About Breast Cancer
Breast Cancer Detection
Signs & Symptoms of Breast Cancer
If any of these signs or symptoms are detected, a doctor should be seen as soon as possible:
- A lump in the breast or under arm area
- An inverted nipple
- Crusting or reddening of the nipple, or patchy areas on the nipple
- Discharge or bleeding from the nipple
- Changes to the shape and size of the breast
- Changes to the skin of the breast
Early detection is the best defence against breast cancer. Although screening and other detection methods cannot prevent breast cancer, it can save lives.
Breast Self-Examination
A breast self-examination (BSE) is performed to detect any changes in the breast. A mammogram or clinical exam are the most reliable methods of finding breast cancer, but regular BSE is a good way to learn what is normal for a woman’s own breasts. That way, if there is a change, it will be noticeable and a doctor can be contacted for further examination.
The next few pages include some guides to doing a breast self-examination and a breast screening life plan. You can also visit www.breastselfexam.ca for more information.
Here are some guides to doing a breast self-examination:
Use a Mirror
Begin checking your breasts by standing in front of a mirror. Leave your arms at your side and look at your breasts. Slowly turn from side to side and see if you notice any changes in size and shape. Also look for rashes or puckery skin, and any discharge from the nipples.
Arms Up
Lift your arms above your head while still looking in the mirror. Put your hands behind your ears and look at your breasts and under your arms. Lower your hands to your nose and squeeze your palms together. Do you notice any changes?
Keep Standing
While still standing, hold the fingers of your hand together with your fingers stiff and your palm flat. Using the pads of your fingers, not the tips, go over the curves of your breast, starting just below your collarbone. As you go over the curves, bend your wrist slightly and keep in constant contact with your skin. There are two methods for covering the entire breast:
Grid Method
To check your breasts using the grid method start by making small circles in straight lines starting just below your collarbone, and make these circles all the way across your breast. Then, move your fingers down and cross the breast again, repeating the small circles and eventually covering the entire breast. Remember to check your nipple for a discharge or puckering.
Circular Method
To check your breasts, using the circular method, make small circles starting at the outside edge of your breast, and make small circles all the way around the breast. Keep making continually smaller circles towards the nipple, and check the nipple as well.
After you have checked your entire breast using one of these techniques, check under your arm. To do this, relax your arm by your side and slide your hand under the relaxed arm. Make small circles as done in the circular method.
Lie Down
It is also important to check your breasts while lying down in order to flatten the breast which makes it easier to check. To do so, lie on your back on a firm surface. Check each breast and the area around it very carefully using one of the patterns described above.
If you find a change while conducting a breast self-examination, visit your doctor as soon as possible. Usually, a change you might find is not cancer. But it is still important that you visit your doctor right away.
Mammogram
A mammogram is low-dose x-ray done to find abnormal changes in the breast. There are two types of mammograms: screening and diagnostic. A screening mammogram is for women with no symptoms of breast cancer, while a diagnostic mammogram is used to check out a possible symptom. A technologist will assist during a screening mammography. Each breast is placed on a plate and compressed, which helps to spread out the breast tissue and reduce the amount of radiation required to photograph the breast. It also makes it easier to detect small cancers. Once the breast is positioned properly, it will be x-rayed at different angles to pinpoint the location of abnormality, if present. Screening mammograms are able to find breast cancers several years before they can be felt by hand.
Screening mammography has proven to be beneficial for women 50-69 years of age. In research studies, 25-30% fewer women died of breast cancer if they had regular screening mammograms starting at age 50. Scientific research shows a smaller benefit from screening mammography in women age 40-49 compared to older women.
There are a few disadvantages to screening mammograms. Some cancers cannot be seen on a mammogram. There is a risk that a woman will get a “normal” screening, but in reality they may have a lump that needs further investigation. If any new lumps or breast changes are found, the patient should ignore the “normal mammogram report” and see their doctor.
Beyond the Screening Mammogram
A screening mammogram is done to separate women with normal mammographic findings from those that need further testing. If a lump is found in the breast, the next step is to figure out exactly what it is. Once a complete physical exam and medical history is done, the doctor will usually order a diagnostic mammogram, which is used to evaluate a patient with any abnormal findings found during a screening mammogram. Diagnostic mammography is more thorough than a screening mammogram, and involves more compression of the breast to give a clearer image of the area in question. This clearer image can reveal more about any suspicious lumps, and also tiny flecks of calcium, which can sometimes be associated with cancer.
An ultrasound is another test which might be offered, since it can distinguish between cysts, which are harmless, and more serious lumps. Cysts are a very common condition, and if the doctor suspects a cyst is present, they might perform a fine needle aspiration. This involves inserting a thin needle into the lump. If fluid is drawn, it is a cyst. If blood is drawn, or no fluid at all is extracted, then further testing is needed.
Other detection options, such as thermography, light scanning and MRI are still being investigated for effectiveness.
Breast Screening Life Plan
These guidelines are an excellent way to keep track of your breast health:
If you are 20-39
- Become familiar with how your breasts look and feel so you can recognize monthly breast changes
- See your doctor regularly for a periodic health exam
If you are 40-49
- Have a clinical breast exam every year by a trained health professional
- Discuss your risk of breast cancer and the risks and benefits of mammography with your doctor
- Check your breasts regularly for changes
If you are 50-69
- Have a clinical breast exam every year by a trained health professional
- Have a screening mammogram every two years
- Check your breasts regularly for changes
If you are 70 and over
- Have a clinical breast exam every year by a trained health professional
- Talk to your doctor about whether you should have regular mammograms
- Check your breasts regularly for changes