Breast Health Begins With You

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Breast Health Begins With You
What you need to know about breast cancer.
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• National Breast Cancer Awareness Month is October

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The Numbers Dont Lie
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Statistics on Breast Cancer

• An estimated 40,600 deaths (40,200 women, 400
  men) from breast cancer are expected next year.
• Breast cancer ranks second among cancer deaths in
  women.
• Breast cancer also strikes a small percentage of
  men.
• An estimated 192,200 new invasive cases of breast
  cancer are expected to occur among women in the
  United States this year alone.
• About 1,500 new cases of breast cancer are
  expected to be diagnosed in men next year.

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What do we know about causes?
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Factors that increase risk

• Lifestyle

• Family History

• Personal History

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Family History

• FAMILY HISTORY If your mother, sister, or
  daughter has developed breast cancer before
  menopause, you are three times more likely to
  develop the disease. If two or more close
  relatives (e.g., cousins, aunts, grandmothers)
  have/had breast cancer, you are at increased risk
  as well. Recently, scientists have found that
  mutations in genes BRCA1 and BRCA2 increase one's
  susceptibility to breast cancer. A simple blood
  test can tell you if you have such a condition.

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Personal History

• If you've had breast cancer, you have an
  increased risk of getting it again. Also, if
  you've had benign breast disease (e.g.,
  fibrocystic breast disease), you are at an
  increased risk.
• The following also put you at greater risk
• If you began menstruating early (before age 12)
• If you take birth control pills (though evidence
  is not conclusive)

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Additional Risk Factors

• If you never have children
• If you have children when you are 30 or older
• If you have menopause at 55 or older
• If you take Hormone Replacement Therapy (HRT)
• Higher estrogen levels are strongly linked with
  susceptibility to breast cancer.

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Lifestyle

• Several studies found a lower incidence of breast
  cancer among women who exercise regularly
• Higher proportion of breast cancer among obese
  women.
• There is increased risk of breast cancer with
  increased alcohol use (i.e., 3 or more drinks per
  week) perhaps due to the fact that alcohol
  increases blood estrogen levels.

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Resources to Check Out

• Womens Information Network Against Breast
  Cancer www.winabc.org/newweb/resources/Index.htm
• American Cancer Society's Breast Cancer Resource
  Center
• www3.cancer.org/cancerinfo/res_home.asp?ct5
• Breast Cancer Action www.bcaction.org
• Celebrating Life Foundation www.celebratinglife.o
  rg/index.html
• The promotion of charitable endeavors that
  encourage the advancement of knowledge and
  awareness of breast cancer risk and risk
  management in the African American community and
  for women of color.

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• Department of Defense Breast Cancer Decision
  Guide www.bcdg.org
• For individuals diagnosed with breast cancer and
  their family members.
• National Alliance of Breast Cancer Organizations
  www.nabco.org
• Provides information, assistance and referral to
  anyone with questions about breast cancer, and
  acts as a voice for the interests and concerns of
  breast cancer survivors and women at risk.
• Imaginis.net - the Breast Health Specialists
  www.imaginis.net/breasthealth
• Comprehensive, up-to-date information on breast
  health and related breast cancer prevention,
  screening, diagnosis and treatment procedures.

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Why Do a Breast Self Exam?
Be Safe, Be Sure
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Breast Self Exam Information
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When to do a Breast Self-Exam

• The best time to do breast self-exam is right
  after your period, when breasts are not tender or
  swollen. If you do not have regular periods or
  sometimes skip a month, do it on the same day
  every month.

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About Your Breast Self Exam

• Remember, you are looking for changes, so you
  need to collect a month or two of data before you
  really understand what change looks or feels
  like. You must also realize that 9 out of every
  10 breast lumps found, thank heavens, are not
  cancerous.

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• There are two basic steps to conducting a Breast
  Self Exam (BSE) first you look at your breasts,
  and then you touch them.

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Step 1 a

• Visual Examination
• During the first part of the BSE, the visual
  examination, you are looking for changes in each
  breast. So if your breasts have always been
  mushy, that's not a concern unless this is a new
  change.

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Step 1 b

• Stand in front of a mirror and look for the above
  changes in your breasts (from both a frontal and
  profile view) in 3 different positions
• With your arms up behind your head
• With your arms down at your sides
• Bending forward

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The changes you are looking for include
Step 1 c

• Size
• Shape
• Bumps/lumps NOTE normal lumpiness, like in the
  week before and of your menstrual cycle, will
  appear as very small and separate lumps like the
  texture of an orange.
• Contour or symmetry (is there a difference in the
  level between your nipples? Do both breasts look
  symmetrical?)

