The document provides guidance on when a person should say they have a breast mass. It outlines that a breast mass should be suspected if a dominant mass is felt during breast self-examination, a physician feels a dominant mass, or diagnostic imaging shows a mass. It advises seeing a breast specialist immediately in these cases. The specialist will examine the person, make a diagnosis, and recommend next steps such as additional tests or watchful waiting if benign, or biopsy and treatment if cancer is suspected. The document aims to educate people on the importance of breast self-awareness and seeking prompt medical attention for breast masses.

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

2. When to say
you have a
breast mass?
July 22, 2023
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have an
essential
understanding of
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
Welcome all!
MUTE yourself but always
show your video picture.
Sign in your name, FB
account, or email address in
the Chat Box! Include names
of companions attending.
Use the Chat Box to ask
questions and make
comments while the PEP TALK
is on.
There will be group pictures
at start and end of PEP TALK –
show your face in video.

3. 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.

4. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

5. When to say
you have a
breast mass?
Empowerment
objective - for
laypeople to have an
essential
understanding of
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

6. When to say
you have a
breast mass?
Empowerment
objective - for
laypeople to have an
essential
understanding of
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START PEP TALK
PROPER IN 2
MINUTES!
Pls. turn on your
video!
Show your face!

7. When to say
you have a
breast mass?
Empowerment
objective - for
laypeople to have an
essential
understanding of
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

8. 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.

9. 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.

10. When to say
you have a
breast mass?
Empowerment
objective - for
laypeople to have an
essential
understanding of
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
My PEP TALK today is
entitled:
When to say you
have a breast
mass?

11. When to say
you have a
breast mass?
Contents
• When to say you have a breast mass?
• What to do after you have discovered you
have a breast mass?
• What to expect from a breast specialist after
you have consulted him/her for a breast
mass?
Disclaimer:
ROJoson PEP Talk
contains ROJoson’s
Thoughts,
Perceptions,
Opinions and
Recommendations
(TPORs) culled from
experiences of other
professionals and
ROJoson.

12. When to say
you have a
breast mass?
Disclaimer:
ROJoson PEP Talk
contains ROJoson’s
Thoughts,
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
mass during breast self-examination
(emphasizing the importance of BSE)
and
then what to do thereafter, relying on the
expertise of a breast specialist who will give
advice accordingly and with informed consent
(emphasizing the importance of a breast
specialist)
NOT to jump to diagnostic tests without prior
BSE and Breast Specialist’s advice.

13. When to say
you have a
breast mass?
When to say you have a breast mass?
First of all, all human beings have breasts - have
breast tissues including males.
The breast tissues of males are usually “dormant”
and remain small or flat throughout their lifetime.
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.
Thus, both males and
females can have a
breast mass
developing in their
breasts, though
uncommon in males.

14. When to say
you have a
breast mass?
When to say you have a breast mass?
Both male and female breasts can have 2 general
categories of unusual development:
1. Hormonal changes causing hypertrophy
(enlargement) and atrophy (decreased in
size)
2. Tumor or mass formation which can either be
cancer or not cancer

15. When to say
you have a
breast mass?
Illustrations of hypertrophy (enlargement) and
atrophy (decreased in size)
Progressive enlargement – part of normal development
Atrophy – part of normal development – AGING

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

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

18. When to say
you have a
breast mass?
When to say you have a breast
mass?
A breast “mass” is something
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.”

19. When to say
you have a
breast mass?
In palpation, one has to
differentiate “lumpy” breast
tissues from a real mass which is
medically called “dominant” 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).

20. When to say
you have a
breast mass?
To look for a
“dominant” mass
or to distinguish it
from a “lumpy”
breast tissue,
use the flats of the
fingers to palpate
and not the tips of
the fingers to
palpate.

21. When to say
you have a
breast mass?
If a “dominant”
mass is felt, one
can now use the
tips of the fingers
to determine the
characteristics of
the mass in terms
of size, nature,
consistency,
border, fixation,
etc.

22. When to say
you have a
breast mass?
A “dominant” mass
can usually be
palpable if it is one
cm or more.
Less than one cm,
the dominant mass
is usually not
palpable.

23. When to say
you have a
breast mass?
SO, when to say you have a
breast mass on breast
palpation?
When you found on
palpation, there is a
“dominant” mass
which you think is not
a lumpy breast surface.

24. When to say
you have a
breast mass?
SO, when to say you have a
breast mass on breast
palpation?
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.

25. When to say
you have a
breast mass?
Another situation in which you
can say you have a breast mass
is when a physician palpates
your breasts and found a
“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).

26. When to say
you have a
breast mass?
Still another situation in which you can say you
have a breast mass is when diagnostic tests
(imaging procedures such as ultrasound and
mammogram) show there is/are suspected or
evident breast mass/es.

27. When to say
you have a
breast mass?
Still another situation in which you can say you
have a breast mass is when diagnostic tests
(imaging procedures such as ultrasound and
mammogram) show there is/are suspected or
evident breast mass/es.

28. When to say
you have a
breast mass?
Still another situation in which you can say you
have a breast mass is when diagnostic tests
(imaging procedures such as ultrasound and
mammogram) show there is/are suspected or
evident breast mass/es.

