Lumps – Ru Bi

Diagnosis of Lumps: Discovery of lump(s) in breast(s) that are of different size, amount or shape than normal. Can have pain or no pain, can change in size w/ cycle and emotions (luteal phase = larger, follicular phase = smaller).

Patient should get mammogram, if lump is malignant it will be hard, fixed, and feel like cauliflower, there may be an inverted nipple (significantly inverted- including areola), the edge of areola may not be distinct (fades to pale orangey), pink fluids may leak, check lymph nodes (axillary, 52-53 nodes).

Etiology (causes) of Lumps: Primary cause is Liver Qi stagnation (emotional, worry a lot, depressed, sad, generally more on the down side of emotions)

1. Both Liver and Stomach Qi stagnation Blood Stasis or Phlegm stagnation.

2. Qi and Phlegm stagnation Spleen Stomach or Dampness Phlegm or/, Kidney Yang fluid metabolism Phlegm or/, Liver Qi stagnation Spleen Phlegm

3. KI Essence blood Liver blood can’t soothe Qi flow Phlegmor/, Chong and Ren are empty, external pathogenic invasion, Phlegm

Chinese Medicine Differentiation and Treatment

LR Qi stagnation can start in puberty, can change size with cycle and/or emotions, accompanied by pre-menstrual breast distension, dysmenorrhea, and infertility. Plus – Liver Qi stagnation symptoms (see Appendix 1)

Principle of Treatment: – soothe LR, regulate Qi, promote circulation to dissolve lumps

Herbal Medicine Formula: Xiao Yao San + Yu Jin, Ju He, Xia Ku Cao (dissolve hardness)

Phlegm and Qi stagnation soft lumps like a hard boiled egg (smooth), no significant pain, does not necessarily change with cycle, usually in younger women, dizziness, nausea Plus – Phlegm symptoms (see Appendix 1)

Principle of Treatment: – soothe LR, invigorate SP, eliminate Phlegm

Herbal Medicine Formula: Xiao Yao San + Hai Zao Yu Hu Tang or Gua Lou Xie Bai Ban Xia Tang

KI w/ Liver Qi stagnation chronic, small sand/bean plentiful lumps, irregular menses, infertility, dark eye circles,weak back/knees Plus – Kidney symptoms (see Appendix 1))

Principle of Treatment: – nourish KI, soothe Liver to regulate Jing Luo to dissolve lumps

Herbal Medicine Formula: Ding Jing Tang + dissolve hardness herbs (as above)