Tuesday, January 22, 2008


What is Fibroadenoma ?

Fibroadenomas are benign breast tumors commonly found in young women in the age group of 15 to 40 years. Fibroadenoma means "a tumor composed of glandular (related to gland) and fibrous (containing fibers) tissues."

Described as feeling like marbles, these firm, round, movable, and "rubbery" lumps range from 1-5 cm in size. Giant fibroadenomas are larger, lemon-sized lumps. Usually single, but some women have more than one. While some types of breast lumps come and go during the menstrual cycle, fibroadenomas typically do not disappear after a woman's period, and should be checked by a doctor.

What causes Fibroadenoma?

The cause of breast fibroadenomas is unknown. They may be dependent upon estrogen, because they are common in premenopausal women, can be found in postmenopausal women taking estrogen, and they tend to grow larger in pregnant women. Generally when it occurs in young women, it is benign, but when it occurs in postmenopausal women, they need to take extra care as they are found to be malignant. Fibroadenomas usually cause no symptoms and may be discovered during breast self-examination, or during a routine check-up.

If a breast is injured by trauma, tiny blood vessels can rupture to cause an area of localized bleeding. Trauma to the breast can damage the fat cells in the breast tissue, a condition called fat necrosis. The injury can also form a lump in the breast. These types of lumps that follow a significant trauma are not cancerous.

What to do when you find a lump on the breast?

Immediately go to your family doctor, who will advise you to meet a Surgeon.

How will the doctor diagnose?

The doctor takes a complete medical history, they will ask when the lump was first noticed, if there were any symptoms or changes in lump size, and if there is any personal or family history of breast disease.

The doctor thoroughly feels the breasts (palpates). Tests are done, usually including mammography or ultrasound scans, or surgical removal of cells or tissue for examination under a the microscope (biopsy).

What are the different diagnostic tests administered?

Diagnostic tests include:

  • Mammogram. An x-ray examination of the breast.
  • Ultrasound scan. A technique that uses sound waves to display a two-dimensional image of the breast, showing whether a lump is solid or fluid-filled (cystic).
  • Fine-needle aspiration biopsy. A minor procedure wherein fluid or cells are drawn out of the lump through a small needle (aspirated).
  • Core biopsy. A procedure wherein a larger piece of tissue is withdrawn from the lump through a larger needle.
  • Incisional biopsy. A surgical procedure wherein a piece of the lump is removed through an cut (incision).
  • Excisional biopsy. A surgical procedure wherein the entire lump is removed through an cut (incision).
What is the treatment for Fibroadenomas?

Breast fibroadenomas are removed by lumpectomy, or surgical excision under local or general anesthesia. Sometimes lumps in younger women are not removed but are monitored by self-examination, yearly doctor check-ups, and mammograms. Surgery is generally recommended for women over 30, and especially for lumps that are painful or enlarging.

Alternative treatments for breast fibroadenomas include a low-fat, high-fiber, vegetarian diet; a reduction in caffeine intake; supplementation with vitamins E and C; and the application of hot compresses to the breast. In addition, a focus on liver cleansing is important to assist the body in conjugation and elimination of excess estrogens. Botanical remedies can be useful in hormone balancing, as can acupuncture and homeopathy. Massaging the breasts with castor oil, straight or infused with herbs or essential oils, can help fibroadenomas reduce and dissipate, as well as keep women in touch with changes in their breast tissue.

Some facts about Breast Fibradenomas.

Breast fibroadenomas are not cancerous. The lumps recur in up to 20% of women. A small number of lumps disappear on their own. Breast fibroadenomas cannot be prevented. They can be discovered early by regular breast self-examination.

Courtesy: HealthAToZ.com , MedicineNet.com

Saturday, January 19, 2008

Fighting Fear

As human beings , we all experience this emotion called "FEAR". It does vary in its proportion and to certain extent also depends upon some internal factors and external factors that influence the breadth and width of this emotion. The external factors could be the people around us and their experiences ; the internal factors could be one's own experiences and observations.