29. When to say
you have a
breast mass?
Still another situation in which
you can say you have a breast
mass is when diagnostic tests
(imaging procedures such as
ultrasound and mammogram)
show there is suspected or
evident breast mass/es.

30. When to say
you have a
breast mass?
SO, when to say you have a breast mass?
• You did a BREAST SELF-EXAM and unfortunately,
you palpated a dominant mass or masses.
• 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.

31. When to say
you have a
breast mass?
SO, what’s NEXT after you have discovered a “dominant
breast mass” in your monthly breast self-examination?
GO SEE A BREAST SPECIALIST RIGHT AWAY!
A breast specialist in the Philippines at the present time
is a general surgeon who has extensive training on breast
palpation, operation, and other forms of treatment.
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!
Reminders:
You should
know how to
do BREAST
SELF-EXAM.
You should
do MONTHLY
breast self-
examination.

32. When to say
you have a
breast mass?
What if the breast specialist did NOT
confirm your finding of a dominant
breast mass. He/she says there is
NO dominant breast mass. What
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.

33. When to say
you have a
breast mass?
What if the breast specialist did NOT
confirm your finding of a dominant
breast mass. He/she says there is
NO dominant breast mass. What
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.

34. When to say
you have a
breast mass?
What if the breast specialist
CONFIRMS your finding of a
dominant breast mass, what
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 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

35. When to say
you have a
breast mass?
What if the breast specialist
CONFIRMS your finding of a
dominant breast mass, what
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 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

36. When to say
you have a
breast mass?
What if diagnostic tests are
done (in the presence of a
dominant mass), what will
the breast specialist usually
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

37. When to say
you have a
breast mass?
What if diagnostic tests are
done (in the presence of a
dominant mass), what will
the breast specialist usually
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

38. When to say
you have a
breast mass?
What if diagnostic tests are
done (in the absence of a
dominant mass), what will
the breast specialist usually
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.

39. When to say
you have a
breast mass?
What if diagnostic tests are
done (in the absence of a
dominant mass), what will
the breast specialist usually
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

40. When to say
you have a
breast mass?
SO, when to say you have a breast mass?
• You did a BREAST SELF-EXAM and unfortunately,
you palpated a dominant mass or masses.
• 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.
Summary
Take Away

41. When to say
you have a
breast mass?
SO, when to say you have a
breast mass?
• To ensure validity of your
finding of a breast mass on
BREAST SELF-EXAM, make
sure to differentiate lumpy
breast surface from dominant
mass.
Summary
Take Away

42. When to say
you have a
breast mass?
SO, when to say you have a breast mass?
Once you palpated a dominant breast mass, GO
SEE A BREAST SPECIALIST RIGHT AWAY!
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!
Summary
Take Away

43. When to say
you have a
breast mass?
SO, when to say you have a breast mass?
On first consult, the breast specialist will
examine you thoroughly and as accurately as
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.
Summary
Take Away

44. When to say
you have a
breast mass?
SO, when to say you have a breast mass?
On subsequent consults, especially if diagnostic
tests are done, the breast specialist will make a
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.
Summary
Take Away

45. When to say
you have a
breast mass?
Contents
• When to say you have
a breast mass?
• What to do after you
have discovered you
have a breast mass?
• What to expect from
a breast specialist
after you have
consulted him/her for
a breast mass?
Disclaimer:
ROJoson PEP Talk
contains ROJoson’s
Thoughts,
Perceptions,
Opinions and
Recommendations
(TPORs) culled from
experiences of other
professionals and
ROJoson.
Summary
Take Away

46. When to say
you have a
breast mass?
Disclaimer:
ROJoson PEP Talk
contains ROJoson’s
Thoughts,
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
mass during breast self-examination
(emphasizing the importance of BSE)
and
then what to do thereafter, relying on the
expertise of a breast specialist who will give
advice accordingly and with informed consent
(emphasizing the importance of a breast
specialist)
NOT to jump to diagnostic tests without prior
BSE and Breast Specialist’s advice.

47. When to say
you have a
breast mass?
Be always in touch with reliable medical
information on how to recognize presence
of a BREAST MASS and what to do
thereafter.
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.
Take Away in
relation to
Patient
Empowerment

48. When to say
you have a
breast mass?
Empowerment
objective - for
laypeople to have an
essential
understanding of
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.

49. When to say
you have a
breast mass?
July 22, 2023
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have an
essential
understanding of
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
Welcome all!
MUTE yourself but always
show your video picture.
Sign in your name, FB
account, or email address in
the Chat Box! Include names
of companions attending.
Use the Chat Box to ask
questions and make
comments while the PEP TALK
is on.
There will be group pictures
at start and end of PEP TALK –
show your face in video.

50. 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.

51. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

52. When to say
you have a
breast mass?
Empowerment
objective - for
laypeople to have an
essential
understanding of
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

53. When to say
you have a
breast mass?
Empowerment
objective - for
laypeople to have an
essential
understanding of
“WHEN TO SAY YOU
HAVE A BREAST
MASS” in their
health management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START Q&A AND
INTERACTIONS!
Pls. turn on your
video!
Show your face!