ANALYSIS/OPINION:
The American Cancer Society reported earlier this month that breast cancer death rates declined almost 40 percent between 1989 and 2015 – averting an estimated 322,600 deaths. The reduction is attributed to screening and early detection by self-exams, mammography and improvements in treatments over the recent decades.
And while everyone is in agreement that there is so much more to be done, there is good reason that people are tickled pink with this marked shift and forces are joining together in concert to beat the drums this month, designated as Breast Cancer Awareness month. It makes a difference!
Year-round I attend events to share and support the importance of awareness, screening and early detection. And I am always deeply moved beyond words and respect when the valiant hearts in the crowds are asked to stand if they have been diagnosed with breast cancer or a breast cancer survivor. Or, if they have a mom, sister, aunt, or other family member, neighbor, co-worker, or friend who has or has had breast cancer. Nearly always, everyone is on their feet. As I write, I know the facts are that your life has more than like been impacted, as has mine.
There are only two ways to detect breast cancer: mammography and self-breast exams. I recommend that all women, not just those with a family history of breast cancer, conduct self-breast exams as well as receive a mammogram, as their physician recommends. And today, for those who do receive a diagnosis, we have remarkable resources, technology and treatment options available – along with dedicated teams of professionals with a range of expertise to support every step forward.
Here’s helpful information offered from the National Breast Cancer Foundation and other leading health organizations committed to the research, prevention, and treatment of breast cancer – as well as making a difference in each valiant heart’s life.
Dr. Nina’s What You Need to Know: About Early Detection, Breast Examinations and Mammograms
Early Detection: The second-leading cause of death among women, breast cancer is a group of cancer cells that originates in the cells of the breast. Early warning signs of breast cancer may involve the discovery of a lump or a change in the breast tissue or skin. It’s important to conduct monthly breast self-exams and for any symptoms or suspicious changes to be discussed with a physician. In addition, regular, routine mammograms are important, as recommended by your doctor.
In order to improve breast cancer outcome and survival, early detection remains the cornerstone. And, beginning self-exams at a young age is more important than ever, as we’re seeing an increase in diagnoses in women under the age of 50, and unfortunately, breast cancer in younger women is often more aggressive.
And while all people, whether male or female, are born with some breast cells and tissue that have the possibility to develop into cancer, breast cancer in men is rare, with only about 2,190 diagnoses each year.
Signs and Symptoms: Many breast cancer symptoms are invisible and not noticeable without a professional screening, but some symptoms can be caught early just by being proactive about your breast health. Signs and symptoms of breast cancer include a mass or lump in the breast, redness of the skin, nipple or swollen lymph nodes, blood-stained or clear fluid discharge from the nipple, and changes in the shape or texture of the nipple or breast (dimpled, inflamed, puckered or scaly) or an area that is distinctly different from any other area on either breast as well as a marble-like hardened area under the skin. Most often, these are not due to cancer, but any symptom you notice should be investigated as soon as it is discovered. If any of these are noticed, it is important to see a healthcare provider so that the problem can be diagnosed and treated.
Self-Breast Exam: Johns Hopkins Medical along with other leading medical organizations, encourage adult women of all ages to perform breast self-exams at least once a month, noting that: “Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.”
And while mammograms can help you to detect cancer before you can feel a lump, breast self-exams help you to be familiar with how your breasts look and feel so you can alert your healthcare professional if there are any changes.
Approaches to Breast Self-Exam
• In the Shower: Using the pads of your fingers, move around your entire breast in a circular pattern moving from the outside to the center, checking the entire breast and armpit area. Check both breasts each month feeling for any lump, thickening, or hardened knot.
• In Front of a Mirror: Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead. Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match—few women’s breasts do, so look for any dimpling, puckering, or changes, particularly on one side.
• Lying Down: When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently in small circular motions covering the entire breast area and armpit. Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.
And if you find a lump, schedule an appointment with your doctor, but don’t panic — 8 out of 10 lumps are not cancerous. Always call a physician whenever there are any concerns.
Clinical Breast Exam: Conducted by a healthcare professional who is trained to recognize many different types of abnormalities and warning signs, a clinical breast exam is performed in a healthcare office. This exam will most likely be completed by a family physician or gynecologist during an annual exam.
Along with self-exams, regular clinical breast exams are an important part of early detection, as an experienced professional may notice a suspicious place that fails to register as a warning in a self-exam, further recommending scheduling a follow-up mammogram.
Mammogram: An X-ray, a mammogram allows a qualified specialist to examine the breast tissue for any suspicious areas. The breast is exposed to a small dose of ionizing radiation that produces an image of the breast tissue.
With technological advancements, mammograms can often show a breast lump before it can be felt. They also may show tiny clusters of calcium called microcalcifications—while usually non-cancerous, they can be an early (and the only) presenting sign of breast cancer. Lumps or specks can be caused by cancer, fatty cells, or other conditions like cysts and further tests may be needed to find out if abnormal cells are present. If the mammogram shows an abnormal area of the breast, the doctor will order additional tests offering clearer, more detailed image of that area.
Although lumps are usually non-cancerous, the only way to be certain is to perform additional testing, such as an ultrasound or MRI. If they reveal that the mass is solid, your radiologist may recommend a biopsy, a procedure in which cells are removed from a suspicious area to check for the presence of cancer.
The report issued this month by the American Cancer Society is an important sign underscoring that early detection, self-exams, clinical and mammogram screening along with improved treatments are helping women survive breast cancer.
We must remain vigilant in supporting one another to take action in early detection and talk openly and often about screening and self-exams. Breast cancer in the U.S. remains the most commonly diagnosed cancer among women and the second deadliest. Join me and millions of others in supporting one another and talking more often to order to bring awareness of early detection through self-exams and mammograms – it is vital in sustaining the decline in deaths and making all the difference!
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