Managing fear is a challenging task. If managed properly, it will produce positive results and work in one's favour, otherwise it can be disastrous. The best way to manage fear is by sharing and discussing the same with a trustworthy family member, friend or a professional helper. Firstly it reduces the anxiety level and then instigates one towards taking relevant action which will facilitate in managing, tackling and overcoming this monster called 'Fear".

On October 15, 2007, this monster entered my life. I have been doing a routine self examination of breasts, since my mom was diagnosed with breast cancer last November and she is currently undergoing treatment at Army Command Hospital, Kolkota. I found a small pea sized lump in my right breast and panicked for a while. Later on I told my husband and he took it rather in stride, did not panic and assured me not to worry. So I found myself regaining my calm. I immediately approached my Homeopath, Dr. Annapurna Waghray , who told me not to worry, as it could only be a case of "Fibrodenoma", but nonetheless get a mammogram and FNAC (Fine Needle Aspiration Cytology) done. I spoke to my brother Ravi who is a doctor and he too assured me that the lump should be benign but advised immediate medical attention. I did a lot of reading and research on the diagnosis and treatment of "Fibroadenoma" and "Breast Cancer" on the internet. Thanks to GOOGLE !

We approached the Railway Hospital, Secunderabad where we are entitled to medical facilities , as my husband is employed with the South Central Railways. My husband's colleague Mr. Prasad Babu , Personal Assistant to the Medical Director of Railway Hospital was of tremendous help. I first approached a Gynecologist, who asked me to meet the Surgeon. And Mr. Prasad Babu suggested we meet the senior surgeon Dr. M. Ravi Kumar and so we did. I explained when I identified the painless lump and that I had a family history of breast cancer ; my mom being diagnosed with the same in November 2006 and undergoing treatment and my paternal aunt, i.e my father's younger sister succumbed to the same about 9 years back. I informed him that there was no nipple discharge or any kind of discomfort. After the clinical examination and a series of queries, I was recommended to the Indo American Cancer Research Center, Jubilee hills, Hyderabad for a Mammogram and Ultra sound. The results indicated a 1 cm palpable lump in right breast and another same sized non-palpable lump next to it and also one in the left breast. The results indicated Fibroadenoma, advising FNAC ( Fine Needle Aspiration Cytology) .

I underwent FNAC at the Railway Hospital with Dr. Neelala Krishnaveni, the Pathologist conducting the same. She was kind enough to clarify a lot of my doubts. After a tension filled two days period wondering if the lump would be benign or malignant, I got the FNAC reports indicating " Fibroadenoma" , a benign lump . I was relieved of my worst fears. I underwent Blood tests , Chest X-Ray and ECG which were all clear and I was happy that my general health was good. Anyway the Surgeon suggested for the "Excision of the lump" which is also referred to as "Lumpectomy" and gave me a date for November 27, 2007 and asked me to get myself admitted the day before. I learned that FNAC reports are 90% accurate whereas biopsy reports are 99% precise. And keeping my family history of the disease in view, the need for excision of the lump became vital. I had to meet the Anesthetist who would see all my reports and declare me fit for surgery. Again Mr. Prasad Babu was kind enough to introduce me to Dr. Ramana Murthy, Anesthetist who checked my Blood pressure which was on the borderline, presumed to be so due to possible stress as I did not have a BP problem. He also checked all my reports and declared me fit. He was very kind and patiently answered to all my queries about the surgical procedures and after effects. I felt very good and confident about the whole thing. I also got enlightened on the important role an anesthetist plays during surgeries.

On Nov 26th, 2007, I got myself admitted in the hospital. I was overwhelmed with the atmosphere. Rows of beds, patients with all kinds of health problems and surgeries, the overworked nurses and smell of medicines got the wrong side of me. By the time I met the Anesthetist in the evening for a PAC ( Preoperative Anesthesiology Clinic ) where the Anesthetist reviews all the test reports, checks blood pressure and informs about the preparation required for the surgical procedure, I was running a slight temperature and coughing like mad with my Blood Pressure indicating hypertension. Well, it was an anti climax. I was advised to recover from the cold, cough and fever and was prescribed medication to reduce my BP and the procedure got postponed. I was discharged the next day and the Surgeon was kind enough to give me a date of my convenience on December 11, 2007.

