Breast Cancer Awareness Week – Go passionately pink

Written by on October 18, 2008 in u

We are asking all women to cherish their breasts by checking them each month for changes to help detect breast cancer early. All women are at risk of being diagnosed with breast cancer. In the past, breast cancer mostly affected women over 40 years old but we are seeing younger and younger women presenting with breast cancer. The key is to detect breast cancer early so that you can get treatment and have a better chance of survival.

Go passionately pink for October and keep cancer survivors close to your heart. This is our message for our awareness campaigns in October, which is International Breast Cancer Awareness Month. The pink ribbon is an international symbol for breast cancer awareness. Many South Africans wear pink or pink items such as pins and ribbons in order to show their support for the cancer cause. Click here to see a list of pink items that are available for sale.

This message was from CANSA:

Signs and symptoms of breast cancer

Symptoms are not obvious in the early stages. Any woman should seek advice if she notices any change in her breast. Later symptoms may include:

  • Breast lumps: these are usually painless, but some cause a prickly sensation
  • Change in nipple appearance: the shape or the skin may change
  • Unusual nipple discharge: especially stained with blood
  • Change in the skin of the breast
  • A lump or swelling under the arm

Occasional symptoms include:

  • Breast swelling
  • Vague discomfort in the breast
  • Breast pain or tenderness
  • Change in breast contour, texture or temperature

How is breast cancer diagnosed?

This is based on the ‘triple assessment’. The physician will take a history and examine the patient. The radiologist will do a mammogram and/or an ultrasound. The cells of the lump may be sampled using a fine needle or by taking a core of tissue.

If all of the above suggest the lump is not malignant, the lump may be watched and followed up. If one of the tests casts any doubt, the lump should be removed.

Clinical Assessment: There are two parts to this: the patient’s history and the examination. The general medical history from the patient includes the history of the illness, family history and past medical history of the patient. In a clinical examination, the examiner gently palpates (feels) your breasts, noting shape, texture, changes in skin and nipples and location of any lumps, as well as whether these are attached to skin or deeper tissues. Lymph nodes under the arm and above the collarbone are palpated for swelling.

Mammography: Low-intensity X-ray of the breast. This may be done for screening (if no abnormalities were found in an examination) or for diagnosis. A mammogram takes about 20 minutes and can detect many changes or abnormalities, before they grow large enough to be felt. Diagnostic mammography may indicate whether a breast lump is malignant or not.

If the mammogram was done for screening and shows an area of abnormal tissue that is probably benign, you return in four to six months for a re-check. If it shows no serious abnormality, regular screening programmes should be adhered to. These include mammographic screening and clinical screening. When the mammogram shows abnormalities, the radiologist may recommend another type of exam, such as a biopsy.

If the mammogram was done as a diagnostic test, the results must be seen in the light of the clinical findings and the biopsy.

What happens during a mammogram? You stand or sit in front of a special x-ray machine while the radiological technologist lifts each breast and positions it on a platform that holds x-ray film. A plastic plate presses the breast against the platform. Pressure for a few seconds means the x-ray dose can be lowered and ensures the x-ray shows as much breast tissue as possible. This pressure is harmless and usually not painful, but it can be uncomfortable. Avoid having mammograms when your breasts are tender, such as before your period.

Discuss results with your doctor. Calcifications are mineral deposits, which may appear as white spots on the film. They may be caused by benign conditions or, less often, by cancer. If the mammogram shows masses, these are usually biopsied if they are not cysts (benign collections of fluid).

Ultrasound or removal of fluid with a needle (aspiration) may confirm whether a mass is a cyst. Some masses are monitored with periodic mammograms; others require biopsy.

Mammograms can suggest but not prove the presence of cancer. Mammography detects 85 to 90 percent of breast cancers. Approximately 10 to 15 percent are not visible on mammography, but are felt on physical examination. Mammograms are more unreliable in woman younger than 40.

