Headwear Etc Blog

Evaluating a Breast Lump

The discovery of a breast lump—whether by chance, during a routine breast self-exam, or during a clinical breast exam—can be stressful for a woman. Because a lump can be a symptom of breast cancer, all persistent breast lumps should be evaluated by a physician. However, the majority of breast lumps (approximately 80%) are due to non-cancerous causes.

Main Menu:

What Should a Woman Do If She Finds a Breast Lump?
What Signs Suggest a Lump is Likely to Be Cancerous?
How Are Breast Lumps Evaluated By Physicians?
Breast Lumps During Pregnancy
Additional Resources and References

What Should a Woman Do If She Finds a Breast Lump?

First, it is important for all women to practice monthly breast-self exams beginning at age 20. These self-exams allow women to become familiar with how their breasts look and feel so they can more readily detect any changes that may occur. Many women naturally have some lumpiness and asymmetry (differences between the right and left breast). The key to the breast self-exam is to learn to find changes in the breast(s) that persist over time. If a new lump is found and does not disappear after the menstrual cycle, then it should be reported to a physician for clinical evaluation.

All persistent breast lumps should be evaluated by a physician. Practicing monthly breast self-exams helps women get to know their breasts and more easily detect changes.

What Signs Suggest a Lump is Likely to Be Cancerous?

It is not possible for a woman or a physician to know for certain whether a breast lump indicates breast cancer until imaging exams (such as mammography and ultrasound) and/or biopsy are performed. A breast biopsy involves taking a sample of breast tissue and examining it under a microscope to determine whether it contains cancer cells. However, there are certain characteristics associated with lumps that can suggest whether they are more likely to be cancer or benign (non-cancerous).

Signs that suggest a lump is more likely to be cancerous:

The lump is firm and hard
The lump is not discrete; it is not easily distinguishable
The lump is fixed in the breast; it does not move
There is only one lump
There is not an identical lump in the opposite breast
The skin of breast is dimpled
The lump is accompanied by bloody nipple discharge

Signs that suggest a lump is less likely to be cancerous:

The lump is soft
The lump is discrete; it is easily distinguishable
The lump moves in the breast
There are multiple breast lumps
There is an identical lump in the opposite breast
The lump disappears after the menstrual cycle

While the above signs can help suggest whether a lump is more likely or less likely to be cancerous, having one or more of these characteristics does not guarantee or eliminate the possibility of having breast cancer. These characteristics merely provide clues for the physician when evaluating a lump. Some breast cancers can have characteristics found in the “less likely to be cancerous” category. Therefore, all persistent breast lumps need to be presented to a physician.

Fibrocystic breasts: Fibrocystic breast condition is a common, non-cancerous condition that affects more than 50% of women at some point in their lives. In fact, the condition is so common that many physicians refrain from using the term “fibrocystic” and simply tell their patients that their breasts are lumpier than average but are still normal.

The most common signs of fibrocystic breasts include: lumpiness, tenderness, cysts, areas of thickening, fibrosis, and breast pain. Having fibrocystic breasts, in and of itself, is not a risk factor for breast cancer. However, fibrocystic breast condition can sometimes make it more difficult to detect a hidden breast cancer with standard examination and imaging techniques. Therefore, it is important that women with fibrocystic breasts practice monthly breast self-exams, receive regular clinical breast exams, and have yearly screening mammograms (the latter beginning at age 40).

Symptoms of Fibrocystic Breasts

cysts (fluid-filled sacs)
fibrosis (scar-like connective tissue)
lumpiness
areas of thickening
tenderness
pain

The degree to which women experience symptoms of fibrocystic breast condition varies considerably. Some women with fibrocystic breasts have only mild breast pain and may not be able to feel any breast lumps when performing breast self-exams. Other women with fibrocystic breasts may experience more severe breast pain or tenderness and may feel multiple lumps in their breasts. Most fibrocystic breast lumps are found in the upper, outer quadrant of the breasts (near the armpit), although these lumps can occur anywhere in the breasts. Fibrocystic breast lumps tend to be smooth, rounded, and mobile (not attached to other breast tissue), though some fibrocystic tissue may have a thickened, irregular feel. The lumps or irregularities associated with fibrocystic breasts are often tender to touch and may increase or decrease in size during the menstrual cycle.

