July 22, 2023

1400H - 1500H
Via Zoom

Empowerment
objective - for
laypeople to have an
When to say
essential
you have a
understanding of
breast mass?
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
 July 22, 2023
1400H - 1500H
Via Zoom
Welcome all!

MUTE yourself but always

Empowerment show your video picture.
objective - for
Sign in your name, FB
laypeople to have an
When to say account, or email address in
essential the Chat Box! Include names
you have a of companions attending.
understanding of
breast mass?
“WHEN TO SAY YOU Use the Chat Box to ask
questions and make
HAVE A BREAST comments while the PEP TALK
is on.
MASS” in their
health management. There will be group pictures
at start and end of PEP TALK –
show your face in video.
Reminder after the PEP
Talk:

Take the Online Learning

cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.

Link is in Chat Box.

Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation
 ROJOSON’S REQUEST:
Empowerment
objective - for FEEDBACK TO THIS
laypeople to have an PEP TALK!
When to say
essential
you have a Pls. type in your
understanding of feedback in the chat
breast mass?
“WHEN TO SAY YOU box during the open
HAVE A BREAST forum and before we
MASS” in their adjourn!
health management.
Thank you!
 LET’S NOW HAVE A
GROUP PICTURE
Empowerment TAKING BEFORE WE
objective - for START PEP TALK
laypeople to have an PROPER IN 2
When to say MINUTES!
essential
you have a
understanding of
breast mass? Pls. turn on your
“WHEN TO SAY YOU video!
HAVE A BREAST Show your face!
MASS” in their
health management.
 Empowerment ROJoson PEP Talk
objective - for
laypeople to have an I have a Patient
When to say Empowerment
essential
you have a Program in which I
understanding of
breast mass? like to empower the
“WHEN TO SAY YOU lay people or
HAVE A BREAST patients to take
MASS” in their control in the
health management. management of
their health.
I started the PEP Talk
on May 15, 2021.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
 From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer depending on
our enthusiasm,
discipline and
perseverance.
 Empowerment
objective - for
My PEP TALK today is
laypeople to have an
When to say entitled:
essential
you have a When to say you
understanding of
breast mass? have a breast
“WHEN TO SAY YOU
HAVE A BREAST mass?
MASS” in their
health management.
 Contents
• When to say you have a breast mass?
When to say • What to do after you have discovered you
Disclaimer:
you have a have a breast mass?
ROJoson PEP Talk
breast mass? • What to expect from a breast specialist after
contains ROJoson’s
you have consulted him/her for a breast
Thoughts,
mass?
Perceptions,
Opinions and
Recommendations
(TPORs) culled from
experiences of other
professionals and
ROJoson.
 Emphasis of PEP Talk:
How to recognize the presence of a real breast
When to say mass during breast self-examination
Disclaimer:
you have a (emphasizing the importance of BSE)
ROJoson PEP Talk
breast mass? and
contains ROJoson’s
then what to do thereafter, relying on the
Thoughts,
expertise of a breast specialist who will give
Perceptions,
advice accordingly and with informed consent
Opinions and
(emphasizing the importance of a breast
Recommendations
specialist)
(TPORs) culled from
experiences of other
NOT to jump to diagnostic tests without prior
professionals and
BSE and Breast Specialist’s advice.
ROJoson.
 When to say you have a breast mass?
When to say Thus, both males and
First of all, all human beings have breasts - have
you have a females can have a
breast tissues including males.
breast mass
breast mass?
developing in their
The breast tissues of males are usually “dormant”
breasts, though
and remain small or flat throughout their lifetime.
uncommon in males.
While breast tissues of females are usually
“active” and increase in size over time,
particularly during puberty and adolescence.
Once they reach full size, they stop growing in size
after adolescence, usually about 18 years old.
 When to say you have a breast mass?
When to say Both male and female breasts can have 2 general
you have a categories of unusual development:
breast mass?
1. Hormonal changes causing hypertrophy
(enlargement) and atrophy (decreased in
size)
2. Tumor or mass formation which can either be
cancer or not cancer
 Illustrations of hypertrophy (enlargement) and
atrophy (decreased in size)
When to say
you have a
breast mass?

