issue: breast
NOVEMBER, 2018 | THE HEALTH
09
EVERYDAY HEALTH
3 step
breast
examination
Why does the nipple dart have
discharge?
UM Specialist Centre Consultant
Oncoplastic Breast Surgeon Dr See
Mee Hoong revealed that this is
caused by lesions, disease or papil-
loma in the lobules connected to the
nipple dart of the breast lobules that
secretes blood and so on.
“So, the benign type, if the tissue
get injured when you squeeze, they
might have a clear fluid mixed with
blood. Always squeezing can also
cause trauma. But those that are
really spontaneous, already have
blood. This type, you have to be alert
and careful as it might be an early sign
of cancer.”
3 steps examination
Breast cancer usually present with a lump although there might be other symptoms that one can look out for.
Early
T
indicators
of breast
cancer
HE most common presentation
for breast cancer is a lump.
Nevertheless, they can present
with other symptoms.
Ramsay Subang Jaya Medical
Centre (SJMC) Consultant Clinical
Oncologist, Dr Yap Beng Khiong
emphasised that sometimes, the
cancer can be quite small and cannot
be felt.
“Usually in those circumstances,
you only detect the cancer when it is
“If the cancer spread to the brain, they can
present with symptoms like stroke and
headaches. It depends on which part of the
body the cancer is affecting. If a patient does
not present with that lump, say – if the cancer
is affecting the bones – they can present with
pain in that particular part of the bone.”
Early
detection key
to survival
“For breast cancer, the success
of treatment depends on early
detection of the cancer than if you
present very late,” said
Ramsay Subang Jaya Medical
Centre (SJMC) Consultant
Clinical Oncologist, Dr Yap Beng
Khiong.
affecting other organs that is caus-
ing that particular symptom. For
example patient has breast cancer
spread to the lymph nodes in the
armpits and they can present with a
swollen arm.”
“If the cancer spread to the brain,
they can present with symptoms like
stroke and headaches. It depends on
which part of the body the cancer is
affecting. If a patient does not pres-
ent with that lump, say – if the cancer
is affecting the bones – they can pres-
ent with pain in that particular part
of the bone.”
“However, the most common is
still a breast lump, accompanied
with some redness and abnormal
discharge from the nipple which is
a sign that there is cancer.”
“The lumps can be any part of the
breast and not in particular only one
part of the breast – it can be under-
neath the nipple or even very close
to the armpit.”
“If there are persistent symptoms
of lumps more than two to three
months that aren’t going away, the
best is to consult a doctor to have
a clinical examination. In the past
there has been a lot of emphasis
on self-examination, however, they
have to be taught how to do it as not
everyone knows the correct method
of doing so.”
“Once, cancer has spread
beyond the breast and the regional
nodes, it is considered incurable.
So, obviously, we want to treat
patients at a curative stage. So,
that is why early presentation is
important so that the patients can
get treatment early.”
See explained that all patients who
have these problems would generally
undergo a three step examination
which is to ask the questions and
examine, confirm that there is a dis-
charge from one dart or from many
darts, the colour before proceeding
with a mammogram or ultrasound
just to look at the dart and any other
lesions around and over other parts
of the body of the breast.
“If there is, we would do a biopsy
to confirm whether it is a suspicious
lesion.”
“Generally 80 to 90 per cent
of lump presented in the clinic is
benign while the rest is cancerous.
The nature and the characteristics
of the discharge tell us a lot, whether
we should list them as urgent to
investigate or to do a normal check
on them.”
“The ratio of getting this disease
– the worst scenario is cancer. This
kind of cancer (papillary breast
cancer) occurs in the middle and old
age group (40 - 70 years old). For this
age group, we always think of cancer
first when they present with any
symptoms before we can rule out if
it is non-cancerous.”
Ductal
papilloma
Ductal papilloma usually occurs in
persons from 30 to 50 years old.
UM Specialist Centre Consultant
Oncoplastic Breast Surgeon Dr See
Mee Hoong explained these patients
would usually present with a swelling
in the breast that looks like it is filled
with water, while there are some
others that don’t feel any lump but
the dart is blocked.
“There are a lot of presentation
which is presented differently.”
“When the dart is blocked, they
would feel pain and uncomfortable.
What is normally done is after biopsy,
if it is still suspicious, we will go in
and do a surgery and take out the
affected duct. It will be removed up
to four - five centimetre away from
the nipple. This is then inspected by
the pathology whether there is any
malignant cells.”