Self-examination for breast cancer

By Injil Abu Bakar

NEW YORK (JP): The American Cancer Society estimates that in the United States in 1999 alone, over 175,000 women will be diagnosed with breast cancer and approximately 43,300 will die from this disease.

In the U.S., breast cancer accounts for 29 percent of all cancers in women. One woman out of eight will develop breast cancer sometime during her life. Although earlier detection results in higher cure rates, breast cancer remains the leading cause of death from cancer in adult women under 54 years of age and the second most common cause after the age of 54.

Among women of all ages, breast cancer is second only to lung cancer as the leading cause of death from cancer in women. Less than 1 percent of all breast cancer cases occur in men. The causes of the disease and its clinical management are very similar to that in women.

Q: Who is at risk from developing breast cancer?

A: Every woman is at risk from breast cancer and her risk increases with age. Breast cancer is the most common cancer among women and it should be pointed out that three-quarters of all breast cancer cases occur in women over 50. A woman of 70 is almost twice as likely to develop breast cancer in the next year as a woman aged 50.

Are there women who are especially at risk?

Yes. Risk is higher in women with a personal history or whose close female relatives -- their mothers or sisters -- have had the disease, especially if the relative was diagnosed before menopause. Four out of five women who develop breast cancer, however, have no family history of the disease.

What can be done to protect against breast cancer?

Since we don't know what causes breast cancer or how to prevent it, the best protection is to detect and treat it promptly. Researchers are also investigating the possible roles of heredity, environment, lifestyle and diet.

What is the recommendation for early detection of breast cancer?

The American Cancer Society and some of the leading health organizations in the U.S. recommend this 3-step early detection program:

1. Have regular mammograms. Annual mammograms should begin at the age of 40.

2. See your doctor for a regular breast examination. This means at least every three years from the age of 20 to 39 and every year, beginning at the age of 40.

3. Practice monthly breast self-examinations.

These guidelines for the early detection of breast cancer are for women who have no symptoms. They are designed to find breast cancer at the earliest stage when there is the best opportunity to treat it successfully.

Why should one carry out a breast self-examination?

There are many good reasons for conducting a breast self- examination each month. One reason is that it is easy to do and the more you do it, the better you will get at it. When you get to know how your breasts normally feel, you will quickly be able to feel any change. Early detection is the key to successful treatment.

Remember: A breast self-examination could save your life. Most lumps in breasts are found by women themselves, but in fact, most lumps are not cancerous. Be safe, be sure.

When should one conduct a breast self-examination?

The best time to do a breast self-examination is right after your period, when breasts are not tender or swollen. If you do not have regular periods or sometimes skip a month, do it on the same day every month.

How does one do a breast self-examination?

1. Lie down and place a pillow under your right shoulder. Place your right arm behind your head.

2. Use the finger pads of your three middle fingers on your left hand to feel for lumps or any thickening. Your finger pads are the top third of each finger.

3. Press firmly enough to know how your breast feels. Learn what your breast feels like most of the time. A firm ridge in the lower curve of each breast is normal.

4. Move your fingerpads around the breast in a set way. You can choose either a circular motion or up and down. Do it the same way every time. It will help you to make sure that you have gone over the entire breast area and to remember how your breast feels.

5. Now examine your left breast using your right hand finger pads.

6. Repeat the examination of both breasts while standing, with one arm behind your head. The upright position makes it easier to check the upper and outer part of the breasts (toward your armpit). You may want to do the standing part while you are in the shower. Some breast changes can be felt more easily when your skin is wet and soapy.

For added safety, you can also check your breasts for any dimpling of the skin, changes in the nipple, redness, or swelling while standing in front of a mirror right after your breast self- examination each month.

If you find any changes, see your doctor right away.

What are the signs and symptoms of breast cancer?

Symptoms or breast changes to be aware of include any lump, thickening, swelling, dimpling, skin irritation, distortion, retraction of the nipple, scaliness or pain. A mammogram can pick up changes in the breast that might signal cancer long before any can be felt.

Remember -- most lumps are not cancerous, but, to be sure, see your doctor even if you have had a mammogram recently.

What is a mammogram?

A mammogram is an x-ray picture of the breast taken with a special machine that uses only a small amount of radiation. A specially trained technologist positions your breast between two plastic plates. For a few seconds, pressure is applied to flatten the breast and get a good, clear picture.

Two pictures are usually taken of each breast. Some women report a little discomfort, but it only lasts a few seconds and firm compression is an important part of a quality exam. The entire mammography examination takes about 15 minutes. A specialist, called a radiologist, will read the mammogram to see if there are any suspicious areas.

What if breast cancer is found?

A woman diagnosed with breast cancer should thoroughly review her treatment options with her doctor before making a decision about therapy.

The greatest variety of treatment options and best chance for survival are available if breast cancer is found early. Treatment for early breast cancer can include lumpectomy (limited surgery that removes the cancer but not the entire breast) followed by radiation therapy, or mastectomy (removal of the entire breast). Additional treatments may include chemotherapy or hormone therapy. Breast reconstruction may be an option after mastectomy.

What are the chances of surviving breast cancer?

Survival depends on the stage of breast cancer at diagnosis. Eighty-five out of every 100 women diagnosed with breast cancer will survive at least five years. Survival is much better if the disease has not spread and the prognosis is poorer if the disease has spread by the time it is diagnosed. This is why early detection is so important.