Progressive enlargement – part of normal development

Atrophy – part of normal development – AGING

 Illustrations of hypertrophy (enlargement) and
atrophy (decreased in size) This is normal as long as there is
When to say
you have a NO associated underlying MASS
in / on the breasts.
breast mass?

Progressive enlargement – part of normal development

Atrophy – part of normal development – AGING

 Illustrations of hypertrophy (enlargement) and
atrophy (decreased in size) If there is an underlying mass
When to say
you have a in / on the breasts, then it is
considered ABNORMAL.
breast mass?

Progressive enlargement – part of normal development

Atrophy – part of normal development – AGING

 When to say you have a breast
mass?
When to say
you have a A breast “mass” is something
breast mass? unusual to the point of being
abnormal.

One has to differentiate the

so-called “lumpy” breast
tissue from a “dominant”
mass when we talk of
palpation looking for a breast
“mass.”
 In palpation, one has to
differentiate “lumpy” breast
When to say
tissues from a real mass which is
you have a medically called “dominant” mass
breast mass? (a more-or-less round or oval
hump with a feel that is different
from the surrounding normal
breast tissues). If there is
palpated dominant mass,
automatically it is considered as a
red flag (for further investigation
as it signifies an abnormality).
 To look for a
“dominant” mass
When to say
or to distinguish it
you have a from a “lumpy”
breast mass? breast tissue,

use the flats of the

fingers to palpate
and not the tips of
the fingers to
palpate.
 If a “dominant”
When to say
mass is felt, one
you have a can now use the
breast mass? tips of the fingers
to determine the
characteristics of
the mass in terms
of size, nature,
consistency,
border, fixation,
etc.
When to say
you have a A “dominant” mass
can usually be
breast mass?
palpable if it is one
cm or more.

Less than one cm,

the dominant mass
is usually not
palpable.
 SO, when to say you have a
breast mass on breast
When to say palpation?
you have a
breast mass? When you found on
palpation, there is a
“dominant” mass
which you think is not
a lumpy breast surface.
 SO, when to say you have a
breast mass on breast
When to say palpation?
you have a
breast mass? When you found on
palpation, there is a
“dominant” mass
which you think is not
a lumpy breast surface. This goes to show that a BREAST SELF-
EXAMINATION (BSE) will be able to tell
whether you have a breast mass or not.
SO DO monthly BSE.
 Another situation in which you
can say you have a breast mass
When to say is when a physician palpates
you have a your breasts and found a
breast mass? “dominant mass” in/on your
breast/s. (so-called “clinical
breast examination”)

Again, it should be a “dominant

mass” to be a “real” mass (not
lumpy breast surface).
 Still another situation in which you can say you
have a breast mass is when diagnostic tests
When to say (imaging procedures such as ultrasound and
you have a mammogram) show there is/are suspected or
breast mass? evident breast mass/es.
 Still another situation in which you can say you
have a breast mass is when diagnostic tests
When to say (imaging procedures such as ultrasound and
you have a mammogram) show there is/are suspected or
breast mass? evident breast mass/es.
 Still another situation in which you can say you
have a breast mass is when diagnostic tests
When to say (imaging procedures such as ultrasound and
you have a mammogram) show there is/are suspected or
breast mass? evident breast mass/es.
 Still another situation in which
you can say you have a breast
When to say mass is when diagnostic tests
you have a (imaging procedures such as
breast mass? ultrasound and mammogram)
show there is suspected or
evident breast mass/es.
 SO, when to say you have a breast mass?
When to say • You did a BREAST SELF-EXAM and unfortunately,
you have a you palpated a dominant mass or masses.
breast mass?
• You consulted a physician and unfortunately,
he/she palpated a dominant breast mass or
masses.

• You subjected yourself to imaging diagnostic tests

(such as ultrasound and mammogram) and
unfortunately, the radiologist reported presence
of breast mass or masses.
 SO, what’s NEXT after you have discovered a “dominant Reminders:
breast mass” in your monthly breast self-examination?
When to say You should
you have a GO SEE A BREAST SPECIALIST RIGHT AWAY! know how to
breast mass? do BREAST
A breast specialist in the Philippines at the present time is SELF-EXAM.
a general surgeon who has extensive training on breast
palpation, operation, and other forms of treatment. You should
do MONTHLY
DO NOT HAVE IMAGING PROCEDURES DONE WITHOUT breast self-
SEEING A BREAST SPECIALIST WHO WILL PALPATE YOUR examination.
BREASTS TO VERIFY YOUR FINDINGS. They may not be
necessary after the breast specialist’s examination!
 What if the breast specialist did NOT
confirm your finding of a dominant
When to say breast mass. He/she says there is
you have a NO dominant breast mass. What
breast mass? will he /she usually do?
He/she will make a DIAGNOSIS
statement based primarily on
his/her physical examination
findings and if needed, symptom
data. Then, he/she will make
recommendations on what to do
next.
Scenario 1.1: Breast specialist
management
DIAGNOSIS: NO dominant mass, R / L
breasts; FIBROCYSTIC CHANGES; normal
breast findings.
MANAGEMENT: explanation of findings &
diagnosis; allayance of fear and anxiety;
queries answered; informed consent for
decided treatment obtained.
RECOMMENDATIONS: observe and do
further self-monitoring; do monthly breast
self-examination; return for follow-up
advice; no need for diagnostic tests.
 What if the breast specialist did NOT
confirm your finding of a dominant
When to say breast mass. He/she says there is
you have a NO dominant breast mass. What
breast mass? will he /she usually do?
He/she will make a DIAGNOSIS
statement based primarily on
his/her physical examination
findings and if needed, symptom
data. Then, he/she will make
recommendations on what to do
next.
Scenario 1.2: Breast specialist
management
DIAGNOSIS: NO dominant mass, R / L
breasts; FIBROCYSTIC CHANGES; normal
breast findings; “mass” pointed to by
patient is a prominent RIB.
MANAGEMENT: explanation of findings &
diagnosis; allayance of fear and anxiety;
queries answered; informed consent for
decided treatment obtained.
RECOMMENDATIONS: observe and do
further self-monitoring; do monthly
breast self-examination; return for follow-
up advice; no need for diagnostic tests.
 What if the breast specialist
CONFIRMS your finding of a
When to say dominant breast mass, what
you have a will he /she usually do?
breast mass?
He/she will make a
DIAGNOSIS statement based
primarily on his/her physical
examination findings and if
needed, symptom data.
Then, he/she will make
recommendations on what to
do next.
Scenario 2.1: Breast specialist management
DIAGNOSIS: Breast mass, right; FIBROADENOMA.
MANAGEMENT: explanation of findings &
diagnosis; options for further management and
treatment given; allayance of fear and anxiety;
queries answered; informed consent for decided
treatment obtained.
Options for further management / treatment:
• Observe and monitor; do monthly BSE
• Needle biopsy
• Excision-biopsy
• Ultrasound prior to biopsy and excision
• Others
 What if the breast specialist
CONFIRMS your finding of a
When to say dominant breast mass, what
you have a will he /she usually do?
breast mass?
He/she will make a
DIAGNOSIS statement based
primarily on his/her physical
examination findings and if
needed, symptom data.
Then, he/she will make
recommendations on what to
do next.
Scenario 2.2: Breast specialist management
DIAGNOSIS: Breast mass, right; BREAST CANCER.
