Breast Cancer Awareness Month

Breast cancer occurs due to cells dividing abnormally and in a disorganized fashion. It usually starts in the sacs that produce milk (lobules) or the tubes (ducts) that carry milk from the sacs to the nipple. 

Apart from breast cancer being the most common cancer in women, it is also the second commonest cause of death caused by cancer. About 1% of men get diagnosed with breast cancer as well. The predisposing factors to breast cancer include age, family history of breast cancer, previous history of breast cancer, breast cancer gene mutation, age of first menstrual period, age of first pregnancy and age of menopause, prolonged use of oral contraceptives (hormonal therapy), poor diet, obesity, lifestyle and radiation exposure.  

Allow me to break down these risk factors to show you the link between them and breast cancer.  

Increasing age is the most common risk factor with the peak age being age 75. After 50 years, the risk of acquiring breast cancer increases seven fold. In previous history of breast cancer, complete remission can be difficult to achieved in some cases. The chances of acquiring breast cancer also increase significantly if there is positive history in first degree relatives compared to distant relatives. Breast cancer is also caused by mutations in two specific genes; BRCA 1 and BRCA 2. Mutations in these genes also increase the risk of ovarian cancer. These mutations are however not commonly seen. Early start of menstruation, pregnancy at older age (above 30 years) and never having a child (nulliparity) all are occurrences that increase the risk of acquiring breast cancer later in life. The risk of acquiring breast cancer is seen to be higher for women who are obese after menopause as fat cells produce the hormone estrogen. Excessive smoking and alcohol consumption also increases the risk of breast cancer. Exposure to radiation such as radiation from x-rays contributes to developing breast cancer eventually. 

At the onset, breast cancer does not present with any symptoms and can be easily missed. The first symptom is usually a distinct lump that appears in one breast only and can freely move under the skin when manipulated with both hands in the early stages. However in the later stages, this lump will be more adherent to the surrounding tissue making it less mobile when manipulated. In advanced cases, the skin over the lump will be dimpled and leathery looking like the skin of an orange. If the cancer has spread, the lymph nodes particularly in the armpit of the affected side may be swollen, feeling like small hard lumps and are usually painless. 

Since breast cancer may be hard to detect in its early stages due to its asymptomatic nature, it is important to carry out regular screening to detect it early. Prognosis of breast cancer is best when it is discovered early and treatment initiated early.  

How many of us ladies love to feel in control of our bodies and our health? I know it can’t just be me. 

So I will focus on breast self-examination. Remember the lump I mentioned earlier that appears as the first common sign of breast cancer? Well, that is what self-examination enables us to detect. The steps to carrying out breast self-examination include: 

Observation of breast physical changes in front of a mirror: Look out for changes in size between the two breasts, changes in the nipples, dimpling of the skin and nipple discharge. 

Observation of the shape and contour of the breasts: This is done with the hands clasped at the back of your head in front of a mirror to help notice more subtjble changes especially in the lower part of the breasts. After this, firmly place your hands on your hips and bend slightly forward toward the mirror, pressing your shoulders and elbows forward to also observe the shape and contour. 

Feeling for lumps and nipple discharge of each breast, one at time, while standing and while lying down. 

To note is that this examination should be done at the same time each month and particularly two or three days after the end of the menstrual period for menstruating women. 

Allow us to walk this journey with you as we offer you a variety of specialists ready to consult with you and appropriately manage your symptoms at whatever stage of your diagnosis and a variety of lab and imaging tests that enable the process of breast cancer screening on 

Remember that an early diagnosis is always better than a late diagnosis. Make time for yourself and get screened and learn how to self-examine. 

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