Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
Breast lumps are very common. Fortunately, they’re not always a cause for concern. Ordinary reasons, such as hormonal changes, can cause breast lumps that appear and disappear on their own. Many women are screened each year for breast lumps, and these tests show that up to 80 percent of lumps are benign, or noncancerous. While it may be difficult to determine whether or not a lump is cancerous, learning how to do a breast examination and understanding some signs to look out for can determine if a lump might be concerning, and help to decide when to seek medical care.
A breast self-examination is a screening technique that can be done at home to check for breast lumps.
A breast self-exam can help screen for:
* Tumours
* Cysts
* Other abnormalities in the breasts
NOTE:
Breast self-examination was once thought to be a good screening process for breast cancer. Now a self-exam is considered to be less effective than other techniques, such as regular mammograms. This has led groups such as the American Cancer Society to deem breast self-exam optional. However, in Guyana’s setting, where services for ultrasound or mammogram may not be readily available, the breast self-exam can be a crucial tool in early diagnosis of breast cancer and other breast-related issues.
A breast self-examination helps to familiarise oneself with the shape, size, and texture of their breasts. This is important, because it can help to determine if the experience is normal or abnormal. This should also be reported to a healthcare provider.
Preparation
The best time to do a breast self-exam is a few days after the monthly menstrual cycle ends. Hormonal changes can affect the size and feeling of the breasts, so it’s best to perform the exam when the breasts are in their normal state.
Women who don’t menstruate should choose a certain day to perform the exam, such as the first day of each month.
A journal of the self-exams should be kept, because it helps to track and record any changes that were noticed in the breasts.
PERFORMING A BREAST SELF-EXAMINATION
Start by standing topless in front of a mirror with hands at the sides.
Visually inspect your breasts for the following:
* Changes in size, shape, or symmetry
* Dimpling(deep hole-like appearance on the skin)
* Inverted nipples
* Puckering
* Asymmetrical ridges at the bottom.
Check for these signs with the hands at the sides. Then, with the arms over one’s head, and again when lifting one breast at a time.
* Using the pads (base) of the fingers, not the tips, inspect the breasts while lying down, and again in the shower. The water and soap in the shower would allow the fingers to glide easily over the skin.
* Using varying pressure, and with gentle care, massage the fingers over the breasts in a spiral pattern, starting at the nipple. Make a way up to the top of the breast near the collarbone, to the centre by the breastbone, and to the sides near the armpits. Do this by putting one arm over the head while massaging the breast with the other hand.
* Lastly, gently squeeze the nipples to check for discharge.
RISKS OF A BREAST SELF-EXAM
There’s no medical risk involved in a breast self-exam. Finding a lump in the breast can be alarming, but most breast lumps are not malignant, or cancerous; they’re typically caused by other benign conditions.
Breast self-exams have also been associated with an increase in unnecessary breast biopsies, which are procedures that involve the surgical removal of breast tissue. Because most abnormalities in breast tissue are noncancerous, the extra surgical procedures put women at risk for rare complications, such as bleeding and infection.
AFTER A BREAST SELF-EXAM
Finding a lump or abnormality is not cause for panic. Remember that the vast majority of breast abnormalities turn out to be benign, or noncancerous.
Besides cancer, breast lumps can be caused by:
* Fibro-adenoma, which is a benign tumour of the breast tissue
* Fibrocystic breast disease (changes), which is painful, lumpy breasts caused by hormone changes, especially during breast enlargement.
* Intraductal papilloma, which is a small, benign tumour of the milk ducts
* Mammary fat necrosis, which refers to lumps formed by bruised, dead, or injured fat tissue
* Abscess- treatable
* Cyst- Treatable
* Lipoma/Treatable
* Mastitis/Inflamed breast due to infection or trauma, and is treatable with antibiotics.
However, this doesn’t mean that a lump or abnormality should be ignored. Finding a lump should motivate persons to make an appointment with their healthcare provider to have their breasts professionally examined, or additional test ordered.
