Breast Cancer : How To Check For Breast Lumps

Hola...! I've just read an article about women with breast cancer in a women magazine that I bought last week. Suddenly it reminded me of what had happened a few years back when I thought that I'm gonna have a breast cancer as I found two small lumps (like 10 & 20 cents coins) had developed under my armpit closed to my left breast. It makes me so worried when the lumps hurt me (especially when I wore bra) & it also makes me felt uncomfortable everytime I laid down with my left side. Therefore, after an advice from my hubby, I underwent few checked up at the general hospital (as an outpatient and then she - the doctor - refered me to the gynae) and they said that it was just a normal pain when my hormones changed during my menses & the lumps will be gone without my notice. So I felt relieved & happy to hear it. The doctor gave me a prescribed medicine (forgot the name) & also she adviced me to take evening primprose oil (EPO) from any pharmacies outlet. I followed her advice & the EPO did work - no lumps found after a year of checked up! Alhamdullilah.. But a few months after that the lumps were back! That time I were so worried, more worried than before as I didn't expect the lumps would appeared again. I continued consume the EPO but they were still there. After about a month suffering the pain ('stubborn me') so I decided to see the same doctor at the gynae & she refered me to the surgical specialist (a male doctor - blushing meh..). After a quite long discussion & a "blushing checked up" (luckily there was a lady nurse who accompanied me throughout the session & to watch out the doctor..hehe..), then he decided to send me to the x-ray department to do an ultrasound. During the ultrasound, unfortunately the doctor couldn't find any lumps around my both breasts & I was amazed..but that time I could still felt the pain. So after another discussions with my male specialist doctor, then they decided to send me to undergo a mamogram scan at the x-ray department during my next appoinment. To make my story short, I underwent a mamogram scan & they did find the lumps with 20 and 50 cents of sizes. And the good news was they were not a breast cancer. Alhamdulillah....I felt so relieved and happy to hear it. They were just a common breast lumps when age turn to thirty (nah kedapatan tia umur ku...hehe..) & they were harmless. The pain would came especially before getting menses & when you consumed hormones medications (in which I did).

BREAST cancer is the commonest cancer in women in most parts of the world. In Brunei alone, as I quote from the RTB news on 29th Jan 2005, the number of women who were diagnosed with Breast Cancer last year was almost doubled the number more than five years ago. This is partly attribute to the subject of breast cancer is still much a taboo or rarely discussed openly among women themselves. More frequently it is something that most women in this country are not aware of. Unfortunately over two third of the cases were discovered rather late due to fear and shame.

According to the World Health Organisation (WHO) some ten million women were affected with the cancer and out of the number, four million have died. In Asia, younger women are at higher risk.

So for ladies out there (or concern boyfriends / hubbies who care for their love one, plz inform them about these):

WHAT IS A BREAST CANCER?

A cancerous (malignant) breast lump is often painless, hard and irregularly shaped. It feels different from surrounding breast tissue. If the breast lump is attached to underlying muscle, it may not move when you press on it. Overlying skin on your breast may be dimpled or red.

Other signs include:

* A spontaneous clear or bloody discharge from your nipple
* Retraction or indentation of your nipple
* A change in the size or contours of your breast
* Any flattening or indentation of the skin over your breast
* Pitting of the skin over your breast, like the skin of an orange

Treatment depends on the type of cancer, its stage and the appearance of cancer cells under the microscope. Options include surgery, radiation, chemotherapy and hormone therapy. Detecting breast cancer in its earliest possible stage — by having regular mammograms and clinical breast exams — gives you the best chance for successful treatment.

RISK FACTORS

The exact causes of breast cancer are not known. Studies have shown that breast cancer increases with increasing age. Most patients do not have any of the risk factors listed below, apart from the risk of increasing age.

A woman’s chances of getting breast cancer are increased in the following conditions:

# Women who have had breast cancer have an increased risk of getting breast cancer in the other breast.

# Women whose mother, sister or daughter had breast cancer.

# Changes in genes like BRCA1, BRCA2 and others increase the risk. Gene testing in families in which there is breast cancer may sometimes show the presence of genetic changes that increase the risk. In women who have these genetic changes, doctors may suggest ways to try and delay or prevent the development of breast cancer, to improve detection.

# There is evidence to suggest that the longer a woman is exposed to estrogen, the more likely she may develop breast cancer, that is, the risk is somewhat increased in those whose periods began early (before 12 years), had a late menopause (after 55 years) or who took hormone replacement therapy for the long-term (more than 3-5 years).

# Women who have their first child late (after 30 years) have an increased risk than women who have a child at a younger age.

# Women whose breasts were exposed to radiotherapy before 30 years, especially those who had radiotherapy for Hodgkin’s disease, have an increased risk. The younger a woman had radiotherapy, the higher will be her risk of breast cancer in later life.

