4 Real Things We Learned From Breast Cancer Awareness Month

November 13, 2019

4 Real Things We Learned From Breast Cancer Awareness Month
October: the month of goblins and boobies. Not to say they go together, but shouldn’t they be given equal attention? It’s so discouraging to see that we have no problem stocking Halloween decorations into our carts but buying a pink ribbon in support of breast cancer seems to cost our lives. Come on, it’s breast cancer awareness month. An illness that has taken away multiple lives of women – mothers, daughters, aunts and spouses. It knows no boundaries and it gives no mercy to no one. Did you know that about one in 19 women are Malaysia are at risk? That’s quite a lot!

Don’t let it be a hankering when you lose your two globes. It won’t take much time and effort to love them, just some attention monthly to make sure they’re healthy and their normal selves. Starting with the breast self-examination, it’s a small step you can take right? Now take off your clothes and let your juggies run lose. We’re here to teach you how to check them correctly.
How to Self-Check Your Tits
How to Self-Check Your Tits
Step 1: Visual Examination
Stand in front of a mirror with your shoulders straight and your arms on your hips. Observe your boobs to check whether there’s a change in size, shape or colour. Next, raise your hands and look for the same changes.

Step 2: Physical Examination
Using the pads of your three fingers, move in a pattern that covers the entire area and armpit. It can be done in a circular motion, up-down vertically in rows or a compass manner. And when you’re done, pinch your nipples for any breast discharges.

As for the pressure:
Light pressure: when you’re feeling the skin and tissue just beneath
Medium pressure: for the tissues in the middle of your breasts.
Firm pressure: when you’re reaching the deep tissues at the back, press hard and you should be able to feel down to your ribcage.
Multiple Positions to Check:
In Front Of A Mirror
Lather your fingers with lotion to help your fingers glide more smoothly over the skin. After checking around the boobs, don’t forget to raise your hands and examine the sides and armpits.

When In the Shower
Most girls prefer to do this in the shower when boobies are wet and slippery. The steps are the same as the other self-exam types and you can either do this sitting or standing.

When Laying Down
Breast tissues spread out evenly along the chest wall, which makes it easier to spot any lumps. When you’re checking your right breast, put your hand behind your head and use your left hand to check your breast. As you’re ready to check the other side, do the same but with opposite hands. In short: check your left side with your right hand and right side with your left hand! Got it?
When to Make a Visit to the Doctors:
When to Make a Visit to the Doctors
Dimpling, puckering or bulging of the skin
  • the appearance of your skin is similar to the texture of an orange peel.
  • it’s often associated with inflammatory breast cancer.
A nipple that has changed position or an inverted nipple
  • unless you’re born with it, this is usually one of the symptoms.
  • instead of pointing outwards, the nipple is pulled the breast.
Nipple discharge
  • milky discharge is common when you’re breastfeeding but this should turn the red light if you’re not.
  • This can be in watery, milky, yellow fluid or blood form.
Changes in size & shape of the breast
  • If you notice your breasts swelling at times other than your menstrual cycle, or if only one breast is swollen, consult your doctor!
  • In cases of normal swelling, both breasts remain symmetrical. It won’t suddenly be larger or more swollen than the other.
Peeling, scaling, or flaking skin
  • Don’t immediately scream breast cancer when you notice these symptoms. It can simply be a characteristic of atopic dermatitis, eczema, or other skin conditions.
  • Have your doctor run a few tests to rule out these diseases.
Skin rash on the breasts
  • In cases of inflammatory breast cancer (IBC), skin rash or redness is an early symptom.
  • IBC doesn’t usually cause lumps, but your breasts may become swollen, warm and appear red.
What’s Next?
Don’t panic if you felt a lump (but don’t go without having it check out either just because we said so!). Pick up the phone to make an appointment with your gynaecologist or a breast specialist. They will most likely have you do an ultrasound or mammogram depending on your age.

While you're anxiously waiting for the day of your appointment, heed advice from a professional instead of Googling your symptoms and thinking it to be cancerous. We've managed to sit down with Dr Kiran, a general surgeon who specializes in breast surgery from Columbia Asia Hospital Klang, to discuss about the most commonly asked questions about breast cancer.

