A safety net
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Early detection of breast cancer improves the chance of treatment going well, writes Dr. SELVI RADHAKRISHNA on the occasion of Breast Cancer Awareness Month now being observed.
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GETTING to know your body helps to learn what is normal for you. This makes it easier to notice any changes that need to be evaluated. In this case, it is the breasts, which start developing before a girl begins to mensturate, because of hormonal changes that happen around puberty. With each menstural cycle, the breasts change and most women experience some heaviness, tenderness and a lumpy feeling before each period. This normally subsides a few days after periods.
During pregnancy, the glands enlarge to produce milk. The breasts are larger, firmer and sometimes even tender. Once breast-feeding is stopped the breasts return to normal size.
With a reduction in the hormone influence around menopause the glands shrink in size and are replaced by fatty tissue. But if a woman is on hormone replacement therapy, the changes are less pronounced.
Not all breast conditions are cancerous. But all women are at some risk for cancer. The risk increases, as they become older.
Infections of the tissue can cause skin redness, warmth and tenderness. This usually occurs during breast-feeding. This is treated with antibiotics and sometimes drainage is necessary.
A minimal clear thin discharge from the nipple on squeezing is normal. Other kinds of discharge — dark or blood stained — may be symptoms of a breast condition. A nipple discharge that is dark or bloody or that happens without squeezing should be checked by the doctor.
Changes occur in the glandular cells that may cause pain, tenderness, heaviness and sometimes even cysts (fluid filled lumps). This usually gets worse before periods and settle down after periods. This happens cyclically during a woman's reproductive life. Any lump that persists after the onset of periods each month should be investigated.
Benign breast lumps: The most common form of lump is a fibroadenoma. This may be smooth, rubbery, firm, painless and freely movable within the breast. This usually can be left alone if one is certain about diagnosis. However if there is any doubt it should be evaluated.
It is estimated that one in 30 women is at risk of developing breast cancer in a lifetime in India, with chances of it rising. Although breast cancer is rare in women who are in their 20's and 30's it is not uncommon. The chance of incidence increases with age.
If you notice any of the following see your doctor immediately:
- A firm lump that is different from the tissue around it.
- A change in skin texture or colour.
- A dimple (skin depression) on the breast.
- A nipple that becomes pulled in (retracted)
- Blood stained discharge from the nipple
- A change in the size or shape of your breasts
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Early detection of breast cancer improves the chance of treatment going well. This is why ensuring breast self-examination, clinical breast examination and mammography is so important.
When you practise breast self-examination you are not looking for trouble. Instead, you are getting to know what is normal for you. That way if a problem does occur you will find it out right away.
Self-examination should be done monthly, starting at the age of 20. Until menopause, do a self-examination seven to 10 days after your period. It should be done on the same date each month, even if you do not have periods whether it is because you are pregnant, breast feeding or after menopause.
A yearly examination by your doctor starting from age 30 will help to detect breast conditions early.
Have your first mammogram by the age of 40. After that, have a mammogram every year. If you are at high risk for breast cancer, you may need to start having your mammograms early.
High risk of breast cancer includes:
- Women with a family history of breast cancer
- Women with no children
- Women who have had their first childbirth after 30 years
- Obesity
- Early puberty and late enopause
What you should do
When you are between 20 years to 30 years: Monthly breast self-examination
Between 30 years to 40 years: Monthly breast self-examination and an annual clinical breast examination
Between 40 years and above: Monthly breast self-examination, annual clinical breast examination and annual mammography
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