Though October is officially Breast Cancer Awareness month all over the world, now is a good time as any for all women to take extra precaution when it comes to breast cancer. HEALTH presents an in-depth guide to breast cancer…
The incidence of breast cancer, points out specialist breast surgeon Dr. Houriya Kazim is increasing globally. “Interestingly, the more developed countries become, the more breast cancer is seen,” she says and adds that researchers have reported that in the entire Middle East region, breast cancer occurs 10 years younger than expected and the disease tends to be much more aggressive. The good news however is that despite an increase in the number of cases being diagnosed, more women are surviving. “Around five times more women are diagnosed with breast cancer than who die from it,” she notes. “Why it is on the rise is most likely multi-factorial related to changes in lifestyle, food, environmental toxins, genetics and so on.”
Signs to Watch Out For
According to Dr. Iliana Gancheva Dmitrieva, specialist obstetrician and gynaecologist, when breast cancer starts out, it is too small to feel and does not cause signs and symptoms. She explains, “Symptoms later on may include a lump in the breast or underarm, thickening or swelling of part of the breast, irritation or dimpling of breast skin, redness or flaky skin in the nipple area or the breast, pain in the nipple area, nipple discharge, change in the size or the shape of the breast, changes in color or texture, and/or an inverted nipple.”
For women with two or more first degree relatives, risks decrease with age at first live birth, tells Dr. Dmitrieva. “Breast
cancer amongst first-degree relatives–sisters, mother, and daughters–is also a risk factor since having one or more
first-degree blood relatives who have been diagnosed with breast cancer increases a woman’s chances of developing the
disease,” she says. “Another risk factor is breast biopsies as women who have had breast biopsies have an increased risk
of breast cancer, especially if the biopsy showed a change in breast tissue, known as atypical hyperplasia.” Other risk
factors are age at menopause, use of birth control pills, high body mass index, a high-fat diet, alcohol, radiation exposure,
and environmental pollutants, and use of hormone therapy.
These include a personal history of breast abnormalities and age, since the risk of developing breast cancer increases with age. The majority of breast cancer cases occur in women older than age 50 as well as the age at menarche (first menstrual
period). “Women who had their first menstrual period before age 12 have a slightly increased risk of breast cancer and also the age at the woman’s first live birth and the family history of breast cancer,” Dr. Dmitrieva explains.
Breast Self- Examination (BSE)
A breast self-examination has to be done at a regular interval. The duration depends on your own menstrual cycle as the breast is more soft and easy to be checked about five to seven days after the start of the cycle. In women who don’t have a cycle it can be done at any fixed time of the month. Lactating women should also follow the same, only they should do the examination after emptying the breast. Women who have a breast implant should also do a regular self-examination.
How do I perform my BSE?
- Stand or sit undressed from the waist up in front of a full-length mirror with your arms relaxed at your sides. Get to know how your breasts look; even small visual changes may be an important sign of a problem.
- Compare your breasts while turning from side to side. Look for any changes in breast size, shape, skin texture or color including redness, dimpling, puckering or retraction.
- Look for any nipple changes and place your hands on your waist and press inward, then turn from side to side to
note any changes.
- Place your hands at your waist and bow toward the mirror, letting your breasts fall forward. Note any changes in
- Nipple discharge can be an indication of a problem. Also feel above and below your collarbone for pea- and bean-sized lumps or thickening. Check for lumps or thickening under your arm.
For the next steps, lie down
- Place a pillow under your left shoulder. Bend your left arm behind your head and reach across with your right hand to your left breast.
- Begin the exam at the armpit. Move your three middle fingers together using light, medium and deep pressures. Use the pads of your three middle fingers together, to examine every part of your breast tissue. Your hand should move in straight rows to cover all the breast tissue and then repeat on the other side. If you feel anything new in
your breast, visit your doctor immediately.
