Vim & Vigor - Summer 2018 - University of Virginia - 19

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cycle some feelings of fullness or
pain, even a lump," Baskies says.
"Oftentimes, benign issues will disappear or will resolve themselves after
going through a menstrual cycle."
Even if it turns out to be malignant, or cancerous, breast cancer
treatments have improved a lot in
recent years.
"The survival rate for breast cancer
has improved overall to 90 percent. It's
not a death sentence," Baskies says.
Here are some types of lumps that
aren't cancer.

Cysts

Cysts-round, fluid-filled
sacs in the breast-are
the source of many breast lumps.
They're movable and can be tender
to the touch.
Cysts can be found in women of
any age, but they're most common in
women in their 40s. They range in size
from microscopic to 2 inches across,
and they tend to get bigger and more
painful before the start of a period.
They're often diagnosed based on
symptoms, but sometimes an ultrasound may be necessary to see whether
the lump is solid or filled with liquid.
If the lump turns out to be solid or
contain both solid and fluid parts,
your doctor may conduct a biopsy,
removing a tissue sample to rule out
cancer. Solid masses do not necessarily
mean cancer.
As for treatment, a doctor can drain
fluid with a needle, but that may not
be necessary if the cyst isn't causing
discomfort.

Fibroadenomas

Fibroadenomas are solid,
rubbery masses made up
of connective and glandular tissue.
They're most common in women
in their 20s and 30s, but they can be

Breast Lump Research Study
UVA is seeking participants for a study (IRB #19437) testing an investigational technique to treat fibroadenomas without surgery. Learn more at
uvahealth.com/clinicaltrials (search "breast lump").

found in women of all ages. Some
fibroadenomas are too small to be felt,
while others are several inches wide.
If you can feel it, it may seem like a
marble within the breast.
"They can get bigger and bothersome," Baskies says.
Fibroadenomas can be diagnosed
with physical examination, possibly
augmented by an ultrasound, mammogram or biopsy.
Many doctors recommend removing fibroadenomas, especially if they
grow and change the shape of the
breast, to ensure cancer is not behind
the changes.

Mastitis

Mastitis is swelling in the
breast that's usually caused
by an infection and tends to affect
women who are breastfeeding, thanks
to clogged milk ducts and breaks in
the skin of the nipple. The infected
part of the breast can be swollen,
painful, red and warm to the touch.
A woman with mastitis may also
have a headache, fever or other flulike symptoms.
Mastitis is diagnosed based
on symptoms and treated
with antibiotics.

Intraductal
Papillomas

These wartlike tumors
grow within the milk ducts of the
breast and are made up of gland tissue, fibrous tissue and blood vessels.

ULTRASOUND
TREATMENT
FOR LUMPS
Have a bothersome lump but don't
want surgery? You may have another
option. High-intensity focused
ultrasound (HIFU) is already FDA
approved to treat several conditions,
including uterine fibroids. A small
research study at UVA has found
that this technique, which concentrates sound waves, can safely shrink
breast lumps known as fibroadenomas. The researchers presented the
study results, showing that among
20 participants:
* 4 out of 5 could no longer feel a
lump in their breast and
* All who had lump-related tenderness no longer had pain a year after a
one-time treatment.
"The study was so successful that
we've opened a larger clinical trial
(see above) with the goal of obtaining FDA approval," says David Brenin,
MD, the UVA study's lead investigator.

They're often a culprit in clear or
bloody nipple discharge, especially
if it's only coming from one breast.
Intraductal papillomas can be painful
and are sometimes felt as a small lump
near or behind the nipple.
"They can be detected two ways:
physical exam and mammogram or
ultrasound," Baskies says, and they are
often biopsied or removed. ■
S UMME R 2018

http://www.uvahealth.com/clinicaltrials

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