By Lisa Richwine

WASHINGTON (Reuters) - U.S. health officials approved a genetic test on Tuesday that can provide women with early breast cancer an estimate of whether the disease is likely to return in 5 to 10 years.

Officials cautioned, however, that the test was not perfect and should be used with other information to help doctors and patients decide on treatment.

Called MammaPrint and made by Dutch company Agendia, the test is the first with U.S. Food and Drug Administration approval that relies on a complicated computer analysis of several genes. Cancer recurrence depends partly on the activation and suppression of certain genes in a tumor.

The MammaPrint measures the activity of 70 genes using a sample from a breast cancer tumor that has been removed. Women will be told if they have a high or low risk of their disease returning in 5 to 10 years.

Women at high risk have about twice the chance of breast cancer returning and spreading as low-risk women.

The test accurately picked which women were at low risk at least 90 percent of the time, FDA officials said. Conversely, for women who were told they were at high risk for a recurrence within five years, just 23 percent actually had their cancer come back.

Doctors and patients should use the results with other information to choose a course of treatment, FDA officials said.

“You can’t go all the way to the bank with this test,” said Dr. Steven Gutman, head of the FDA’s Office of In Vitro Diagnostic Device Evaluation and Safety.

“I think it’s better than having no information at all. It does provide a risk profile for patients,” he added.

Agendia Chief Executive Bernhard Sixt said in a statement the company was “exploring ways to make this product available in the U.S.” It has been on the market in the Netherlands since 2005.

The FDA said it based the approval on a study of 302 women in Europe, who were under age 61, and had either of the two earliest stages of the disease.

Going Against the Tide
There’s absolutely no question Eddie Murphy delivered a gripping performance as troubled singer James ‘Thunder’ Early in this year’s big musical, Dreamgirls. Murphy more than lived up to expectations and nailed the part, and for that he was honored with the Screen Actors Guild award and a Golden Globe for best supporting actor. He’s also the favorite of a lot of outfits that deal in setting the odds for events like the Academy Awards.

In the Oscar race for Best Supporting Actor, Murphy’s facing the same four actors he was up against for the SAG award. Murphy’s competition consists of Jackie Earle Haley (Little Children), Alan Arkin (Little Miss Sunshine), Mark Wahlberg (The Departed), and Djimon Hounsou (Blood Diamond), all very strong actors who deserve their nominations (that’s worth noting because it doesn’t always hold true). The odds-on favorite, Murphy might pick up his first Academy Award but I’m predicting an upset. Hounsou won’t get it because Blood Diamond didn’t receive as much critical acclaim as the studio had hoped for. I don’t believe Wahlberg will win because I think his fellow actors aren’t quite ready to honor him with this big of an award, although he’s definitely come a long way in earning their respect. Haley’s comeback performance in Little Children was incredible, but I predict this year’s Best Supporting Actor Oscar will go to Alan Arkin.

BLESSINGS ARE THE THINGS WE TAKE FOR GRANTED

Blessings are the things we take for granted.
Each holiday we notice what we see.
Most know the Earth is utterly enchanted
Yet walk through life and love mechanically.
Valuing one’s gifts takes resolution
After days and nights of fantasy.
Love brings the sweet relief of absolution,
Enveloping our hesitance in need.
No touch inspires so swift a revolution,
Transforming all the hieroglyphs we read.
In your love is the charity of spring,
Nor self-obsessed nor blinded by some creed,
Embracing the grey dawns that blessings bring.

SHOP ONLINE: www.headwearetc.com

Hair Loss

The normal scalp contains approximately 100,000 hairs. They are constantly growing, with old hairs falling out and being replaced by new ones. Some cancer treatments will cause some people to lose some or all of their hair (alopecia). For example, with chemotherapy, drugs travel throughout the body to kill cancer cells, and some of these drugs damage hair follicles, causing the hair to fall out.
Hair loss is highly variable. Some people experience it and others do not, even when they are taking the same drugs. While some drugs can cause hair loss on the scalp and elsewhere on the body, others can cause only the loss of head hair. If hair loss does occur, it usually begins within 2 weeks of starting chemotherapy and gets worse 1 to 2 months after the start of therapy. It may come out in clumps that appear on the pillow in the morning or while shampooing or brushing your hair. Hair re-growth often begins even before therapy is completed.

Like chemotherapy, radiation therapy to the head often causes scalp hair loss. Unlike hair lost because of chemotherapy, however, hair lost as a result of radiation therapy to the head may not grow back naturally.