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Other Changes to Look For
Step 1 d

• Sores or scaly skin
• Skin discoloration or dimpling
• Discharge or puckering of the nipple

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Step 2a

• Tactile Examination

Begin by looking for the changes while standing
up. Some women find it useful to do this part of
the BSE in the shower, since soap or bath gel
will aid in the ease of feeling your breasts.
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Step 2b

• For the BSE, you need to pick a pattern to
  feel your breasts and surrounding areas, which
  include
• the breast itself
• between the breast and underarm
• the underarm itself
• the area above the breast up to the collarbone
  and across to your shoulder

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Step 2c

• It is important to check surrounding areas
  because breast cancer may be found in the lymph
  node tissue around your breast and underarm.

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Step 2d

• You use the pads (where your fingerprints are) of
  your three middle fingers on your right hand
  pressed together flat to check your left breast,
  and do the opposite for the right breast.

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Step 2e

• You should press on your breast with varying
  degrees of pressure
• light (move the skin without moving the tissue
  underneath)
• medium (midway into the tissue)
• hard (down to the ribs "on the verge of pain")

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Patterns
Step 2f

• Spiral (concentric circles) begin with a large
  circle around the perimeter of your breast and
  make smaller and smaller circles as you work your
  way toward the nipple.

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Step 2g

• Pie shape wedges pretend your breast is divided
  into sections like pieces of a pie, begin in the
  nipple area and feel your breast in a small
  circular motion within one pie shape section,
  then move on to the next wedge starting in the
  nipple area again.

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Step 2h

• Up and down pretend your breast is divided into
  vertical stripes, begin on one side and feel your
  breast in a small circular motion up and down in
  a zig zag pattern.

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Step 2i

• When using any of the 3 patterns, you should
  always be using a circular rubbing motion (in
  dime-sized circles) without lifting up your
  fingers.

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• Once you've performed the tactile examination
  while standing up in front of a mirror, you
  should do the whole examination again, this time
  while lying down.

Step 3a
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Step 3b

• Put your left arm behind your head and use your
  right hand to examine your left breast.
• Put a small pillow or towel under your left
  shoulder to aid you.
• Again, use the pads of your 3 fingers of your
  right hand to check your left breast in the
  pattern of your choice (spiral, pie shape wedges,
  or up and down).
• Be sure to always use the same pattern (it's the
  best way to know if there are changes).

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Step 3c

• And again, don't forget to feel your breast using
  light, medium, and hard pressure.
• After you're finished, you must repeat the
  procedure again for your right breast.

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Heres what you might find during your breast
exam

• Tender, lumpy breastsThis is usually part of
  your regular menstrual cycle due to swelling
  because you retain more water.
• Overall small lumps and a bumpy/grainy textureIf
  this texture is found on both breasts in the area
  around your nipples and the upper and outer parts
  of your breasts, you might only have fibrocystic
  breasts.

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• Single lump that feels like an oval and is hard
  on the outside, squishy on the insideThis may be
  a cyst. You can usually move a cyst under the
  skin and they sometimes produce a dull pain. A
  cyst is a fluid-filled sac that can vary in size
  from a pea to a half-dollar. Cysts appear most
  often in women aged 35 to 50 and increase as
  menopause approaches. They are benign.

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• Single, solid lump that feels round like a small
  rubber ball and can be movedThis may be a
  fibrodenoma, a benign and painless tumor made up
  of connective tissue and other cells. A
  fibrodenoma may vary in size from a marble to a
  lemon. They are more common in women in their
  late teens and early 20s or older women on
  Hormone Replacement Therapy.

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• Overall distinct large lumpsThese may be just
  exaggerated lumpiness, called pseudolumps. These
  may be caused by scar tissue, a clump of fat
  cells, or an abscess (pus-filled sac). Sometimes
  nursing women experience mastitis, when bacteria
  enters the breast from dry cracks in the skin.

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• Single, solid lump that can NOT be movedLook for
  hard, irregular borders to the lump. Also,
  determine if the lump appears in only one breast
  and if it remains the same size throughout your
  menstrual cycle. Note that thickened or dimpled
  skin is a sign of a lump that can NOT be moved
  (other benign lumps are movable because they are
  filled with fluid or lumps of fat). If all of the
  above occur, these are symptoms of breast cancer.
  Get it checked out immediately.

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• Sores or scaly skinAn open, itchy sore could
  just be a simple skin irritation (like from a new
  lacy bra that's cutting into you, or from
  switching your laundry detergent). However, in a
  few women, this could be a sign of Paget's
  disease, a rare form of breast cancer.

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• Discharge or puckering of the nipplePersistent
  clear or bloody discharge from one nipple may
  indicate cancer in your breast ducts. Also, an
  inverted or puckered nipple (e.g., pulled back
  into the breast) may be a symptom of breast
  cancer.

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• If you find that you exhibit any characteristics
  that are abnormal or concern you (aside from
  normal menstrual lumpiness or retention of
  water), don't screw around. Go see your physician
  immediately for a clinical breast exam and other
  tests. While some of the abnormalities mentioned
  are usually benign, nothing is 100 and it's good
  to keep your doctor in the loop.