Detecting breast cancer

Posted on 15 October 2014

As a woman, it is advisable to examine your breasts regularly for any changes that may indicate an underlying problem like breast cancer. Self-examination is not a substitute for routine mammogram screening, however, but it increases awareness and helps one to learn how the breast normally feel. The early stages of breast cancer may not show any symptoms but as the tumour grows, the breast may change in the way it looks or feels.

How often should I check my breasts and how do I do breast self-examination (BSE)?
You should do a BSE once a month at the same time of the day three to five days after the start of your period or on the same day of the month if you’ve gone through menopause. You need to become familiar with how your breasts look and feel.

Here’s how to do a BSE:
1. In the mirror
Stand in front of a mirror and have a look at your breasts. Check for any changes – is there a difference in their size, nipple discharge, dimpling? You’ll need to have a look from four different angles: arms at your side, arms over your head, hands on your hips and bending forward.
2. Lying down
Next, lie on your back with a pillow under your right shoulder and your right hand under your head. Using the four fingers of your left hand, make small circular firm movements – go up and down over your entire breast, under your arms and right up the shoulder bone. Repeat this process on your left breast.
3. In the bath or shower
Raise your right arm and check your right breast using the same method you did lying down. Repeat on the left side.

What changes am I looking for?
According to CANSA these are typical changes to look out for:
• Puckering of the skin of the breast
• A lump in the breast or armpit
• A change to the skin around the nipple (any bleeding or moist areas that don’t heal)
• Discharge from the nipple (unless you’re breastfeeding and it’s milky)
• Dimpling of the nipple or nipple retraction
• An unusual increase in the size of one breast
• Any change to the nipple position – if you notice one breast is unusually lower than the other and your nipples are at different levels
• Enlarged glands
• Any unusual swelling in the armpit
• Any unusual pain or discomfort in one breast

If you feel a lump or notice any of these changes, make an appointment with your doctor.

Mammograms
According to the World Health Organization, cancer is a leading cause of death worldwide – it accounted for about 8,2 million deaths in 2012. Breast cancer is one of the six more common cancers.

What is a mammogram?
It’s a screening device that uses x-ray images to detect any changes or abnormal growths in breast tissue. A radiologist or technician will compress your breast and take pictures from at least two angles, and this set of images is called a mammogram. The breast tissue shows up white and opaque, while fatty tissue appears darker and translucent.
A screening mammogram x-rays the breast from top to bottom and side to side, while a diagnostic mammogram focuses on a specific lump or area of abnormal tissue.

When should you have your first mammogram?
The general rule is that all women 40 and older have an annual mammogram. If you’re unsure, then speak to your doctor and discuss when to start and how regularly you should have one. Another rule to follow if your mother or grandmother has had breast cancer is this: deduct 10 years from their age when they were diagnosed and start your screening mammograms at that age. So, if your mother was diagnosed with breast cancer at 41 for example, start your screening at 31.

When should I make an appointment?
Don’t schedule it in the week before your period if your breasts are tender during this time. It’s probably best to make it a week after your period.

How do I prepare for my appointment?
On the day it’s scheduled, don’t wear deodorant or powder, or apply body lotion on and around your breasts. Wear jeans and top or a skirt rather than a dress as you’ll be asked to remove your top and bra. You’ll get a hospital gown to cover up.

Do breast implants affect the clarity of a mammogram?
They may obscure a cancer, which is why you may have an ultrasound examination as well. There is also a small theoretical possibility that implants may rupture during the test but the benefits of mammography in the early detection of breast cancer outweigh this risk. Make sure you let your doctor or radiologist know.

 

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.