According to the National Breast Cancer Foundation, breast cancer today is the most common cancer in India. Today, breast cancer accounts for 14 per cent of all tumours in Indian women. Globally, it has taken the lead as the most prevalent cancer among women, surpassing lung cancer in 2020. This concerning trend in India comprises a high percentage of women developing breast cancer at a younger age compared to their Western counterparts. But, this underlines the vital role of early detection and intervention in improving treatment outcomes. As women, we must know how to check ourselves regularly and consult a doctor immediately post noticing unnatural growths.
The importance of awareness
One of the primary factors contributing to the high prevalence of breast cancer is the lack of awareness among Indian women regarding the disease and the significance of early detection. Insufficient knowledge often results in late diagnosis, leading to high mortality rates. Women often wait for symptoms to show up before consulting doctors. In a diverse and culturally complex country like India, where misconceptions and social stigmas can hinder open discussions about breast health, education becomes pivotal. By informing and creating awareness among women, we can dispel myths, alleviate fears, and encourage open dialogue about breast health. Empowering women with knowledge about risk factors, symptoms, and the importance of regular self-examinations and mammograms is crucial. This knowledge equips them to assess their risk and take proactive steps toward prevention and early detection.
Early detection is key
Early detection plays a central role in improving treatment outcomes and saving lives. Empowering women to take charge of their breast health by teaching them the correct method for breast self-examination is a crucial step. This is even more critical for women with risk factors that may increase susceptibility to breast cancer, such as age, family history, hormone replacement therapy, and lifestyle choices.
Self-examinations are simple, cost-effective, and can be performed in the privacy and convenience of one's home. When women are educated on the correct technique for self-examination, they become familiar with the normal look and feel of their breasts, enabling them to promptly identify any changes or abnormalities. This education should encompass recognising signs like lumps, alterations in size or shape, skin dimpling, nipple discharge or inversion, or unexplained breast pain. They should be encouraged to seek medical attention promptly if any changes are observed. Seeking timely medical attention can make a life-saving difference in their breast cancer journey.
How to conduct a self-examination?
Breast self-examination is a method for you to get familiar with your breast's normal texture and identify any potential changes. It should be used alongside mammography and clinical breast examinations, not as a replacement. However, there is debate about its effectiveness in reducing breast cancer mortality. There are two key steps in breast self-examination: tactile and visual examination as per the World Health Organization (WHO)
1. Tactile Examination:
This involves covering the entire breast, lymph nodes, underarms, and upper chest. This should be done using light, medium, and firm pressure in techniques like vertical strip, wedge section, or concentric circle. Use two or three fingers with sensitive palmar pads for a systematic examination, avoiding compression between fingers.
• Vertical Strip: Start from the underarm area, move fingers downward, then slightly toward the middle, and move upwards over the breast. Repeat for the whole breast.
• Wedge Section: Divide the breast into wedges and move the fingers toward the centre for a thorough examination.
• Concentric Circle: Use a circular motion, starting with a small circle around the nipple and widening it to cover the whole breast.
Body posture for conducting the examination:
Tactile examination can be done lying down or standing in the shower, depending on preference. In the lying down position, a pillow or towel is placed under the shoulder, allowing for a more even breast distribution. In the shower, breasts can be examined with wet, slippery fingers, reducing friction.
During the examination, women should look for changes in breast texture, such as new lumps, persistent lumps or tissue thickening, changes in breast size, shape, or symmetry, thickening or swelling, dimpling, skin changes, nipple abnormalities, discharge, tenderness, or retraction.
Specific changes to look out for:
1. A new lump or hard knot in the breast or armpit.
2. A lump or thickening that doesn't reduce after the menstrual cycle.
3. Alterations in breast size, shape, or symmetry.
4. Thickening or swelling of the breast.
5. Dimpling, puckering, or indentation on the breast.
6. Changes in the skin or nipple, such as dimpling or irritation.
7. Redness or scaliness of the nipple or breast skin.
8. Nipple discharge (not breast milk) that is clear, sticky, dark, or occurs without squeezing.
9. Nipple tenderness or pain.
10. Nipple retraction (turning inward).
Promptly reporting these changes to a physician is necessary for early detection and evaluation.
2. Visual breast examination:
This is a valuable tool in detecting potential breast issues. While no two breasts are exactly alike, if you know your breast appearance, you can quickly notice any changes in shape, colour, or structure. To perform a visual examination, follow these steps:
1. Stand in front of a mirror with your upper body unclothed.
2. Position a good light source to the side (not from above) for better clarity.
3. Examine your breasts in various positions:
• With your arms relaxed and at your sides.
• With your arms raised.
• With your palms flat on the sides of your hips and pressing down.
• Optionally, you can clasp your hands in front of your forehead to tighten chest muscles or bend forward to examine the breasts.
While looking in the mirror, check for changes in breast contour, colour, shape, nipple inversion, skin irregularities, and discharge from the nipples.
Specific signs to look for:
• Change in breast contour, like swelling.
• Nipple inversion or retraction.
• Dimpling or puckering of the skin.
• An "orange peel" appearance of the skin, which indicates swollen and shiny skin with large pores, often associated with blocked lymph ducts.
• Whitish scale on the nipples, ulcers, or non-healing sores, which can indicate possible breast disease.
Notably, a flat, inverted, or retracted nipple, especially if it's a new development or if it inverts when leaning forward, could also be associated with breast disease. Detecting these changes is essential for early diagnosis and prompt medical evaluation.
While self-examinations are important, it's essential to know that self-examination should complement, not replace, regular clinical exams and mammograms, which are more effective in detecting cancer at an early stage. We recommend you to consult a medical expert for advice and guidance.