When to examine your breast?

Kiedy badac piersiEvery year breast cancer takes a heavy toll. We are able to change these alarming statistics, though. It all depends on our awareness, vigilance and regular prevention. A fight against a breast cancer is not a lost cause, explains PhD MD Michał Kąkol from Rehasport Clinic in Gdańsk.

Media provide terrifying statistical data. Every year about 17 thousand Polish women contract a breast cancer, and nearly 5 thousand of them die of it. Is this information reliable?
Yes, these statistics are true. Considering the causes of death due to cancer, women’s breast cancer is now the second most common cancer and unfortunately the most common cancer if we take incidence rate into account. This leads us to the conclusion that breast cancer poses a serious threat to women.

Does every breast cancer entail the worst scenario? What determines effectiveness of a treatment?
It is essential that I emphasize the fact that not every breast lump is a cancer. This is the first point. Yet, you cannot ignore a breast lump. Secondly, I am absolutely sure that a cancer detection does not necessarily mean the worst is going to happen. In our country a vast majority of patients, around three fourth, are healed. Truth is that most people manage to deal with this disease.

A lot of attention is paid to women’s self-control, how can they examine their body on their own?
First of all you need to overcome your concerns. You shouldn’t be afraid of examining your own body, including visual and manual (palpation). There is no age limit to such idea. It is believed that every woman, every girl who is about to menstruate should start examining their breast. This must be done on their own and any method seems to be effective, be it in front of the mirror or when you take a shower. Breast must be examined when standing and lying. All you need to do is lift a hand in question and then put it on your head. Next, you must touch your breast with another hand and make circular movements (in both ways). It is also advisable to squeeze a nipple gently to make sure there is no leak. Later, you should switch into another breast and take the same actions. The best position is when you stand in front of the mirror because you can check for asymmetry or change of breast size. It is good to follow the same procedure when you lie.

What is the standard women’s checkup?
It is a very important question, indeed. After all every palpation self-examination must be verified with the so-called objective examination. It is all about examination performed by other persons with the use of diagnostic methods. The medical examination is the basic verification. As a rule it takes places at the gynecologist’s or surgeon-oncologist’s. If any irregularities are identified or if a patient or doctor suspects some irregularities, this clinical testing is supplemented with imaging examination. Speaking of young people, the basic examination for persons aged up to 45 is ultrasound examination.

In this age group the structure of a breast has glands, which is best visible in ultrasound examination. Speaking of persons aged more than 50, that is after the menopause, breasts are made mainly of fatty tissue. Such breasts perform much better in mammographic examination. Although both examinations are non-invasive, that is do not entail skin cuts, it happens that the mammographic examination causes pain. It is a result of the examination technique, which requires pressing the breast gland. I need to stress that the age limit I have mentioned before is arbitrary. It happens that a way younger people undergo mammographic examinations while older – ultrasound scanning.

What about magnetic resonance, is it used for the purposes of breast diagnostics?
Indeed, the breast magnetic resonance has been increasingly useful in the last couple of years. Nevertheless it is still a supplementation for the first two examinations. In case something is unclear, or there are difficulties in detecting suspicious changes, the resonance proves to be decisive. It is a common knowledge that thanks to today’s breast examination system, modern digital mammographic equipment as well as high-end ultrasound devices, these two examinations are basic and frequently sufficient.

Women happen to refrain from examining their breasts because they are afraid that doctors are bound to find something wrong.
Yes, similar to other disorders, doctors often encounter patients who are afraid of undergoing additional examinations and being diagnosed. They are frequently afraid of invasive testing, that is the so-called biopsy during which a tissue is taken by means of the needle or by making cuts. From the point of view of oncologists, it is essential that I emphasize that all actions we can take will let us identify some changes and often let us detect them very early. Identification of minor irregularities should convince patients to visit a specialist. If we ignore such visits or diagnostic testing, it may lead to development of the disease, and thus its identification at the advanced stage, which in turn may result in reduced effectiveness of the treatment.

I would like to add that according to analyses, nearly 50% of the diagnosed breast cancers are detected by women themselves. I can say that most of these people found something and decided to consult a doctor after they had identified a lump. Today we would like to diagnose cancers at their very early stages. This is why every woman in her 30s, who is active, who regularly examines her breasts should choose to have her breast examined by means of the ultrasound scanning. It is highly important especially if other members of the family already had cancers, or when this person takes hormonal preparations.

What are breast cancer treatment methods? Do all treatments entail breast removal?
Nowadays a vast majority of patients are subject to the so-called breast conserving treatment (BCT) or restorative treatment. Amputation, a standard at the close of XX century, is now chosen by fewer than 1/3 of women. Most patients undergo a conserving treatment which requires elimination of the pathological sources of the disease and lets the remaining part of the gland be intact. Such conserving treatment, if feasible, is as effective as breast removal. In addition, more and more patients may undergo the so-called restorative treatment. Where it is impossible to save the gland due to existence of many sources of changes or relatively considerable lump in relation to a small breast, we can remove the entire gland and maintain the skin intact. During the first surgery we insert an implant which reconstructs the missing breast.

So far we have been taking about women, does this problem apply to men as well?
It does, indeed. In fact men’s breast gland is minor but it is estimated that one out of a hundred women’s cancers is a men’s cancer. Similar to women, men should be vigilant and react if they detect any irregularities when feeling or touching their breast glands. Sadly we have not found any effective method of detecting men’s breast cancer because mammography is unfeasible and such people undergo ultrasound scanning usually very late. This leads to the situation in which men’s cancers are diagnosed at their advanced stage. Nonetheless, the treatment is similar to the one used among women.