Breast Self Examination

Don't Ignore

Self Examination of the Breast

How does one perform self examination of the breast?

A breast self-examination is easiest in the shower, using soap to smooth your skin. Look for dimpling. Using light pressure, check for lumps near the surface. Using firm pressure to explore deeper tissues. Squeeze each nipple gently; if there is any discharge — especially if it is bloody — consult your doctor.

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Any time you find a new or unusual lump in your breast, have your doctor check it to make sure it is not cancerous or pre-cancerous. Most lumps are benign and do not signal cancer. The best test for distinguishing a cyst from a solid tumor is ultrasound; a needle biopsy may also be done.

A baseline mammogram with a low-dose X-ray of the breast is sometimes recommended for women between the ages of 35 and 40. Most women should also get a mammogram every other year beginning around age 40. Women at risk for breast cancer should consult their doctor for the best schedule. Any risk of developing cancer from mammography is clearly offset by the benefits: Breast lumps can be identified on a mammogram up to two years before they can be felt.

Several tests can help distinguish a benign lump from a malignant tumor. Feeling the lump may provide clues: A benign cyst may feel like a round, slippery bean, whereas a tumor may feel thicker and may cause dimpling of the skin above it. Since malignant and benign lumps tend to have different physical features, imaging tests such as mammography and ultrasonography can often rule out cancer. The only way to confirm cancer is to perform needle aspiration or a biopsy and to test the tissue sample for cancer cells.

In the event of malignancy, you and your doctor need to know how far along the cancer is. Various tests are used to check for the presence and likely sites of metastasis. Cancer cells can be analyzed for the presence or absence of hormone receptors, to find out if the cancer is likely to respond well to hormone therapy. Other tests can help predict the likelihood of metastasis and the potential for recurrence after treatment.

What is the Treatment for breast cancer?

Treatment of breast cancer depends on how advanced the cancer is, the age of the patient, and her health. In most cases breast cancer is treated surgically, followed usually by some combination of radiation therapy, chemotherapy, or hormone therapy.

The standard surgical procedure for breast cancer was once radical mastectomy — total removal of the breast and the surrounding fat, muscle, and lymph nodes. However this has fallen out of favor now and is done in only very rare cases.

For many women whose breast cancer is detected early and is still localized, lumpectomy — removal of the cancerous lump and the lymph nodes under the arm — is now the preferred treatment. Followed by appropriate radiation therapy, chemotherapy, and hormone therapy, lumpectomy has proved as effective as radical mastectomy for early breast cancer and is much less disfiguring.

In cases where the tumor is more than 1.1 cm in size, modified selective mastectomy is advocated. In this procedure, the tumor and surrounding breast tissue are removed, but most of the muscle on the chest wall is left intact — which is less disfiguring than radical mastectomy.

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