October is Breast Cancer Awareness month.
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. The damaged cells can invade surrounding tissue, but with early detection and treatment, most people continue a normal life.
According to the World Health Organization, breast cancer is the most common cancer among women worldwide, claiming the lives of hundreds of thousands of women each year and affecting countries at all levels of modernization.
EARLY DETECTION IS KEY.
The best way to fight breast cancer is to have a plan that helps you detect the disease in its early stages. Create your Early Detection Plan to receive reminders to do breast self-exams, and schedule your clinical breast exams and mammograms based on your age and health history.
BREAST SELF EXAM (BSE)
1. Make a regular date each month for a breast self exam.
If you are pre-menopausal: Set a regular time to examine your breasts a few days after your period ends, when hormone levels are relatively stable and breasts are less tender.
If you are already menopausal (have not had a period for a year or more): Pick a particular day of the month to do the exam, and then repeat your BSE on that day each month.
2. Visual Exam- Hands on Hips.
In the privacy of your bathroom, strip to the waist and stand before a mirror. You will need to see both breasts at the same time. Stand with your hands on your hips and check the appearance of your breasts. Look at size, shape, and contour. Note changes, if any, in the skin color or texture. Look at the nipples and areolas, to see how healthy they look.
3. Visual Exam- Arms Over Head.
Still standing in front of the mirror, raise your arms over your head and see if your breasts move in the same way, and note any differences. Look at size, shape, and drape, checking for symmetry. Pay attention to your nipples and areolas, to see if you have any dimples, bumps, or retraction (indentation). Look up toward your armpits and note if there is any swelling where your lymph nodes are (lower armpit area).
4. Manual Exam- Stand and Stroke.
Raise your left arm overhead, and use your right-hand fingers to apply gentle pressure to the left breast. Stroke from the top to the bottom of the breast, moving across from the inside of the breast all the way into your armpit area. You can also use a circular motion, being sure to cover the entire breast area. Take note of any changes in texture, color, or size. Switch sides and repeat. This is best done in the shower, as wet skin will have the least resistance to the friction of your fingers.
5. Manual Exam- Check Nipples
Still facing the mirror, lower both arms. With the index and middle fingers of your right hand, gently squeeze the left nipple and pull forward. Does the nipple spring back into place? Does it pull back into the breast? Note whether or not any fluid leaks out. Reverse your hands and check the right nipple in the same way.
6. Manual Exam- Recline and Stroke.
This is best done in your bedroom, where you can lie down. Place a pillow on the bed so that you can lie with both your head and shoulders on the pillow. Lie down and put your left hand behind your head. Use your right hand to stroke the breast and underarm, as you did in step 4. Take note of any changes in texture, color, or size. Switch sides and repeat.
Download your copy of these business card sized Breast Self Exam How-To Cards.
Keep one for yourself and share the rest with the women in your life! breast self exam cards
- You can do a portion of the exam while you are in shower. Incorporating it into a normal activity can make it easier to do, and less of a time constraint. Remember to mark your calendar every month as a reminder.
- Do the self breast exam every month at the same time. Menstruating women should perform it a few days after their period. Women taking oral contraceptives should do the exam on the first day of starting a new pack of pills.
- Report any changes to your physician, even if you feel it is minor.
- You can also choose a friend who will be your BSE (breast self exam) Buddy. She can remind you and vice versa to do the exam monthly.
- Mark your calendar to remind yourself to do your BSE regularly. This is a good way to prevent worry if find a normal cyclic change.
- Stay relaxed and breathe normally as you do your BSE. Becoming tense will produce some knots that you may mistake for something worrisome.
- Remember to have an annual clinical exam and a mammogram.
Keep up with your breast changes. Doing a monthly breast self exam is the best way to stay familiar with the cyclical changes in your breasts. You will get to know the territory better than your health care team, and will spot changes easily. Between puberty and menopause, your breasts will go through many changes, which are affected by hormones, diet, and exercise.
In the teen years, with the start of your monthly cycle, your body enters the maturing process, and you gain curves and may notice skin changes (such as acne) and even hair may change color or texture. Breast tissue is developing during this time too, and may be dense and firm to begin with, especially if you are small-breasted.
Effects of Childbirth. After your body is prepared for motherhood, if you conceive and bear children, and also if you breastfeed the children, that will bring on more changes in your breasts, as well as in the rest of your body. Breasts may become larger and more tender.
Menopause also brings changes in your breasts, as your estrogen and progesterone levels drop, your breast tissue may become less firm and may drape differently than during your teen and child-bearing years.
Breast cancer occurs in two broad categories: noninvasive and invasive.
- Noninvasive (in situ) breast cancer: Cancerous cells remain in a particular location of the breast, without spreading to surrounding tissue, lobules or ducts.
- Invasive (infiltrating) breast cancer: Cancerous cells break through normal breast tissue barriers and spread to other parts of the body through the bloodstream and lymph nodes.
Breast cancer is also classified based on where in the breast the disease started (e.g., milk ducts, lobules), how the disease grows, and other factors. The tabs on the left provide an overview of some common types of breast cancer.
