Hello Doctor,

I have stone-like swellings in my left breast. I went to the hospital and was told there is nothing wrong but I’m afraid that it could be breast cancer. Is this a sign? What are the other signs of breast cancer? What should I do?

Pamela, 25, Kicukiro resident

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Dear Pamela,

Hard painless swelling (if really present), is indeed a sign of breast cancer and that needs to be excluded by suitable tests. But you are too young to have breast cancer.

Breast cancer usually occurs in middle aged or elderly women. Women having no or few children or having children late in life are more prone to breast cancer due to hormonal effects.  As such, women in Sub Saharan Africa are said to have less incidences of breast cancer as they have children early in life and multiple pregnancies. But due to ignorance about the cancer and its consequences, they suffer a lot.

Similarly, estrogen replacement therapy after menopause makes one more prone to it. Taking oral contraceptives for a long time, increases risk of breast cancer in women. Wearing very tight brassieres is also said to lead to breast cancer due to chronic irritation of the breast tissue. Apart from these factors there is a strong genetic component to breast cancer. It is seen more in women who are blood relatives like a mother and daughter or among sisters.

This cancer usually manifests as painless hard fixed swellings in any part of the breast. Swelling in underarm, swelling and redness of one upper limb (peau de orange), eruptions with redness and itching around nipple not responding to anti eczema treatment, bloody discharge from nipple, all these are indicators of breast cancer. Diagnosis of breast cancer is made by biopsy of the affected breast and mammography. Mammography helps in detection of breast cancer at a very early stage.

Once started, it can spread to the lungs, breast, and backbone and other body parts causing more sickness and becoming more incurable. Therefore women are encouraged to do self examination of the breast for early detection and treatment of breast cancer. This is done by feeling the breasts in all 4 sides by standing in front of the mirror. 

There are other swellings which can give a false impression of a breast cancer. These are benign conditions and easily amenable to treatment. Some of these conditions are mammary dysplasia (fibrocystic condition of the breast), fibroadenoma, intraductal papilloma, lipoma, and fat necrosis in the breast. The difference is that breast cancer is usually made by a biopsy. You are most likely suffering from fibroadenoma of the breast, which manifests as a slowly mobile growing painless lump. It commonly occurs in young women and is completely cured by surgery, cryotherapy or focused monograph.

Therefore I think there is no need for you to worry but go ahead with investigations to know the exact nature of the swelling you have.