Revised 28/01/2008
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The information contained in this column is intended for general guide and information only. It is not meant to replace professional consultancy and advice from your doctor(s). Radiology Malaysia regrets that we are not able to enter into personal correspondence concerning your specific medical problem or condition.
| | Talkback Q&A - Unequal breast sizes causes sleepless nights… | | Q I would like to consult you pertaining to my doubts. I am 30 years old. Is it normal if both the breast are not of the same size? Could it be a symptom of breast cancer? I do not suffer from any pain or lumps. Could you please recommend me a lady doctor where I can go for a breast examination to clear my doubts? It's bothering me as I am now having sleepless nights. MA 9 Feb 2004 A http://www.radiologymalaysia.org/breasthealth/YoungerWomen/index.htm You might be able to find some answers in these articles above, and also at the Q & A section of Breast Health here. Specifically your question has already been posted at: http://www.radiologymalaysia.org/breasthealth/TalkBack/symptomsofbreastdisease.htm#Topic4 As for lady doctors, you could visit your family doctor (GP) or see any one of the doctors (ask for ladies) at the various Breast Clinics http://www.radiologymalaysia.org/breasthealth/About/breastclinics.htm It is also important to be able to practice Self breast Examination properly and with confidence. Please do read these articles online at: http://www.radiologymalaysia.org/breasthealth/SBE/index.htm or alternatively you might be interested in picking up a copy of the book - The ART OF BEING BREAST AWARE - A BEGINNER's Guide to breast health and self breast checks. Find out more by clicking here Unequal breast sizes are common and are considered as normal variations but if the disparity is very great, you may need to consult a breast surgeon or a plastic and reconstructive surgeon. Editor
| | Talkback Q&A - Puting payudara saya telah rosak … | | Q Saya berumur 26 tahun dan masih belum berkahwin. Sejak kecil (dalam usia 4 tahun) saya mengalami alahan di bahagian puting payudara. Akibat dari itu puting payu dara saya telah rosak. Sehingga usia saya menjangkau remaja saya mempunyai puting payu dara yang ke dalam (inverted nipple) yang tidak normal seperti kaum wanita yang lain. Saya pernah membuat pemeriksaan sebanyak 2 kali (semasa usia 19 tahun dan 23 tahun) di klinik kesihatan luar dan Dr. memberitahu bahawa ia adalah normal tetapi jarang berlaku. Buat masa ini saya kadang kala mengalami gatal-gatal di bahagian payudara terutama sekali apabila hampir waktu 'period'. Ada pepejal seperti susu beku berkumpul di sekeliling kawasan puting payu dara saya yang kadang kala mengeluarkan bau yang kurang menyenangkan. Saya telah dinasihatkan oleh Dr sebelum ini agar kerap membuang sisa pepejal itu kerana ia akan mengakibatkan kegatalan. Soalan saya, apakah kemungkinan saya juga mengalami kanser payu dara disebabkan puting yang rosak dan adakah kaedah dalam dunia perubatan untuk memulihkan semula puting payu dara agar saya mampu menyusukan anak saya suatu hari nanti? Tolonglah doktor huraikan masalah yang telah 26 tahun saya alami ini. Ee 1 Dis 2003A Doktor memang betul bahawa puting yang tenggelam ke dalam bukanlah kanser dan boleh disenaraikan sebagai variasi “normal”. Setengah orang dilahir dengan puting yang tenggelam ataupun “inverted”. Tetapi, kerana ia tenggelam, menjaga kebersihan kenalah dilakukan dengan lebih teliti. Setengah orang juga boleh “menolak” keluar puting buat sementara waktu, cukup untuk membersihnya. Puting merupakan tempat mana keluaran kelenjar susu payudara bertumpu, kalau tidak dibersihkan, boleh tertimbulnya masaalah alahan ataupun infeksi. Bacalah mengenai payudara di www.radiologymalaysia.org/breasthealth/BM/PSP/perihalpayudara.htm Memang lebih sukar menyusu anak kalau mempunyai puting “inverted” tetapi kalau ia boleh ditolak keluar, penyusuan anak boleh dilakukan, lebih-lebih lagi kalau hanya satu puting saja yang “inverted”. Pengarang