Breast ultrasound: sound waves are bounced off tissues and the echoes converted into a picture (sonogram). Ultrasound helps distinguish between cysts and solid tumours. It is particularly useful in younger patients whose breasts are too dense for mammography.

MRI Scan: This is being done in some specialist centres through out the world. It is very effective in picking up small cancers, especially in young women who have dense breasts. Several studies from Europe have shown that it is useful in screening women who have a genetic susceptibility to cancer. The problem is that it is very expensive and unpleasant for the patient.

Nipple discharge examination:Initially, it is to check for blood. If blood is present a sear is done to check for cancer cells. Clear or milky secretions are very unlikely to result from cancer. A red-brown colour may indicate cancer, although benign conditions are more likely. Even when no cancer cells are found, cancer cannot be ruled out. If a suspicious mass is also present, a biopsy is necessary.

Biopsy (sampling of the tissue): This may be done as part of the assessment of a lump even though the clinical examination and the radiological examination suggest that the lump is not cancerous. Alternatively, an abnormality on a mammogram may be sampled using special radiological equipment. 80 percent of biopsies are non-cancerous.

Fine-needle aspiration biopsy: A needle is guided into the abnormal area while the doctor palpates the lump. Once the needle is in place, fluid is drawn out. Clear greenish fluid usually indicates a benign cyst. Bloody or cloudy fluid can mean a benign cyst or, rarely, cancer. With a solid lump, tissue cells are aspirated. In most cases, examination under a microscope will determine whether abnormalities are benign or cancerous.

Core needle biopsy: A small cylinder of tissue is removed from an abnormality.

If after the ‘triple assessment’ the lump is suspected to be cancerous or the diagnosis is still not known, then the lump should be removed.

Surgical biopsy: All or part of a lump is surgically removed for examination. Excisional biopsy removes the abnormality along with a surrounding margin of apparently normal tissue, and is usually considered the first of a two-step procedure (a diagnosis of cancer by needle biopsy can also be considered the first step.)

The second step is complete local treatment of the cancer through radiation therapy or additional surgery. With the two-step procedure for biopsy, a cancer diagnosis is known shortly after biopsy, but the extent of cancer is not known until after local treatment surgery.

If the abnormality is not a lump but a change on a mammogram that cannot be palpated, then the tissue has to be removed using a technique called a ‘hookwire biopsy’. The patient has another mammogram and the area of concern on the mammogram is located. The radiologist then places a wire into the area using the x-ray machine to guide it into position. The surgeon then cuts out the wire along with the surrounding tissue and sends it to be x-rayed again, to check the abnormal tissue has been removed.

Can breast cancer be prevented?

At the moment breast cancer cannot be prevented, but it can be diagnosed much earlier than before. Early diagnosis is possible with routine mammography and early biopsy of suspicious lesions. The earlier cancer is found, the better the chances of a cure.

American specialists advise that women should have a baseline mammogram at the age of 40. Between 40 and 50 years of age, mammograms are recommended every other year. After age 50, annual mammograms are recommended.

Between 20 and 39, women should have a clinical breast examination every three years, and annually from 39 on.

The following may help prevent breast cancer:

  • A low-fat diet (less than 20 percent fat), with plenty of fruits and vegetables, and ideal weight maintenance.
  • When cancer is found and treated early, there are more treatment choices and a better chance of recovery. Talk to your doctor about symptoms to watch for, and an appropriate check-up schedule.
  • Between clinical check-ups, do a monthly breast self-exam (BSE). Every woman’s breasts are different, and they change with age, the menstrual cycle, pregnancy, menopause, or taking oral contraceptives or other hormones. It may be normal for your breasts to feel lumpy, swollen or tender at times, such as immediately before a period or during pregnancy. By doing a monthly BSE, after age 20, you learn what is normal for your breasts, and are more likely to detect changes.
  • Breast-feeding may slightly decrease risk, especially if continued for 18 to 24 months. Strenuous exercise in youth might provide life-long protection. Even moderate physical activity as an adult can lower risk.

Health 24

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