Breast discomforts should not be taken for granted

Breast discomforts should not be taken for granted – Dr. Persaud

Oct 15, 2011 News

Three main breast concerns that can surface among women and which should not be taken for granted are: ‘I have a pain in my breast,’ ‘I have a breast mass or ‘I have a breast discharge.’ This is according to, General Surgeon and Director of Caribbean Surgery, Dr. Surendra Persaud.
Dr. Persaud said that women should not hesitate to seek medical attention in such cases which should see them being subjected to clinical breasts examination. “If there is a lump or there is a pain and the woman is over 40 years of age we will recommend a mammogram…”
However, Dr. Persaud asserted that the recommendation of a mammogram when a lump is detected is not to confirm that a lump is there but rather to determine whether there is any other underlying problem.
“Once you take out that breast lump or biopsy that lump you are going to change the architecture so getting a mammogram afterwards doesn’t meant that you know if the change you are seeing is due to your surgery or due to a lump.”

Dr. Surendra Persaud

Having detected a lump, sometimes medical experts opt to recommend an ultrasound which determines whether it is a solid lump or a cystic lump. And according to Dr. Persaud if it is a cystic lump “you can always stick a needle in and withdraw the fluid and if it comes back a second time you draw it out again but if comes back the third time you may have to take it out.”
If the lump turns out to be solid, it is recommended that either the entire lump or a piece be removed and sent to the laboratory for pathology. According to Dr. Persaud it is only a Pathologist who decides what the lump really is under the microscope.
“It is not what we think it feels like or what we think it looks like but it is the Pathologist who determines this…”
The most common lump found in the breast of a woman is a fibroadenoma which never becomes a cancer, the expert asserted. This, however, cannot be deduced simply from a physical examination or the mammogram whether a lump is benign or malignant.
While lumps in the breast are very common, Dr. Persaud noted that emphasis must always be given to the fact that early detection is crucial to a better chance of survival.
Once it has been confirmed that an individual has been inflicted with cancer, there are usually four forms of treatment that can be engaged. Firstly there is a surgical treatment which can be employed to remove the cancerous lump and the lymph nodes under the arm or remove the entire breast.
However, Dr. Persaud asserted that it is not every woman with breast cancer needs to have their breast removed. The surgical procedure is usually followed by chemotherapy once the cancerous lump is less than one centimeter.
The recommendation, he said, is that pretty much every woman would require chemotherapy after surgery.
Dr. Persaud is of the view that since the recommendations have changed over the years more persons are being exposed to radiation therapy than in the past.
Meanwhile, he is convinced that an area that requires much attention and development is that of hormonal treatment. He explained that hormonal treatment can be helpful with where the cancer can be tested for Estrogen Receptor (ER) and Progesterone receptors (PR).
“If those receptors are positive then blocking those receptors with medications is part of the treatment. However in Guyana we have a little difficulty getting that testing done,” Dr. Persaud opined, thus the need for development of the treatment.
In the interim though, he noted that persons in need of radiation therapy can access same at the Guyana Cancer Registry situated at the junction of Lamaha and East Street, Georgetown, and chemotherapy is available at a number of private hospitals including the Georgetown Public Hospital through which patients can benefit from subsidized treatment.