What to do when you discover a lump

Feeling a lump in your breast can be alarming but you can still be in control by knowing what to do next

Getting a doctor to look at you is essential in determining whether or not a breast lump is cancerous. PHOTO: GETTY IMAGES
Getting a doctor to look at you is essential in determining whether or not a breast lump is cancerous. PHOTO: GETTY IMAGES

If you feel a lump in your breast, do you know what to do next?

Breast cancer, the most common cancer among women in Singapore, may be the first thing that comes to mind when you discover a lump. While every woman is at risk, a lump in the breast does not necessarily mean you have breast cancer, which accounts for 17.3 per cent of cancer deaths in Singapore from 2011 to 2015.

At least nine out of 10 lumps are benign or non-cancerous. These types of lumps tend to be smooth around the edges and can move around the breast. There are different causes of lumps in the breast, such as hormonal changes and infections. But even if the lump appears to be benign, it is still best to see a doctor to get it checked out.

The doctor might perform a mammogram, which is an x-ray examination, or an ultrasound. There might also be a biopsy to check for abnormality in your breast tissue.

Dr Andrew Lee, Gleneagles Hospital general surgeon, shares, “Breast lumps are common in women. Thankfully, the majority of lumps (about 90 per cent) are benign. So there is no need to panic. However, every lump needs to be checked as it is not possible to distinguish what is benign and what is cancerous simply by feeling the lump. Sometimes, a lump can feel benign but turn out to be cancerous especially in younger ladies. This is why you should be seen by a doctor, who should initiate investigations such as breast ultrasound and mammograms. If necessary, a biopsy is required to determine the exact nature of the lump.”

Women are advised to monitor any unusual changes to their breasts, like lumps, changes to the nipples and discharge by performing a self-breast examination monthly. This can easily be done either by lying down or standing up in front of a mirror or while in the shower. The key is to feel each breast and underarm for any lumps and bumps. For ladies on their period, they should examine themselves seven days after the start of their menstruation. Otherwise, having a self-breast examination on a fixed date every month is recommended.

How are breast lumps removed?

There are various ways of removing breast lumps depending on the type. The majority of benign lumps do not need removal and can be safely monitored. However, some ladies may wish to have their lumps removed for various reasons such as reassurance and increase in size.

“For benign lumps smaller than 2cm, it is possible to remove these lumps by needle extraction (vacuum-assisted removal). It is a day-case procedure with quick recovery time and minimal scarring (<5mm),” says Dr Lee. “Some benign lumps require removal with the lump intact. This can be done by surgical excision commonly referred to as excision biopsy. It is also done in the operating theatre as a day-case procedure. The lumps are usually removed via a small incision.”

Lumpectomy is the surgical removal of a breast lump, usually associated with breast cancer, with a rim of normal breast tissue. But unlike mastectomy, it allows the preservation of the breast. When done with oncoplastic breast surgery, the procedure may lead to favourable cosmetic results. Lumpectomy is more suitable for smaller cancers that are detected early by self-breast examination and breast screening.

Generally, a lumpectomy is an outpatient procedure with quick recovery time, so patients can return to normal activity following the surgery.

No worries over your hospital bill

Going through the procedure and handling the costs can be worrisome. But a new programme by Parkway Pantai can help alleviate those concerns.

The private healthcare provider now has Price Guarantee Procedures (PGP), a programme that uses artificial intelligence (AI) to give patients an accurate price on surgical procedures like lumpectomy before their surgery.

Under the programme, the patient will be given an overview of her medical bill – which covers related complications that might arise. At discharge, she will see the exact hospital bill that was presented to her before their surgery.

PGP is set in place to help patients and their families make well-informed decisions on the available medical treatment options and the fees prior to admission. Other surgical procedures under the programme include the removal of piles, ovarian cysts, gall bladder, thyroid and tonsils.

The healthcare group has leveraged AI to generate more than 40,000 hospital bill estimations based on 36 criteria, including the average length of stay in hospital, ward type, diagnosis and surgical procedures since November 2018.

PGP is currently offered at Parkway Pantai's four hospitals: Gleneagles Hospital, Mount Elizabeth Hospital, Mount Elizabeth Novena Hospital and Parkway East Hospital. All self-paying and insured patients are eligible for PGP, which are available from doctors who are participating in the programme.

For more information, please call 6812-3789 or visit the hospital websites: Gleneagles Hospital, Mount Elizabeth Hospital, Mount Elizabeth Novena Hospital and Parkway East Hospital.

This article is for informational purposes only. Please refer to the specific procedures’ financial counselling forms for detailed programme inclusions and exclusions. Prospective patients should always seek independent medical advice.