October, Breast Cancer Awareness Month

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In a global attempt to raise awareness on breast cancer, October has been characterized as a pink month. The pink month carriage carries the load of the thousands of awareness and fundraising campaigns where efforts are introduced for the well-being of women.

Breast cancer has been a deadly cause of chest pain among women long before when the information was insufficient and deficient. Since the introduction of this pink month, the death rate has reduced to significantly low in affluent countries and to moderately low in poverty-stricken countries.

Early detection ensures the complete cure, while the treatment is limited to palliative therapy for the later and crucial stages where the benefit is only temporary relief.

In low-income countries, the awareness mainly emphasizes on the early detection by clinical breast examination every year in the menopause stricken women. Mammography being costly, is the 

Signs and Symptoms:

Common breast cancer signs and symptoms include:

  • a lump or swelling in the breast, upper chest or armpit – you might feel the lump, but not see it.
  • a change to the skin, such as puckering or dimpling
  • a change in the color of the breast – the breast may look red or inflamed
  • a change to the nipple, for example, it has become pulled in (inverted)
  • rash or crusting around the nipple
  • any unusual liquid (discharge) from either nipple
  • changes in size or shape of the breast

Pain in the breast doesn’t necessarily mean cancer, it might be one of the symptoms of premenstrual syndrome (PMS).

Metastasized Symptoms:

1- Lungs:

Whooping cough, Dyspnea (Shortness of breath)

2-Brain:

Headache, Nausea, Vomiting, Seizures, Memory problems, Speech Problems, Difficulty swallowing, Paresthesia (numbness), Loss of coordination and balance

3-Liver:

Hiccups, Ascites (fluid in the abdominal cavity), Jaundice

4-Bones:

Fractures, pain

5-Skin

Rash, Infection, Odor, Lymphedema (swelling in arms), Nodules

Breast Self-Examination:

Self-examination every month, after 4-5 days of the menstrual cycle helps in the early detection of the cancer but also prevents its spread to the whole body.

Mayo Clinic explains the self-examination as follows:

A breast self-exam for breast awareness is an inspection of your breasts that you do on your own. To help increase your breast awareness, you use your eyes and hands to determine if there are any changes to the look and feel of your breasts.

If you notice new breast changes, discuss these with your doctor. Though most breast changes detected during a self-exam for breast awareness have benign causes, some changes may signal something serious, such as breast cancer.

Why it’s done?

A breast self-exam that you do for breast awareness helps you understand the normal look and feel of your breasts. If you notice a change in your breasts that seems abnormal or if you notice one breast is different when compared with the other, you can report it to your doctor.

Many conditions can cause changes in your breasts, including breast cancer. Although the breast self-exam technique isn’t always a reliable way to detect breast cancer, a significant number of women report that the first sign of their breast cancer was a new breast lump they discovered on their own. For this reason, doctors recommend being familiar with the normal consistency of your breasts.

If you menstruate, choose a time in your cycle when your breasts are least tender. Your hormone levels fluctuate each month during your menstrual cycle, which causes changes in breast tissue. Swelling begins to decrease when your period starts. The best time to perform a self-exam for breast awareness is usually the week after your period ends.

Begin with a visual examination of your breasts

Sit or stand shirtless and braless in front of a mirror with your arms at your sides. To inspect your breasts visually, do the following:

  • Face forward and look for puckering, dimpling, or changes in size, shape or symmetry.
  • Check to see if your nipples are turned in (inverted).
  • Inspect your breasts with your hands pressed down on your hips.
  • Inspect your breasts with your arms raised overhead and the palms of your hands pressed together.
  • Lift your breasts to see if ridges along the bottom are symmetrical.

If you have a vision impairment that makes it difficult for you to visually inspect your breasts, ask a trusted friend or a family member to help you. Next, use your hands to examine your breasts.

Common ways to perform the manual part of the breast exam include:

  • Lying down. Choose a bed or other flat surface to lie down on your back. When lying down, breast tissue spreads out, making it thinner and easier to feel.
  • In the shower. Lather your fingers and breasts with soap to help your fingers glide more smoothly over your skin.

When examining your breasts, some general tips to keep in mind include:

  • Use the pads of your fingers. Use the pads, not the very tips, of your three middle fingers for the exam. If you have difficulty feeling with your finger pads, use another part of your hand that is more sensitive, such as your palm or the backs of your fingers.
  • Use different pressure levels. Your goal is to feel different depths of the breast by using different levels of pressure to feel all the breast tissue. Use light pressure to feel the tissue closest to the skin, medium pressure to feel a little deeper, and firm pressure to feel the tissue closest to the chest and ribs. Be sure to use each pressure level before moving on to the next spot. If you’re not sure how hard to press, talk with your doctor or nurse.
  • Follow a pattern. Use a methodical technique to ensure you examine your entire breast. For instance, imagine the face of a clock over your breast or the slices of a pie. Begin near your collarbone and examine that section, moving your fingers toward your nipple. Then move your fingers to the next section.

Diagnosis:

Confirm diagnosis is made by following a series of tests:

  • Mammography
  • ultrasound
  • MRI
  • Biopsy
  • Lab tests

Treatment:

Treatment options depend upon the severity of the disease.

Chemotherapy where combination of drugs is given to destroy or to slow down the growth of cancerous cells.

Radiation Therapy where radiations are applied to the cancerous cells.

Surgery is the most common option available for breast cancer.

In Pakistan, Prime Minister’s Project, Shaukat Khanum Hospital is serving best facilities to the cancerous patients. However, the dilemma is that it doesn’t admit patients of stage III Cancer where the cure isn’t assured any way but the palliative therapy is needed.

Other than that, CMH, PINUM, NORI, Agha Khan, Shifa International hospitals do stand tall in terms of their well equipped services.

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