and to the moment when you finally get your results.

The waiting is the worst; so if you have the chance to go private, go. I had the chance and didn´t go, but I regret it now a bit.

But let´s hope you don´t have Cancer and this is just a scare. It could just be a Fibroadenoma, a solid benign tumour quite frequent in premenopausal women, that aren´t painful and that move easily when the doctor feels it.

Mine was very movable but it ended up being Cancer unfortunately. After this first visit, before having any results, the doctor will rate your lump with numbers, based on the looks of the tumour, where:

1 is definitely not a malignant tumour

2 is probably not, but you never know

3 they don´t know (although my doctor insisted that it didn´t look at all like a malignant tumour)

4 is probable that it is Cancer

5 it is definitely Cancer.

I was given a 3.

But, hey you, if you do have Cancer, like I do, this is not the end of the world. You are gonna fight. And, if you fight, you will always win.

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