Here's my .02 on waiting and watching for breast lumps.

I disagree with Pat that nothing is to be gained by waiting.  On the
contrary, many a breast lump turns out to be just a benign lump.

One of the easiest non-invasive ways to distinguish nasty from nice breast
lumps if whether they grow over time.  By the time a breast lump is big
enough to be palpable, if it is cancerous, it has been in existence for
about 10 years on average.  Waiting a few months isn't going to make much
difference on long-term outcomes.

Typical breast cancer tumors double their size every couple of months.  They
start out with one abnormal cell, then grow to 2 cells, then 4 cells, then 8
cells, and so on.  That's why one month the tumor is too small to feel (say
1/8" across) and after several months it's easy to feel (1/4" across).  And
of course if you weren't checking, and waited several more months, it would
be 1/2" across, and several months later 1" across, and so on.

Breast surgery (for any reason) is one of the big risk factors for
developing breast cancer, so you want to avoid surgery on your breasts for
any reason -- including "let's get that lump out of there just in case."
The first lump may not have been cancerous, and the woman goes away
reassured that she merely had a 'benign fibroadenoma' or whatever, but the
surgery may then trigger a cancerous lesion at the site of the surgery --
many years down the road.

If you find a lump, most physicians will do a mammogram and an ultrasound,
even a needle biopsy.  But many will also take as the first step a "watch
and wait" approach.  If the lump has not increased in size after several
months, then it's almost definitely NOT cancerous -- because a cancerous
tumor would most likely have doubled in size during that time.  If the lump
has stayed the same size, then there is no need for risky surgery.  If the
lump has gotten bigger, then the surgeon will recommend a needle biopsy or
go straight ahead with a lumpectomy.

My reading on this topic suggests that one should be very conservative about
doing surgery on the breasts, for any reason.  Because we have been taught
in the US to freak out about breast cancer, many women are demanding (or
going along with their doctor's recommendation) to have a lumpectomy for any
lump.  Hardly anyone is told that breast surgery itself increases their risk
for breast cancer.

For anyone who works with breasts (all of us here) I highly recommend two
books:  "Patient No More" and "Teratologies" -- about the cancer industry.

Kathy Dettwyler
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