Some other types of breast cancer include, but are not limited to: Paget’s disease of the nipple, sarcoma of the breast, medullary carcinoma, tubular carcinoma, mucinous carcinoma, metaplastic carcinoma, adenocystic carcinoma, phyllodes tumor and angiosarcoma. (Cancercenter.com)
SYMPTOMS OF BREAST CANCER
Symptoms of breast cancer vary from person to person. Some common breast cancer signs and symptoms include:
- Skin changes, such as swelling, redness, or other visible differences in one or both breasts
- An increase in size or change in shape of the breast(s)
- Changes in the appearance of one or both nipples
- Nipple discharge other than breast milk
- General pain in/on any part of the breast
- Lumps or nodes felt on or inside of the breast
Symptoms more specific to invasive breast cancer are as follows:
- Irritated or itchy breasts
- Change in breast color
- Increase in breast size or shape (over a short period of time)
- Changes in touch (may feel hard, tender or warm)
- Peeling or flaking of the nipple skin
- A breast lump or thickening
- Redness or pitting of the breast skin (like the skin of an orange)
- Aging: On average, women over 60 are more likely to be diagnosed with breast cancer. Only about 10 – 15 percent of breast cancers occur in women younger than 45. However, this may vary for different races or ethnicities.
- Gender: Although nearly 2,000 men will be diagnosed with breast cancer each year, breast cancer is 100 times more common in women. The National Cancer Institute estimates that over 190,000 women will be diagnosed with breast cancer annually.
- Family history: Having a family history of breast cancer, particularly women with a mother, sister or daughter who has or had breast cancer, may double the risk.
- Inherited factors: Some inherited genetic mutations may increase your breast cancer risks. Mutations in the BRCA1 and BRCA2 genes are the most common inherited causes. Other rare mutations may also make some women more susceptible to developing breast cancer. Gene testing reveals the presence of potential genetic problems, particularly in families that have a history of breast cancer. Read about Angelina Jolie’s decision based on her BRCA1 test.
- Obesity: After menopause, fat tissue may contribute to increases in estrogen levels, and high levels of estrogen may increase the risk of breast cancer. Weight gain during adulthood and excess body fat around the waist may also play a role.
- Not having children: Women who have had no children, or who were pregnant later in life (over age 35) may have a greater chance of developing breast cancer. Breast-feeding may help to lower your breast cancer risks.
- High breast density: Women with less fatty tissue and more glandular and fibrous tissue may be at higher risk for developing breast cancer than women with less dense breasts.
- Certain breast changes: Certain benign (noncancerous) breast conditions may increase breast cancer risk.
- Menstrual history: Women who start menstruation at an early age (before age 12) and/or menopause at an older age (after age 55) have a slightly higher risk of breast cancer. The increase in risk may be due to a longer lifetime exposure to the hormones estrogen and progesterone.
- A sedentary lifestyle: Physical activity in the form of regular exercise for four to seven hours a week may help to reduce breast cancer risk.
- Heavy drinking: The use of alcohol is linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed.
- Birth control pills: Using oral contraceptives within the past 10 years may slightly increase the risk of developing breast cancer. The risk decreases over time once the pills are stopped.
- Combined post-menopausal hormone therapy (PHT): Using combined hormone therapy after menopause increases the risk of developing breast cancer. Combined HT also increases the likelihood that the cancer may be found at a more advanced stage.
- Diethylstilbestrol exposure (DES): Previous use of DES, a drug commonly given to pregnant women from 1940 to 1971 to prevent miscarriage, may slightly increase the risk of developing breast cancer. Women whose mothers took DES during pregnancy may also have a slightly higher risk of breast cancer.
- Radiation exposure: Women who, as children or young adults, had radiation therapy to the chest area as treatment for another cancer have a significantly increased risk for breast cancer.
Read the stories of several women who have battled Breast Cancer
I was sitting on a couch during a birthday party for my younger sister when I first noticed the lump. It didn’t feel right so I made an appointment with my gynecologist. Because I always made sure to go for annual check-ups, I wasn’t very concerned. I’m 29 years old and many women my age develop cysts; so I assumed this lump was just that, a cyst. Read More.
After feeling a sharp pain in my breast one night, I made an appointment to see my primary care physician in my home town of Las Vegas, Nevada. She referred me to a breast specialist in the same building. Two weeks later, a sonogram indicated that I had breast cancer, and a subsequent biopsy confirmed the diagnosis. Read More.
I was diagnosed at age 39, 6 years after my twin sister Denise was diagnosed with Stage 2 invasive breast cancer and 4 years after our aunt died of a breast cancer recurrence (she was only 61). Since I was ‘on the lookout’ and had been having annual mammograms and been performing diligent self exams, an appearance of a small lump in my right breast was no surprise to me. Even when the Radiologist performing the core-needle biopsy and proclaimed ‘This doesn’t look like cancer’, I knew it was. Sure enough, a week later, I received the news no woman wants to hear, “This is breast cancer.” Read More.
Check out the Living Breast Artist Series, a beautiful art project celebrating life, hope and the strength to overcome by painter Denise Milito and Photographer Josh Gromley.
“The Living Breast Artist Series examines how breast cancer affects our bodies and our lives. During the project, women directly affected by breast cancer were body painted and photographed. The goal is to show that breasts are beautiful and life-giving, yet not what defines a woman. The life and energy of every woman comes from within and cannot be taken away by breast cancer. The paintings, like the women who bear them, are unique and full of energy.”