# Some studies suggest a slightly increased risk in women who consume alcohol; have a diet rich in animal fats; are obese after menopause and who are in the higher socio-economic group.

SYMPTOMS

There maybe no symptoms at the initial stages of the development of breast cancer. As it grows, it can cause changes, which every woman should be aware of:

# thickening or lump in or near the breast or armpit (axilla)

# change in the size, shape or outline of the breast

# dimpling, ridges or pitting (skin appears like that of an orange)

# change in the appearance or feel of the skin of the breast, nipple or areola e.g. warm, swollen, red or scaly

# nipple discharge or tenderness

# nipple pulled back (retracted) into the breast

If there is one or more of the above symptoms, a doctor should be consulted without delay. In most instances, it may not be cancer but it is important that any problems are diagnosed and treated as soon as possible.

Breast self-examination (BSE) should be performed every month. Become familiar with how your breasts usually look and feel so that you may notice any change from what is normal for you.

* If you still menstruate, the best time to do BSE is several days, or about a week, after your period ends. These are the days when your breasts are least likely to be tender or swollen.
* If you no longer menstruate, pick a certain day - such as the first day of each month - to remind yourself to do BSE.
* If you are taking hormones, talk with your physician about when to do BSE.

Changes to be aware of:

Check with your physician if you find any change in your breast(s) that causes you concern. Changes in your breasts may include:

* development of a lump
* a discharge other than breast milk
* swelling of the breast
* skin irritation or dimpling
* nipple abnormalities (such as pain, redness, scaliness, turning inward)

HOW DO I CHECK FOR LUMPS?

1. Stand in front of a mirror that is large enough for you to see your breasts clearly. Check each breast for anything unusual. Check the skin for puckering, dimpling, or scaliness.
Look for a discharge from the nipples.

2. Watching closely in the mirror, clasp your hands behind your head and press your hands forward.

3. Next, press your hands firmly on your hips and bend slightly toward the mirror as you pull
your shoulders and elbows forward.

Do steps 2 and 3 to check for any change in the shape or contour of your breasts.
As you do these steps, you should feel your chest muscles tighten.

4. Gently squeeze each nipple and look for a discharge.

5. The breasts are best examined while lying down because it spreads the breast tissue evenly over the chest. Lie flat on your back, with one arm over your head and a pillow or folded towel under the shoulder.
This position flattens the breast and makes it easier to check.

Use the pads of the fingers of your other hand to check the breast and the surrounding area firmly, carefully, and thoroughly. Some women like to use lotion or powder to help their fingers glide easily over the skin. Feel for any unusual lump or mass under the skin. Feel the tissue by pressing your fingers in small, overlapping areas about the size of a dime. To be sure you cover the whole breast, take your time and follow a definite pattern: lines, circles, or wedges.

Some research suggests that many women do BSE more thoroughly when they use a pattern of up-and-down lines or strips. Other women feel more comfortable with another pattern. The important thing is to cover the whole breast and to pay special attention to the area between the breast and the underarm, including the underarm itself. Check the area above the breast, up to the collarbone, and all the way over to your shoulder.

* Lines:
Start in the underarm area and move your fingers downward little by little until they are below the breast. Then move your fingers slightly toward the middle and slowly move back up. Go up and down until you cover the whole area.
* Circles:
Beginning at the outer edge of your breast, move your fingers slowly around the whole breast in a circle. Move around the breast in smaller and smaller circles, gradually working toward the nipple. Don't forget to check the underarm and upper chest areas, too.
* Wedges:
Starting at the outer edge of the breast, move your fingers toward the nipple and back to the edge. Check your whole breast, covering one small wedge-shaped section at a time. Be sure to check the underarm area and the upper chest.

The American Cancer Society recommends using three different levels of pressure to examine your breasts:

* light pressure - to examine the tissue closest to the skin
* medium pressure - to feel a little deeper
* firm pressure - to feel deeper tissue closer to the chest wall

6. Some women repeat step 5 in the shower. Your fingers will glide easily over soapy skin, so you can concentrate on feeling for changes underneath.
What do you do if you find a lump?

One of the most frightening moments for a woman is if she feels something different or unusual while performing breast self-examination. One of the most important reasons to perform regular breast self-examination is so that you know what is normal for your breasts. If you find a lump, it is important not to panic.

If you discover a lump in one breast or feel something "different" in the tissue, or you feel a definite lump, there may be valid reason for concern and it is important to contact your physician. Sometimes, the lumpiness may be due to menstrual changes; however, if you have nipple discharge or skin changes such as dimpling or puckering, your physician may want to see you right away.

It is natural to be frightened when discovering a lump, but do not let the prospect of cancer delay you from taking action. Remember that 80 percent of all breast lumps are benign (non-cancerous).


Watch a video on BSE: