Dr Lucienne van Schalkwyk

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Services includes :

• Breast pain
  Breasts mature over time due to the release of oestrogen. During menstruation, the release of specific hormones leads to variations in the breast’s tissue. Also, breasts are incredibly sensitive and become painful during menstruation. We refer to menstrual breast pain as cyclical pain. Non-cyclical breast pain may arise due to trauma but is more challenging to identify as compared to cyclical pain. Breast pain occurs as a result of hormonal fluctuations or due to cysts. Anovulation happens when fat replaces breast tissue. Fibrocystic breasts feel lumpy and are tender.
• Nipple discharge
  Nipple discharge is liquid that exits the nipple. The discharge comes out of the nipple either by force or on its own. Usually, nipple discharge isn't severe, but it could be a symptom of breast cancer. It’s crucial to receive a thorough diagnosis to find out the reason for nipple discharge. The doctor will discuss the different types of nipple discharge to check whether the condition warrants an additional diagnosis. A yellow or white cloudy discharge is often a sign of a nipple or breast infection. Green nipple discharge is a sign of cyst. A cheese-like, brown discharge is a symptom of a blocked milk duct. A clear or bloody discharge is concerning and requires urgent medical care.
• Breast mass/lump
  Although most breast lumps are not severe, it still needs to be checked out. A breast lump is a noticeable bulge in the breast that feels different from the rest of the tissue. Both females and males are prone to breast lumps. A breast lump could be a sign of infection, a cyst, fibroadenoma, fat necrosis or trauma. The only way to find the cause of a breast lump is to have it checked out. The doctor will conduct an ultrasound scan or mammogram to identify the breast lump.
• A change in size or shape of breasts
  Pregnancy, age, genetics and hormonal fluctuations contribute to the change in size or shape of breasts. Naturally, different breast shapes range from round, bell-shaped, conical, teardrop and asymmetrical. The areola is a dark ring of tissue that surrounds the nipple. A set of areolae are never the same-it can be tan or pink and differ in texture. Also, pregnancy and breastfeeding influence the change in the size and shape of the areolae.
• Change in breast skin
  A change in breast skin may arise due to a variety of conditions such as eczema, sunburn, rash and psoriasis. Variations in breast skin could also be a sign of inflammatory breast cancer. The breast skin will begin to thicken, dimple or become red. It’s vital to take note of any changes such as nipple discharge, nipple retraction or red skin as these are all signs of breast cancer. It’s crucial to get the doctor to check out any abnormalities like orange-peel skin or a rash close to the nipple.
• Nipple retraction
  A nipple retracts as soon as it turns inward. Unlike an inverted nipple, a retracted nipple doesn't stand up but instead leans against the areola. A nipple can retract when it's suckled on or cold. Ageing, Paget's disease and mammary duct ectasia cause the nipples to retract. Nipple retraction could also be a sign of breast cancer. Carcinoma is confirmed through a mammogram. Usually, nipple retraction isn't something to be concerned about because some people are born with retracted nipples. It is, however, essential to check it out thoroughly to prevent other related complications.
• Nodularity of breasts
  Lumps tend to form in the breasts and armpit. Changes in the breast in terms of size, colour and texture are often signs of breast cancer. The doctor examines the patient’s breasts to check for lumps, nipple discharge or bloody discharge. A breast examination, ultrasound scan, mammogram and biopsy determine if the patient has breast cancer. A breast lump could also be a benign fibroadenoma or cyst. The doctor first needs to identify the breast lump before she decides on a suitable treatment plan.
• Axillary lymphadenopathy or axillary glands
  Axillary lymphadenopathy increases the size of lymph nodes. Swelling may occur in one or a few of the 20-40 lymph nodes in the armpits. Inflamed axillary gland lymph nodes vary in size from that of a pea to a grape. The lymph nodes are either soft or hard. Other symptoms of this condition include redness, inflammation, fever and fatigue. The doctor first needs to find out the size, location and how many lymph nodes are affected.
• Breast abscesses/cysts
  A breast abscess is an accumulation of pus in a specific region of the breast. Symptoms of a breast abscess include red and inflamed breasts as well as a lump in the breast. Breast abscesses are signs of a breast infection. The doctor performs an ultrasound scan to locate an abscess. She cuts the skin or uses a tiny needle to drain the abscess. The patient returns home on the day of the procedure and takes antibiotics for a week or so. The abscess should heal within days or a week.
• Intraductal papilloma & multiple papillomatosis
  Intraductal papilloma is a lump about the size of a wart in the milk duct. Multiple papillomatosis occurs when five or more of these lumps form in a portion of the breast. This lump is near the nipple but can develop in other parts of the breast. Women over forty are more susceptible to intraductal papilloma. As women age, their breasts change. Although it's rare, men can also get intraductal papilloma. Signs of intraductal papilloma include a tiny lump and bloody or clear nipple discharge. Generally, intraductal papilloma isn't painful, but some women may experience pain their breasts. To diagnose intraductal papilloma, the doctor carries out an ultrasound, mammogram or biopsy.
• Fibrocystic breast disease
  Fibrocystic breast disease is a benign condition that happens when the breasts feel lumpy. Even though fibrocystic breast disease is harmless, it can become uncomfortable and concerning for some women. Because of fibrocystic breast disease, the diagnosis for breast cancer becomes more challenging to complete. Breast tissue adapts in its response to hormones that are released by the ovaries. Because of fibrocystic breast disease, the breast begins to swell and lumps form in the tissue.
• Breastfeeding related issues
  Breast engorgement and sore nipples are common breastfeeding issues. Nipples become sore when the baby isn't positioned accurately. The pain only gets worse over time, and that’s why it’s so important to consult with the doctor about this particular issue. Another problem is that some mothers don’t have enough breast milk to nourish their babies. Dirty wet nappies and hearing the baby swallow is a sign that he or she is feeding properly. Breast engorgement happens when the breast is filled with milk and becomes painful. Difficulty latching is another breastfeeding problem that needs to be addressed at a consultation with the doctor.
• Mastectomy
  A mastectomy is the extraction of all the breast tissue. This procedure is performed to treat breast cancer or ensure its prevention. A mastectomy is done to remove a tumour in one or both breasts. There are different types of mastectomy as the surgeon can remove the whole breast or preserve the skin and nipple. Breast reconstruction can happen directly after a mastectomy. Usually, a mastectomy lasts for two hours but takes longer when reconstruction is done. The surgeon cuts around the nipple to remove breast tissue. Also, a sentinel lymph node biopsy is necessary to check whether cancer has spread to nearby lymph nodes.
• Lumpectomy
  A lumpectomy is the dissection of a malignant lump from breast tissue. Not all breast lumps are cancerous, but a biopsy can help confirm this. A lumpectomy also removes benign bumps to restore the appearance of the breast. A lumpectomy is a quick 30-minute procedure that’s performed under general anaesthesia. First, the surgeon needs to mark the area where the lump is present. After the area is marked, the surgeon removes the lump along with a margin of tissue. A sentinel lymph node biopsy helps find out whether cancer has spread.
• Preventative mastectomy
  A preventative mastectomy removes one or both breasts to minimise the risk of breast cancer. Women who test positive for a particular gene mutation are likely candidates for preventative mastectomy. Women who undergo this type of procedure can choose to preserve their breast skin or nipples. Should they choose to preserve parts of the breast, reconstruction must happen after the preventative mastectomy. The surgeon dissects all of the breast tissue and drains excess blood.