Diagnosis and Treatment
According to Dr. Kazim, the best early diagnosis for breast cancer should include a combination of routine breast self-examination, an annual physical examination by an expert and screening mammograms in women over the age of 40. Screening means women over the age of 40 with no obvious symptoms of the disease such as no pain, no lump, and no
nipple discharge and then using various techniques such as clinical examination, mammograms and so forth to pick the disease up at an early and treatable stage. Once detected, she adds that the management of breast cancer is individualized for the most part and is improving rapidly in all fields. “Treatment is in four stages – surgery, chemotherapy, radiotherapy and hormone therapy but not every case of breast cancer will require all these treatment modalities,” she says.
Mammographic screening for breast cancer, explains Dr. Dmitrieva, uses x-rays to examine the breast for any uncharacteristic masses or lumps. “In some countries a screening mammogram is suggested at age 40, with a repeat screening every year or two,” she says while some national programs start mammography at 45. Mammography screening is recommended at an earlier age and additional testing may include genetic screening that tests for the BRCA genes and / or magnetic resonance imaging.
Many women opt for breast reconstruction after treatment. Plastic surgeon Dr. Malcolm D. Paul explains that the most common options for breast reconstruction are: the placement of a tissue expander to stretch the remaining breast envelope followed by insertion of a permanent breast implant. “This is desired by many women who do not want or are not candidates to have their abdominal skin and fat used for reconstruction,” he says. “Another is the use of skin and fat from the abdomen to reconstruct the breast providing a natural feel to the reconstructed breast while simultaneously improving the contour of the abdomen.” There are also fat injections alone to reconstruct the breast. This is desirable because there is minimal downtime; no use of an implant in many cases and provides a soft, natural feeling breast.
Foods That Help Fight Breast Cancer
While there is no proven diet that can prevent breast cancer there are certainly specific foods we can eat to help reduce our chances of breast cancer.
- Oily Fish – Fish oil will provide long chain omega-3, a powerful anti-inflammatory in the body that has been shown to re-lengthen telomeres, which shorten when you have cancer.
- Sunflower Seeds – High in zinc and natural vitamin E. Zinc helps vitamin C do its work and accelerates healing time.
- Mushrooms – There´s an enormous body of research evidence now that shows how ´medicinal´ mushrooms
(Shiitake, Maiitake, and cordyceps) boost the immune system and fight cancer.
- Tomatoes – According to Harvard research 7 to 10 helpings a week has an influence on many cancers such as lung, colon, cervix, and breast.
- Green leafy vegetables – Along with avocado, beans, carrots, apricots, pumpkins, and egg yolk green vegetables will give you folic acid. This will help your DNA to replicate properly and protect it during radiotherapy.
The Psychological Impact
According to psychologist Devika Singh-Mankani, a breast cancer diagnosis changes a woman’s life across multiple domains. “Breast cancer can affect relationships, everyday functioning including self-care, emotional functioning, sexuality, employment as most report discrimination because the cancer treatment may involve time away from work and may have negative effects on performance,” she says.
A positive attitude has also been known to help with individuals suffering with cancer- evidence from studies with various types of cancer patients suggests that a positive outlook can improve mood, quality of life, and coping, as well as ameliorate disease and treatment-related symptoms, such as chemotherapy-induced nausea, vomiting, and pain.
Tips to Help Cope with Breast Cancer
- Don’t blame yourself. No one knows what causes breast cancer.
- Seek help early. Seek alternative therapies to complement your treatment plan as these have been shown to help with recovery and prevention. Join a support group or form one if you don’t have one in close proximity to you.Focus on yourself. Sleep, nutrition, educating yourself about the do’s and don’ts will keep you feeling stronger and empowered. Remember you are not alone. There are millions of women making this journey with you.
(Credit: Devika Singh-Mankani)
3. Brest Friends – Brest Friends is a doctor-led, independent not-for-profit organisation for breast cancer patients and survivors. Dr. Houriya Kazim, Specialist Breast Surgeon explains, “When I decided to start the support group, the only qualifications that I brought to the task were the experience of treating breast cancer patients and my desire to help others emotionally survive the experience. I had never set up or run a support group of any kind in my life. Our support group is a place for people in similar situations to give and receive both emotional and practical support as well as to exchange information. Ladies who attend the group can expect to both learn more about their cancer and get new ideas from others who have “been there, done that.” Brest Friends meets once a month; for further details, visit www.brestfriends.org