| | Talkback Q&A - I’m 24, with mastalgia and fibroadenosis and now more pain after operation… | Q I’m 24 years old. I have a great problem. First I went to the doctor because of severe breast pain. She had my ultrasound that showed lumps in both breasts and one was much bigger. She gave me antibiotics but it was of no use. Then I had a biopsy and the lump was removed by an operation. Now 8 months have passed and I still get severe pain which seems worse after the operation. I have a big scar and it looks so bad and I can’t sleep on that side due to pain. Now I’ve consulted a breast specialist and have been told that I have fibroadenosis and mastalgia and it only needs medication. Secondly, she says that some tissue of my breast has been taken out and it’ll not grow now. Is that right? Because the place where the operation was done seems empty and I get dimple on the nipple of that breast and sometime a secretion of yellowish color comes out of it. I feel that my problem seems to be getting worse day by day. Now I’m taking evening primrose capsules with ponstan forte but I still have pain. I’ve been taking this medicine for 6 days but no relief from breast pain. I’m very worried. Can this be cancerous? If I get married will it be problematic? Or it can be beneficial that I get better after marriage? I’m very worried? FHS, 15 Oct 2003 A Fibroadenosis and mastalgia are common non-cancerous conditions of the breast. For further reading: www.radiologymalaysia.org/breasthealth/About/howcanitell.htm (Go to the section on Aberrations of Normal Development and Involution of the breast in this article) www.radiologymalaysia.org/breasthealth/YoungerWomen/index.htm (several articles on breast health issues in women younger than 35 years old) As with regards the dimpling of your skin, some degree of scarring is expected in any surgical biopsy. The scarring normally gets better with time but in some people, their skin tends to “scar” excessively, some to the extent of large keloids. As for pain relief and the follow up of your condition, if possible, you should continue to see the breast specialist so that he/she has feedback from you with regards the effectiveness of the medication that has been given to you and how much relief you have. Can fibroadenosis become cancerous? If you read the article on Risk Factors:
www.radiologymalaysia.org/breasthealth/About/bcriskfactors01.htm You will note that benign breast disease (and fibrocystic disease is included) may have a very slight increase in risk. However, this does not mean you will get breast cancer. Most women with breast cancer have NO risk factors at all. Smoking is far more dangerous to health! Once you understand yourself and your breasts, there should be no problems with marriage at all. Symptoms that you feel may wax and wane – sometimes improving or sometimes getting worse or may even completely go away for some time. Reading the following section may give you better understanding of what goes on in your breasts. www.radiologymalaysia.org/breasthealth/Who/index.htm In fact if you read through all the articles in our Breast Health Info Centre, you would have armed yourself with enough information not to worry excessively but just be breast aware. Editor
| | Talkback Q&A - Only 20, operated for breast lumps and now there is pain… | Q I would like to ask about breast cancer. I just had an operation to remove my breast lumps 2 months ago. There are 3 lumps on the left side and another 2 on the right side. But I just removed those on the left side. Maybe next year I will remove those for the other side. Now, I think I'm facing a bigger problem as each time it is raining or cold, I'll feel a lot of pain inside my breast. I also feel discomfort in my nipple because there is white discharge and sometimes it become yellowish. Is it normal or maybe I should refer to the hospital that I went for an operation before? And for your information my auntie just removed her breast because of cancer. I had 2 other close relatives who had breast cancer and died after 1 year. Is it possible for me to have breast cancer? I'm only 20. I also want to ask, is it possible for me to have Putrajaya Hospital email that can directly link me to the doctors that can help me about this because I'm quite busy to go the hospital. Maybe when I email them, I will know a bit about my symptoms, and then I will go to the hospital for further checkup. Fa, 2 Oct 2003 A From your explanation of the operation, most likely the lumps that you had were benign. Nevertheless you should consult the surgeon who operated on you to confirm the final diagnosis which should be available from the histology of the lumps removed. The pain that you are having now could be hormonal and nothing to do with the lumps. However a small percentage of patients do suffer mild pain after removal of lumps from the breast presumably from the scar, though this pain will usually subside after some time. The pain could