FINDING A LUMP - Full extract 

No matter in which part of your body you find a lump, it can be a rather scary experience. All sorts of possibilities come to mind, such as whether it could be cancer. Although most lumps we see in general practice are not due to anything sinister, they should all be checked. 

GP's see lots of lumps every day. We see lumps in the neck, lumps in the breast, lumps in the groin, lumps around the bottom, even lumps on testicles. As medical students we had a lot of clinical teaching on lumps. Under the watchful eye of our teachers we were taught to feel lumps, measure them, identify where they arose from, and even shine torches through them to see if they contained fluid. 

These are just some of the lumps we see... 

Lymph glands   in the neck are the most common. They enlarge with ear infections and tonsillitis as part of the normal immune response to help combat and localize infection. They may also enlarge in areas like the groin if there has been an infection on the foot or leg. At times enlarged lymph glands can also indicate a more serious health problem. 

Sebaceous cysts   arise from oil glands in the skin that have become blocked and turned into walled-off cysts. They occur in hair-bearing areas like the armpits and scalp and they vary in size from a grain of wheat to a golf ball. They do not require removal unless they continually become infected or they are unsightly. 

Ganglions   are a different type of cyst, occurring on areas like the back of the wrist or the ankle. They are caused by degeneration around a tendon sheath or a joint capsule and they contain lubricating fluid. In days gone by, people used give them a whack with the family bible and some disappeared. No doubt quite a few wrists and ankles were injured in the process and this method of treatment is not advised. Ganglions are usually only removed if they are causing pain. 

Lipomas    are soft lumps of fatty tissue that occur on any part of the body and are of little significance. 

Breast lumps   are very common and cause a lot of anguish when they are found. Frequently they turn out to be cysts or areas of hormonal breast change called fibroadenosis. However, any lump that persists requires specialist assessment and biopsy, regardless of mammogram findings; the mammogram is a useful test but a normal result cannot be relied upon if a lump persists. Women should carefully examine their breasts at least once a month; if in doubt they should ask their doctor to demonstrate how it is done. Fortunately, screening mammograms are now available. Women with a family history of breast cancer should make a point of seeing their doctor for regular breast examinations and mammograms. 

Hernias    often appear as a lump in the groin. They may occur after lifting or straining and are more obvious when standing. They are due to a protrusion of bowel through a weak spot in the lower part of the abdominal wall. Because a loop of bowel may become caught, referral to a specialist is usually arranged in case a repair operation is necessary. 

Testicle and scrotal swellings   deserve a special mention. Most men go through life trying to keep their testicles out of harm's way. Yet very few regularly feel and examine their testicles for lumps. If you are not sure what you should be feeling, ask your doctor. Besides cysts and collections of fluid, cancer of the testicle can also occur. Although treatment has vastly improved in recent years, early diagnosis always offers the best outcome. 

Health tips: 
* If you are not sure about any lump, wherever it is, get it checked.

* Mammograms are a very useful examination. However, any breast lump that persists requires specialist assessment, and in most cases, removal for pathology testing. 

* Men, don't be shy about it; learn how to examine your testicles.

Dr. Andrew Pattison: Common Consultations
North East Valley Division General Practice, Melbourne, Australia.   Disclaimer
  - Last modified: August 18, 2001