I came home in the evening eager to surprise my daughter and was flabbergasted with her reaction. She was disappointed to see me back so soon, because I asked her to get her school books for doing the home work. Her hair was looking untidy as she had left it open. It was hair style for her. Later my mother- in- law told me that she refused to get her hair oiled, combed and tied neatly into a pony tail, pleading to her grandma " Please let me leave my hair and go to school, if my mom is around she will not let me go like this" and when my MIL said " what would the teacher and others in the school think; that you did not have any one to take care of you at home"; my daughter promptly replied " Don't worry, I'll tell them my mom is in the hospital and my grandma is "BUDDI" (Oldie) and can't do much work".

I experienced abnormal living the next two weeks, popping pills, drinking cough syrups, not going out to avoid the cold wave in Hyderabad, steam inhalation and what not to reduce my cold and cough. I recovered well and the Anesthetist gave me a green signal and assured me that they will take care that the procedure will go ahead successfully without any hindrance. I got myself admitted on Dec 10th, 2007. This time I had no apprehensions leaving my daughter (What with her BINDAAS attitude !) I knew she will enjoy her freedom. But she had her exams the coming week which was a matter of concern for me, not her. I was not worried about the home front as my Mother-in-law was there to take care.

As I already had a prelude and was familiar with the staff and other patients, I was comfortable and confident at the hospital. I had company of another lady who was to have the same procedure the next day along with me. She was ignorant of the whole process being an illiterate and had three small kids with the youngest still breast feeding. She was scared that the doctors would remove her whole breast. She did not follow a word of Telugu and could only converse in Marathi and a little bit of Hindi. As I know Marathi, I spoke to her and assured her that everything will be fine and that I was there to give her company. She and her husband were grateful to me for the pep talk. At that moment, I realized about the lack of awareness people have about the whole process .

The Anesthetist guaranteed , he will take care despite some traces of upper respiratory tract infection. Blood Pressure was also normal. On Dec 11th 2007, we were prepared for the surgery, and paraded to the Operation theater in the flimsy gowns wrapped with bed sheets at 8.oo am. I am thankful to the kind nurse Sister Padmavathi and her assistant Bhanu who took good care of me. My husband arrived in time to wish me well. I was the last to get operated on that day and by the time I was shifted to the Surgical Intensive Care unit, it was about 2.30 pm. My husband was patiently waiting near the operation theater for nearly six hours. By the time he was allowed to see me it was 8.00 pm. I was feeling fine and relieved. The next day when the Surgeon came on his rounds, I requested him to allow me to go home. He checked the wound and said I was fine, my BP was normal and to the surprise of the staff , gave me a discharge. I believe the general trend is to keep the patient for a week in such procedures. I later learned from the nurse that he referred to me as a very cooperative and calm patient. WOW, great compliment! The Surgeon asked me to come for a check up after two days and then get the sutures removed on 19th Dec, 2007.

My daughter as expected was disappointed to see me back so soon. She wanted to visit me at the hospital in full filmy style. I told her, the doctor had sent me home immediately so that I could take up her studies for the exams. Her imagination had gone as far as seeing my "Photo on the wall with a garland" if the surgery would fail. The movies and TV serials effect! I was amused but also wondered if it was just" innocence" or was leading to "apathy".

I got my biopsy reports on Dec 22, 2007 which indicated the lump as benign. Though it was a minor procedure, the anxiety it caused was a learning experience.

All my family members and friends were relieved. My mom was keen to see me and I too wanted the same, so we left for Kolkota on Dec 23rd, 2007. My brother Nagaraj and his family also came down from Dubai to Kolkota. And I ushered in the New Year with my six month old nephew "Raghav" , my lovely niece "Gauri" and my baby "Adithi" with their proud grandma - my mom, my two brothers "Nagaraj and Ravi", my Sisters-in-law "Suma and Ashwini" and my hubby "Phani".

I wish you all a Very Happy New Year with special thanks to my friends, relatives and family members who gave me a lot of moral support either by calling on phone or came to see me which made me feel very, very good. I am now committed to spreading awareness about " Fibroadenoma of the breast" and "Breast Cancer". More of it on my next blog.