be relieved with some analgesics. It is still advisable for you to go and see the doctor to examine you again especially when now you complain of having nipple discharge. Your risk of having breast cancer is slightly higher because of the family history though not as high as those who have first degree relatives (i.e mother or sister) with breast cancer. The risk of breast cancer increases with age. At 20 years old, the risk of having it is very low. In general all women are recommended to have screening for breast cancer when they reach 40 and in those with family history to have it done at younger age depending on at what age, the breast cancers occur in your family. As for emailing your doctor in Hospital Putrajaya, please communicate with your doctor and ask if this is possible and practical. Consultant Breast Surgeon,
Breast Clinic, Hospital Kuala Lumpur
| | Talkback Q&A - Lelehan seperti susu daripada puting | | Q Saya mempunyai masalah berkenaan payudara saya yang mengeluarkan cecair seperti susu. Saya berusia 21 tahun dan masih menuntut di ibu negara. Saya masih bujang. Saya ingin bertanya apakah cecair yang keluar dari payudara saya. Cecair itu akan keluar apabila saya memicitnya. Kini saya tidak dapat menumpukan perhatian saya untuk menduduki Final Exam, ini lebih-lebih lagi diberi tekanan oleh kawan-kawan yang mengatakan saya mungkin ada simptom kanser payudara. Mai, 22 Sep 2003 A Bacalah artikel-artikel dalam seksyen Maklumat Kanser terutama artikel “Bagaimana saya tahu saya ada kanser payudara”. Lelehan payudara selalunya bukan kerana kanser payudara. Tetapi ia memerlukan pemeriksaan doktor dan mungkin juga “penyiasatan” selanjutnya kalau lelehan saudari betul-betul didapati merupai susu. Keadaan ini dipanggil “galactorrhoea” dan mungkin kerana terlebihnya hormon prolaktin. Kanser pada lingkungan umur 20an jarang sekali. Saudari sepatutnya menenangkan pemikiran anda and tumpukan perhatian kepada pemeriksaan FINAL. Saudari boleh menjumpai doktor Klinik Payudara di Universiti Kebangsaan Malaysia di Cheras, Pusat Perubatan Universiti Malaya, Hospital Besar Kuala Lumpur di Jalan Pahang dan Hospital Putrajaya di Putrajaya. Pengarang
| | Talkback Q&A - Payudara kiri dua kali ganda saiz payudara kanan! | Q Payudara kiri saya mempunyai saiz 2 kali ganda payudara kanan. Adakah ini normal atau sebaliknya? Diela 10 Sep 2003A Faktor ketidaksamaan saiz payudara sudahpun ditanya oleh “Randy pada July 2002. Ini kadang-kadang boleh terjadi secara semulajadi ataupun adalah akibat menyusu anak pada satu belah payudara sahaja. Keadaan “benign hypertrophy” boleh juga berlaku dan ini memerlukan pembedahan untuk “mengecilkan” balik payudara supaya menjadi seimbang. Walaupun benign hypertrophy bukanlah penyakit yang merbahaya, tetapi payudara yang membesar secara tidak normal mungkin mendatangkan kesusahan “keberatan” payudara, kesusahan membeli coli ataupun pakaian. Untuk membaca jawapan ke pertanyaan Randy pada July 2002, sila klik di sini. Pengarang
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| | | Website Links | “CancerStory.com is a self-funded, non-profit site set up in memory of its founder's beloved mother who was taken away from the joys of life by cancer. She battled with colon cancer for three years and eight months. Through this web site, the founder hopes to share her late mother's cancer experience and help cancer patients and their families face the overwhelming tasks of seeking the best treatment, gathering information and preparing for the battle against cancer.” Click Here to visit Many thanks Kamal for submitting this link - Editor “The National Cancer Centre Singapore – Inspired by Hope, Committed to Care: This website seeks to answer some of the common questions which you may have when you or your relative has been diagnosed to have cancer. It hopes to explain, in simple terms, what cancer is, what treatment is available for cancer, what are the causes of cancer, and information on the more common types of cancer, i.e. lung, colorectal and breast cancer.“ Click Here to visit Thanks Margaret Ho for submitting this link - Editor
| Perak Palliative Care Society | Our reader CYC of the PPCS, wrote about how Radiology Malaysia, in particular the Breast Health Info Centre might aid in the noble deed of caring for the terminally ill. In return, we asked for more information on the PPCS and this is what CYC shared with us. Thanks CYC for your contribution! Click Here for more information.
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