One of the most important symptoms of breast diseases is the detection of a mass in the breast. The mass in the breast is either detected by the person himself or identified by the "breast surgeon" during examination or by appropriate imaging method requested from the Radiology Specialist upon clinical suspicion.
Most of the masses detected by the patient are benign. Even so, it may be perceived as a symptom of cancer and cause fear in the person. The most important task of the surgeon is to definitively determine that the detected mass is not a cancerous mass. The fact that the patient is under 40 years of age or has no risk (family history, radiation history, etc.) does not necessitate not suspecting cancer. The cellular behavioral characteristics of tumor tissue in breast cancer make a delay longer than 8 months difficult for the patient's treatment. For this reason, follow-up intervals should be determined by a general surgeon and radiological assistance should be sought when deemed necessary. We still see that our patients are satisfied with only radiological examinations (USG and mammography) and are distracted by approaches that deem surgical follow-up unnecessary.
Today, a phenomenon called the "trilogy of errors" has been described in cancer diagnosis. The components of this error triangle are;
1.The patient is in his 40s
2.He presents to the physician with a mass detected by himself and the surgeon interprets the patient's examination as normal
3. No signs of cancer are detected in the breast USG and mammography examination performed by the radiologist.
Despite this, today, many of our patients are informed that their breast diseases are monitored and treated by radiologists or family physicians, not surgeons, both on social media and written visual media. We regret to see that there are people and/or organizations that state that this should be done.
It is extremely important that a patient complaining of a mass should first consult a surgeon experienced in his field. Here, the surgeon carefully evaluates the patient's age, risks (family history, diagnosis if a previous biopsy has been performed, menstrual status, hormone exposure, radiation history, etc.) and the duration of the complaint. He then resorts to radiological imaging. Radiological image findings require a general surgeon (breast surgeon or surgical oncologist). It is carefully evaluated by the attending physician together with the physical examination findings. Afterwards, the decision for tissue diagnosis (biopsy) is made.
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