It is normal for someone undergoing cancer treatment to feel distressed about hair loss. But it can help to understand why it happens, to know that hair will probably grow back, and to take some steps to minimize the problem.

What to Do

Choose a wig or toupee before treatment begins or at the very start of treatment, before hair loss begins, so that hair color and texture can be matched
Get a prescription for the wig from the doctor, because the cost is often covered by insurance
Obtain a list of wig shops in your area from the doctor, nurse, or the Yellow Pages
If you have long hair, consider getting a stylish short cut and then having a beautiful wig made from your own hair
Try on different wigs until you find one that you really like
Consider buying 2 wigs, 1 for everyday wear and 1 for special occasions
Before you need to wear the wig, be gentle when brushing and shampooing your own hair
Wear a hat or scarf outdoors in cold weather to prevent loss of body heat
Avoid too much brushing or pulling of hair, and avoid heating it with a hair dryer, electric rollers, or curling iron to help reduce hair loss and damage
Use a sunscreen, sunblock, or hat to protect your scalp from the sun
Choose turbans or scarves as alternatives to wigs
Do Not

Wait to go shopping for a wig; try to have it ready when you need it
Forget your hair will grow back and that a good wig looks very natural.
SHOP ONLINE @ www.headwearetc.com

Preparing Yourself to Lose Your Hair
If your doctor has prescribed a chemotherapy drug that is known to cause hair loss, prepare yourself for hair loss before treatment begins. Early preparation can help you cope when you hair begins to fall out.
How to Prepare for Hair Loss Before Chemotherapy
Buy a wig. Purchasing a wig before hair loss is ideal because it allows you to choose a wig that matches your hair color best, and you will have it on hand right when hair loss starts. You may want to consider buying at least two wigs, so one can be worn while another is being washed or styled.

Cut hair short. Many men and women opt to cut hair short or shave their heads before hair starts to fall out. It is much less shocking to have short clumps of hair fall out in the shower or in your hands than a handful of long strands.
LINKS: www.headwearetc.com

Go hat shopping. Even if you buy a wig, you will need some type of head covering for when you are not wearing a wig, especially in cold weather. Your scalp may be sensitive when not covered, not to mention cold. Scarves and hats also provide excellent protection from the sun and wind.

See a cosmetologist. Because chemotherapy can cause hair loss all over the body, some people consult with a cosmetologist about what to do when eyebrows and eyelashes are lost. A cosmetologist can teach you how to draw in eyebrows with makeup and use false eyelashes.

Stock up on sunscreen. If you venture outdoors without covering your head and you hair has fallen out, you will need to wear sunscreen to prevent sunburns. An already-sensitive scalp combined with a sunburn can be extremely uncomfortable.

If you feel especially anxious about losing your hair during chemotherapy, talk to your doctor. He or she may be able to recommend a chemotherapy support group, where you can discuss your concerns with others who are going through chemotherapy.

Allergic hair dye reactions are increasing as more people - particularly the young - colour their hair, researchers have warned.
In the British Medical Journal, they warn this can lead to facial dermatitis and, in severe cases, facial swelling.

Para-phenylenediamine (PPD) and other related agents which can trigger allergic reactions are contained in more than two-thirds of hair dyes.

The warning comes from St John’s Institute of Dermatology in London.

Some patients have continued to use such dyes even when advised that they are allergic to them and risk severe reactions

St John’s Institute of Dermatology researchers

Allergic reactions to PPD became such a serious problem that it was banned from hair dyes in Germany, France, and Sweden.

Current European Union legislation allows PPD to comprise up to 6% of the constituents of hair dyes on the consumer market.

But the researchers, based at St Thomas’ Hospital, warn that no satisfactory or widely accepted alternatives to these agents are available for use in permanent hair dye.

More in clinics

A recent survey in London found a doubling in frequency of dermatitis over six years to 7.1% in a clinic for adults.

The same clinic reported that between 1965 and 1975 it saw between five and 11 patients with non-occupational PPD allergy each year.

More recently the number has consistently exceeded 40 such patients annually.

A similar trend has also been observed in other countries.

Market research also indicates that more people are dyeing their hair and are doing so at a younger age.

AThe researchers say temporary “henna” tattoos containing high concentrations of PPD might also be contributing to the problem.

Severe hair dye reactions among children have also been reported.