Breast Cancer Awareness Month

By SOS Medika, Medical Department Image from iStock

October is Breast Cancer Awareness Month globally. SOS Medika, ANZA Silver Sponsors provide some useful information on breast selfexamination.

Worldwide, breast cancer is the second most frequent cancer and the fifth cause of cancer-related mortality. It is the most common cancer to affect women and it is second only to lung cancer as the principal cause of cancer-related deaths among women. Though still clouded in controversy, breast selfexamination (BSE) still has an important role to play in the early detection of breast cancer in resourceconstrained settings where routine clinical breast examination and mammography may not be

feasible. In such settings, BSE is recommended because it is free, private, painless, easy, safe, and requires no specific equipment. It has also been shown to improve breast health awareness and thus potentially allow for early detection of breast anomalies.

Why is BSE important? Breast cancer is characterised by the uncontrolled growth of abnormal cells in the milk-producing glands of the breast or in the passages (ducts) that deliver milk to the nipples. A breast self-exam that you do for breast awareness helps you understand the normal look and feel of your breasts. If you notice a change in your breasts that seems abnormal or if you notice one breast is different when compared with the other, you can report it to your doctor. There are many conditions that can cause changes in your breasts, including breast cancer.

Although the breast self-exam technique isn't always a reliable way to detect breast cancer, a significant number of women report that the first sign of their breast cancer was a new breast lump they discovered on their own. For this reason, doctors recommend being familiar with the normal consistency of your breasts.

To prepare for your breast self-exam for breast awareness: Ask your doctor for a demonstration. Before you begin breast self-exams for breast awareness, you may find it helpful to discuss the instructions and technique with your doctor. If you menstruate, choose a time in your cycle when your breasts are least tender. Your hormone levels fluctuate each month during your menstrual cycle, which causes changes in breast tissue. Swelling begins to decrease when your period starts. The best time to perform a self-exam for breast awareness is usually the week after your period ends. Step 1: Begin by looking at your breasts in the 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 colour • Breasts that are evenly shaped without visible distortion or swelling • If you see any of the following changes, bring them to your doctor's attention: • Dimpling, puckering 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: Now, raise your arms and look for the same changes. 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 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 2 to 3cm. • 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 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.

Results - What's normal? Many women find lumps or changes in their breasts, since some of these are normal changes that occur at various points in the menstrual cycles. Finding a change or lump in your breast is not a reason to panic. Breasts often feel different in different places. A firm ridge along the bottom of each breast is normal, for instance. The look and feel of your breasts will change as you age.

When to contact your doctor? If you notice any of the following changes in your breasts, notify your doctor as soon as possible: Changes in the nipple: • Tenderness • Change in appearance • Nipple that is slightly depressed inward (retracted) • Scaliness • Redness • Discharge • Rash

Changes in the appearance of the breast: • A new mass or masses in the breast (not all masses are indicative of cancer) • Unexplained change in the size or shape of the breast • Dimpling or puckering on the skin of the breast • Unexplained swelling or shrinking of the breast • Unexplained pain in one area that is persistent and does not change position • Redness, warmth, or scaly skin on the breast • A hard mass, knot, or thickening inside the breast or underarm • Itching on the surface of the breast