How Do You Do A Breast Self-Exam?

And other things you need to now about breast cancer.
PHOTO: istockphoto

Let's start with some facts: The World Health Organization (WHO) says breast cancer is the most common form of cancer in women, both in developed and developing countries; breast cancer is also considered to be the most common cancer type among Filipinos. In 2018, 24,798 Pinays were diagnosed with the disease. Breast cancer is currently the third leading cause of cancer-related death in the Philippines, just behind lung and liver cancer.

How does breast cancer develop?

According to medical oncologist Dr. Meredith Garcia-Trinidad, breast cancer develops when normal cells in the breast change and grow out of control. This abnormal growth usually leads to lumps or skin changes on the affected breast. It can also involve the armpit area when most of the lymph nodes draining the breast can be found.

Dr. Garcia-Trinidad says most cases of breast cancer are "sporadic," which simply means it occurs at random and can also happen to people with no family history of the disease. Only 10 to 15 percent of cases are considered familial. One-third of these cases are due to inherited mutations in breast cancer susceptibility genes such as BRCA1 or BRCA2 (think Angelina Jolie, who underwent a double mastectomy to reduce her chances of developing cancer).

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A woman's risk for getting breast cancer is higher if she has a mother, sister, or daughter or multiple family members who have the disease. Most of the risk factors associated with the development of breast cancer are also related to increased or prolonged estrogen exposure. Some of these include early onset of menstruation (before the age of 12), giving birth at an older age (after the age of 35), never having a full-term pregnancy, not breastfeeding, late menopause (after the of age 55), and the use of postmenopausal hormone replacement therapy for a long period of time. Other risk factors include age, lack of physical activity, weight, and alcohol use. But Dr. Garcia-Trinidad also points out that many women who develop breast cancer have no identifiable risk factors other than being female.

How can I know if I have breast cancer?

According to the ICanServe Foundation, a Philippine breast cancer support network, early detection offers the best protection against breast cancer. This means that women should be comfortable enough with their own body to conduct breast self-exams.

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Dr. Garcia-Trinidad says women should watch out for a change in the size or shape of their breasts; a lump or area that feels thicker than the rest of the breast; skin changes like redness, rashes, dimpling; changes in nipple appearance; bloody nipple discharge. She also says that breast pain is usually not a symptom of breast cancer, but it can be present in later stages.

Here's how you conduct a breast self-exam:

Start out by looking at your breasts at a mirror with your shoulders straight and your hands on your hips. Look for any changes like swelling, redness, puckering, or dimpling of your skin. Then, raise your arms over your head and check for the same signs along your skin. Then squeeze your nipples gently to make sure that no fluid or discharge comes out. Finally, use your fingers to firmly check for any bulges, lumps, or bumps. Start at your nipple, moving in circles until you reach your cleavage, chest, and underarm. The ICanServe foundation has a pretty detailed video outlining how to conduct a breast self-exam (including ones in Tagalog and Visayan), if you need a more visual guide.

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The best time to perform a self-exam is the week after your period ends. Women, starting at the age of 20, should be performing breast self-exams monthly.

If you do find or feel something unusual in your breast, the next step is to see a doctor for a proper check-up.

The doctor will usually conduct a clinical breast exam and recommend a mammogram if he or she finds anything abnormal. A mammogram is a low-dose X-ray of the breast. Dr. Garcia-Trinidad explains that during a mammogram procedure, each breast is very quickly compressed horizontally then diagonally between two plastic plates in order to take X-ray images of the breast in different views. Some women may feel a slight pain during the procedure, but most women only report some mild degree of discomfort in the process.

If anything unusual is found in the mammogram, the doctor will perform a biopsy in order to check for presence of cancer cells under the microscope. But if you are over the age of 40, a yearly mammogram is recommended.

Why early detection matters

Both the ICanServe Foundation and Dr. Garcia-Trinidad reiterate that the early detection, as well as proper treatment of breast cancer, saves lives. The cure rates are higher for earlier stages of diagnosis.

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According to Dr. Garcia-Trinidad, the estimated five-year survival rate for stage 0 breast cancer or cancer that has not yet spread outside of the milk ducts or lobules of the breast  and stage 1 invasive cancer is at 100 percent. That survival rate drops to 22 percent once the cancer has already spread outside the breast area.

So if you feel something unusual around your chest area, it might be a good idea to conduct a breast self-exam. Who knows, it might just end up saving your life.

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