Breast Cancer - Self Examination for Early Detection

Self Examination of Breasts for early detention of Breast Cancer

Whenever we hear the word 'cancer', we always try to assure ourselves that we can never we afflicted with this deadly disease. But the irony is cancer is a silent killer goes undetected unlike a simple fever. My reason for writing this post on my blog happens to be none other then my mother, who was diagnosed with bilateral breast cancer 2 years ago, fought bravely and is on her road to recovery now. Writing this article, I feel a bit satisfied that I am able to do my little bit in spreading awareness about breast cancer amongst everyone who reads this post. My mother had a benign tumour in one of her breasts which turned malignant after 4 years. Her diagnosis was a chance diagnosis and other then lump in breast, there are few other symptoms of breast which I have briefly discussed here.

Do spare few minutes in reading this article and sharing it with every woman who matters to you. Readers may find a few pictures disturbing.

Breast cancer is the uncontrolled growth of malignant cells in a breast, as a result of mutations or abnormal changes in the genes responsible for regulating healthy growth of cells. A group of such cells constitute a tumour, which may be either benign (not dangerous to health) or malignant/dangerous. Malignant tumors in breast, unless they are classified as non-invasive, have a tendency to spread beyond original tumor site to other parts of the body.

Anatomy of Breast

 
A Ducts
B Lobules
C Dilated section of duct to hold milk
D Nipple
E Fat
F Pectoralis major muscle
G Chest wall/rib cage

Enlargement
A Normal duct cells
B Basement membrane
C Lumen (center of duct)

Breast cancer is mainly of two types:

• Ductal carcinoma - Cancer which occurs in milk ducts; and
• Lobular carcinoma - Cancer occurs in the milk secreting breast lobules

Breast cancer can further be divided into following types, depending upon its tendency to spread to different parts of body. These types can be classified as:

• In-situ breast cancer - The cancer cells remains confined within their place of origin and do not attack surrounding breast tissue; and
• Invasive or metastatic breast cancer - The cancer cells, apart their place of origin, spread to different parts of the body.

Breast Cancer Symptoms: Following abnormalities in the breast anatomy are suggestive breast cancer symptoms:

• ·         Unusual swelling of all or one specific part of the breast
• ·         Continuous skin irritation or dimpling
• ·         Persisting pain in breast
• ·         Persisting nipple pain or inversion of nipple
• ·         Inflammation or thickening of the nipple or breast skin
• ·         An unusual discharge from the nipple other than breast milk
• ·         Lump in the breast or underarm area

Few images of possible symptoms of Breast Cancer:

Inverted Nipple

A Graphic image of tumor in Breast

Pain or unusual swelling in Breast

Causes of Breast Cancer: 

The definite cause(s) of breast cancer are not known, but primarily the following causes have been attributed to cause breast cancer: 

• Age factor: The risk of developing breast cancer increases as a woman gets older. A majority of breast cancer cases are found in women over age 50. 16% of women aged between 40-60 years have breast-related problems, and complain of breast lumps. These breast lumps may carry a potential breast cancer risk.

• Genetic factors: Presence of breast cancer genes BR CA1 and BR CA2 in chromosomes increases the chance of developing either breast or ovarian cancer, or both, by 85%.

• Family History: A family history of breast cancer or any other cancer, increases a woman’s risk of developing breast cancer by 3 to 5 times. If a close relative was diagnosed with breast, uterine, ovarian, or colon cancer, the chances of breast cancer are more. About 20 - 30% of women with breast cancer have a family history of disease. Both maternal and paternal relatives are important. The risk is highest if the affected relative developed breast cancer at a young age, had cancer in both breasts, or if she is a close relative. First-degree relatives, (mother, sister, daughter) are most important in estimating risk and second-degree relatives (grandmother, aunt) with breast cancer may also increase risk. Breast cancer in a male increases the risk for all his close female relatives. Having relatives with both breast and ovarian cancer also increases a woman's risk of developing breast cancer.

• Hormonal disturbances and imbalance: Woman who do not bear children or bear children at a late age are at increased risk to developing breast cancer. Similarly, women who started their menstrual periods before age 12 and women reached menopause after age 55, are also at an increased risk of developing breast cancer. Oral contraceptives are known to increase the risk for breast cancer as they increase production of estrogen hormone in female body. Similarly, post menopausal women who who were on estrogen and progesterone for several years were increased to risk of breast cancer. 

Breast Self Examination: 

Coming back to self examination for early detection of breast cancer, every woman from age 20, should herself physically examine her breasts monthly.  Breast self examination is a very simple procedure to detect any changes/abnormalities in the breast. I came across this comprehensive procedure along with graphic images for Breast Self Examination on www.breastcancer.org and I have reproduced the same below:

Step 1: Begin by looking at your breasts in mirror with your shoulders straight and your arms on your hips. Here's what you should look for:

• Breasts that are their usual size, shape, and color. 
• Breasts are evenly shaped without ANY visible distortion or swelling.              

Step 1

                              

If you see any of the following changes, bring them to your doctor's attention:

• dimpling, puckering, thickening or bulging of the skin.
• a nipple that has changed position or an inverted nipple (pushed inward instead of sticking out).
• redness, soreness, rash, or swelling. 

Step 2: Raise your arms and look for the same changes as described in Step 1.

Step 2

Step 3: While you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).  

Step 3

Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.

Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage. 

Step 4

Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in Step 4.

Any changes/abnormalities noticed during Breast Self examination should be immediately brought to notice of a medical practitioner/doctor. However, every lump or any other symptoms above described are not necessarily malignant tumors, but should be immediately examined by a doctor. 

Step 5

Apart from Breast self examination, early detection involves:

·         Clinical breast exams by a medical professional

·         Screening mammography

·         Mammography, Breast MRI and Breast Ultrasound to help identify the breast lump

·         Breast ultrasound to show whether the lump is solid or fluid-filled

·         Breast biopsy, needle aspiration, or breast lump removal to remove all or part of the breast lump

·         CT scan

·         Sentinal lymph node biopsy

·         PET scan

 

Most experts recommend that women of age 20 and above should examine their breasts once a month during the week following the menstrual period. Women between the ages 20 and 39 should have a doctor examine their breasts at least once every 3 years.

After age 40:

• Women of age 40 years and older should have a mammogram every 1 - 2 years, depending on their risk factors. Women should call their doctor immediately if they notice in change in their breasts whether or not they do routine breast self-exams.
• Women of age 40 years and older should have a complete breast exam by a doctor every year.

Disclaimer: This article is not intended to provide medical advice in any manner and is meant only to create awareness among readers for early detection of Breast Cancer. A substantial amount of information including images provided in this article is procured from www.breastcancer.org.