MANAGEMENT: explanation of findings &
diagnosis; options for further management and
treatment given; allayance of fear and anxiety as
indicated; queries answered; informed consent
for decided treatment obtained.
Options for further management / treatment:
• Biopsy (needle aspiration; core-needle;
others)
• Ultrasound prior to biopsy and excision
• Surgery
• Chemotherapy
• Radiotherapy
• Others
 What if diagnostic tests are
done (in the presence of a
When to say dominant mass), what will
you have a the breast specialist usually
breast mass? do next?
He/she will make a
DIAGNOSIS statement based
on all the accumulated data
on hand. Then, he/she will
make recommendations on
what to do next.
Scenario 3.1: Breast specialist management
DIAGNOSIS: Breast mass, right; BENIGN;
FIBROADENOMA
MANAGEMENT: explanation of findings &
diagnosis; options for further management and
treatment given; allayance of fear and anxiety as
indicated; queries answered; informed consent
for decided treatment obtained.
Options for further management / treatment:
• Biopsy (needle aspiration; core-needle;
others)
• Surgery
• Watchful waiting
• Others
 What if diagnostic tests are
done (in the presence of a
When to say dominant mass), what will
you have a the breast specialist usually
breast mass? do next?
He/she will make a
DIAGNOSIS statement based
on all the accumulated data
on hand. Then, he/she will
make recommendations on
what to do next.
Scenario 3.2: Breast specialist management
DIAGNOSIS: Breast mass, right; BREAST CANCER.
MANAGEMENT: explanation of findings &
diagnosis; options for further management and
treatment given; allayance of fear and anxiety as
indicated; queries answered; informed consent
for decided treatment obtained.
Options for further management / treatment:
• Biopsy (needle aspiration; core-needle;
others)
• Surgery
• Chemotherapy
• Radiotherapy
• Others
 What if diagnostic tests are
done (in the absence of a
When to say dominant mass), what will
you have a the breast specialist usually
breast mass? do next?
He/she will make a
DIAGNOSIS statement based
on all the accumulated data
on hand. Then, he/she will
make recommendations on
what to do next.
Scenario 4.1: Breast specialist management
DIAGNOSIS: NO dominant mass, R / L breasts;
FIBROCYSTIC CHANGES; normal breast findings.
MANAGEMENT: explanation of findings &
diagnosis; allayance of fear and anxiety; queries
answered; informed consent for decided
treatment obtained.
RECOMMENDATIONS: observe and do further
self-monitoring; do monthly breast self-
examination; return for follow-up advice; advice
on further diagnostic tests as indicated.
 What if diagnostic tests are
done (in the absence of a
When to say dominant mass), what will
you have a the breast specialist usually
breast mass? do next?
He/she will make a
DIAGNOSIS statement based
on all the accumulated data
on hand. Then, he/she will
make recommendations on
what to do next.
Scenario 4.2: Breast specialist management
DIAGNOSIS: NO dominant mass, R / L breasts;
SUSPICIOUS FOR BREAST CANCER, LEFT.
MANAGEMENT: explanation of findings &
diagnosis; options for further management and
treatment given; allayance of fear and anxiety as
indicated; queries answered; informed consent
for decided treatment obtained.
Options for further management / treatment:
• Biopsy (mammo- or ultrasound-guided)
• Repeat tests
• Do additional tests
• Others
 SO, when to say you have a breast mass? Summary
When to say Take Away
• You did a BREAST SELF-EXAM and unfortunately,
you have a you palpated a dominant mass or masses.
breast mass?
• You consulted a physician and unfortunately,
he/she palpated a dominant breast mass or
masses.