4 Real Things We Learned From Breast Cancer Awareness Month
Most Commonly Asked Questions
Breasts come in all shape and sizes. How do you know whether they’re normal?
Breasts come in a wide range of shapes and sizes. No two people have breasts that look exactly the same. It depends on our genetic influence, weight, age and other factors such as pregnancy and breast-feeding. We should be concerned if there is a sudden change in the size or shape of our breasts or even sudden change in the appearance of the nipple or skin overlying the breast.

At what age should girls start performing breast exams?
Once a girl hits puberty, she should be encouraged to perform breast self-examination (BSE) regularly. Although there is no evidence on the effectiveness of BSE and it does not have a meaningful impact on breast cancer survival rates, the practice of BSE has been seen to empower women and encourage them to take responsibility of their own health.

How often should you get a breast examination?
Breast examination can be divided into 2 – breast self-examination (BSE) and clinical breast examination (CBE). BSE is usually performed by the woman herself. CBE, on the other hand, is an examination performed by health care providers. There are no specific guidelines recommending the frequency of breast examinations but women are encouraged to perform BSE monthly. There is insufficient evidence to support routine CBE in population-based screening. However, CBE plays an important role especially in women who fear mammograms or those who have limited access to mammography.

* One should also remember that a negative examination does not exclude the presence of breast cancer.

When is the best time to do it?
The best time to do a monthly BSE is about 3 to 5 days after our period starts as our breasts are not as tender or lumpy at this time. It should be performed at the same time every month so that it becomes a routine. For those who have undergone menopause, breast exam can be done on the same day every month.

How do I differentiate a breast gland from a lump?
Breasts contain tissues of varying consistency - including fatty, glandular and connective tissue. Breast related symptoms, such as tenderness or lumpiness, changes with our menstrual cycle. It is difficult to differentiate breast lumps from lumpy glandular breast tissue especially during breast self-examination. If there is any suspicion, do consult your doctor for further examination/ investigation.

Do all lumps translate to breast cancer?
Although breast cancer is the most common cancer found in women, most breast lumps detected during breast self-examination (BSE) or clinical breast examination (CBE) are benign in nature (non-cancerous). In fact, more than 80% of them are benign. Cancerous breast lumps tend to feel hard and irregular shaped, while many benign breast lumps are smooth or rubbery to touch.

Do breast implants raise your breast cancer risk?
There is a possible association between breast implants and the development of breast-implant associated anaplastic large cell lymphoma (BIA-ALCL), an uncommon cancer of the immune system. However, further research is required to understand better the relationship between this condition and breast implants. If you have breast implants, do visit your doctor for routine checkups and report any signs or symptoms promptly. If you are considering breast implants, discuss risks and benefits with your doctor.

What can one do to lower the chances of getting breast cancer?
In terms of reducing the chances of developing breast cancer, we should address our risk factors. Risk factors simply mean factors that increase our chance of developing breast cancer; which can be divided into two types: non-modifiable and modifiable risk factors.

Non-modifiable risk factors are factors that cannot be changed – it includes gender, family history of breast cancer and being a carrier of the BRCA1 and BRCA2 gene mutation. Hitting puberty early (<12 years old) and menopause later in life (>55 years old) increases the risk of developing breast cancer.

Modifiable risks come down to lifestyle choices such as sedentary habits, alcohol consumption, smoking and even long term intake of exogenous hormones in the form of oral contraceptive pills or hormone replacement therapy. Not bearing children, full-term pregnancy after the age of 30 as well as no breastfeeding increases the risk further.

Non-modifiable risks cannot be changed. However, the risk may be lowered for some patients; for example, prophylactic mastectomy can be performed to lower breast cancer risk in BRCA gene mutation carriers. In terms of modifiable risk factors, leading a healthy lifestyle, regular exercise and maintaining a healthy weight will not only reduce the risk of breast cancer but also reduces the risk of recurrence in survivors.

What are the things we keep doing that increases the risk of breast cancer?
Most of us are aware that excessive alcohol consumption, smoking and leading a sedentary lifestyle increases the risk of not only breast cancer but various other cancers. Hence, limiting the amount of alcohol consumption and cessation of smoking is important. Lead a healthy lifestyle, ladies!

Dr. Kiran Kaur D/O Amer Singh
Consultant General Surgeon
Columbia Asia Hospital – Klang

BSc (Hons) (Biomedicine) (UPM), MD (UPM), M Surgery (UM), Special Interest In Breast Surgery
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