• You subjected yourself to imaging diagnostic tests

(such as ultrasound and mammogram) and
unfortunately, the radiologist reported presence
of breast mass or masses.
 SO, when to say you have a Summary
breast mass? Take Away
When to say
you have a • To ensure validity of your
breast mass? finding of a breast mass on
BREAST SELF-EXAM, make
sure to differentiate lumpy
breast surface from dominant
mass.
 SO, when to say you have a breast mass? Summary
Take Away
When to say Once you palpated a dominant breast mass, GO
you have a SEE A BREAST SPECIALIST RIGHT AWAY!
breast mass?

DO NOT HAVE IMAGING PROCEDURES DONE

WITHOUT SEEING A BREAST SPECIALIST WHO
WILL PALPATE YOUR BREASTS TO VERIFY YOUR
FINDINGS. They may not be necessary after the
breast specialist’s examination!
 SO, when to say you have a breast mass? Summary
Take Away
When to say On first consult, the breast specialist will
you have a examine you thoroughly and as accurately as
breast mass? possible.

He/she will make a DIAGNOSIS statement

initially based primarily on his/her physical
examination findings and if needed, symptom
data. Then, he/she will make recommendations
on what to do next, particularly whether you
you need diagnostic tests or not, and which one.
 SO, when to say you have a breast mass? Summary
Take Away
When to say On subsequent consults, especially if diagnostic
you have a tests are done, the breast specialist will make a
breast mass? DIAGNOSIS statement based on all the
accumulated data on hand. Then, he/she will
make recommendations on what to do next,
particularly on the treatment.
 Contents Summary
When to say • When to say you have Take Away Disclaimer:
you have a a breast mass?
• What to do after you ROJoson PEP Talk
breast mass?
have discovered you contains ROJoson’s
have a breast mass? Thoughts,
• What to expect from Perceptions,
a breast specialist Opinions and
after you have Recommendations
consulted him/her for (TPORs) culled from
a breast mass? experiences of other
professionals and
ROJoson.
 Emphasis of PEP Talk:
How to recognize the presence of a real breast
When to say mass during breast self-examination
Disclaimer:
you have a (emphasizing the importance of BSE)
ROJoson PEP Talk
breast mass? and
contains ROJoson’s
then what to do thereafter, relying on the
Thoughts,
expertise of a breast specialist who will give
Perceptions,
advice accordingly and with informed consent
Opinions and
(emphasizing the importance of a breast
Recommendations
specialist)
(TPORs) culled from
experiences of other
NOT to jump to diagnostic tests without prior
professionals and
BSE and Breast Specialist’s advice.
ROJoson.
 Be always in touch with reliable medical Take Away in
When to say information on how to recognize presence relation to
you have a of a BREAST MASS and what to do Patient
breast mass? thereafter. Empowerment
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions /
make better decisions on recognizing real
BREAST MASS and what to do thereafter.
 Empowerment
objective - for
laypeople to have an
When to say
essential
you have a
understanding of
breast mass?
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
 July 22, 2023
1400H - 1500H
Via Zoom
Welcome all!

MUTE yourself but always

Empowerment show your video picture.
objective - for
Sign in your name, FB
laypeople to have an
When to say account, or email address in
essential the Chat Box! Include names
you have a of companions attending.
understanding of
breast mass?
“WHEN TO SAY YOU Use the Chat Box to ask
questions and make
HAVE A BREAST comments while the PEP TALK
is on.
MASS” in their
health management. There will be group pictures
at start and end of PEP TALK –
show your face in video.
Reminder after the PEP
Talk:

Take the Online Learning

cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.

Link is in Chat Box.

Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation
 ROJOSON’S REQUEST:
Empowerment
objective - for FEEDBACK TO THIS
laypeople to have an PEP TALK!
When to say
essential
you have a Pls. type in your
understanding of feedback in the chat
breast mass?
“WHEN TO SAY YOU box during the open
HAVE A BREAST forum and before we
MASS” in their adjourn!
health management.
Thank you!
 LET’S NOW HAVE A
GROUP PICTURE
Empowerment TAKING BEFORE WE
objective - for START Q&A AND
laypeople to have an INTERACTIONS!
When to say
essential
you have a Pls. turn on your
understanding of
breast mass? video!
“WHEN TO SAY YOU Show your face!
HAVE A BREAST
MASS” in their
health management.