Self Breast Examination

“Today was a long operation list, I should go and join my friends, the party must have already started, and oh I am late”. “Why are you taking so long to change”? Someone asked from outside the changing room .She was looking at herself in the mirror and noticed there was a change. Her left armpit seemed to be swollen so she felt for the lump in her breast and thought it was a little bigger and decided that if she had tome she would visit the surgeon the next day. She was a busy gynecologist and her work always took most of her time. The next day she reluctantly went to a surgeon, as she could not waste time for a simple problem. “I’ll be back in 10 minutes and see you” she smiled and reassured her patients .The surgeon had a very serious and worried expression after examination and a few tests were advised .She was told to get her investigations as early as possible as the examination gave the suspicion of a serious problem as there was a hard painless lump with lymph node enlargement. She felt like the room was spinning. “Why me!” she thought. “What have I done wrong? What about my kids?”

Ultrasound and mammography was done and biopsy advised which later confirmed an infiltrating breast cancer.

She had surgery, chemotherapy and later radiotherapy and had all the follow-ups for 5 years and now its about 10 years, she is working and living a healthy life. But all patients of breast cancer are not that lucky, many give their lives due to late diagnosis and treatment. Women don’t come to doctors on time due to ignorance, poverty and majority are shy to discuss.

There are simple steps of self-breast examination that can help you to pick problems at home at a very early stage .If you notice any change then immediately report to your doctor. This self-breast examination should be done after periods.

STEP 1: LOOKING FOR TROUBLE 

• Inspect both breast by standing in front of mirror, shoulders straight and arms by your side.
• Look for Breast size, shape, colour, they should be evenly shaped without discolouration and visible prominent vein.

    Report to doctor IF 

• There is dimpling, puckering or skin bulge 
• There is nipple pushing inwards
• There is redness, swelling, soreness or rash 

STEP 2:LOOKING AGAIN

• Check Again
• Now raise your arms above head and look for the changes mentioned above. Some lumps become prominent when arms are raised.
• Report to doctor
• If any abnormal change is noticed like skin changes, visible lumps or swelling.

STEP 3: NIPPLE DISCHARGE CHECK

• Report to doctor IF Blood, yellow foul smelling fluid

STEP 4: PALPATING BREAST WITH FLAT HAND

• Now feel your breast with flat hand keeping your fingers together .Use Right hand for Left breast palpation and left hand for checking right breast, your touch should be firm and smooth .You should feel the entire breast from top to bottom, collar bone to abdomen, side to side, armpit to middle of chest. Follow a pattern and make sure to cover the whole breast.
• You can place a flat hand; begin from nipple, moving in larger and larger circles till you reach the outer end of breast. 
• You can move your fingers up and down vertically.
• Make sure to feel all the breast tissue with a soft touch to feel the skin and a firm touches to feel tissue under skin.
• Examin each area of breast with a soft touch and increase pressure to feel the deeper  tissue Down to rib cage.
• Feel both armpits for any swelling or lump.

Report to doctor IF 

• Any lump felt EITHER hard or soft 
• Any painful area
•  Any dimple 

STEP 5: FINAL EXAMINATION

• Breasts can be palpated while standing, sitting or lying. Many women find it convenient when skin is slippery, so it is easy for them to examine breast after shower.

IF ALL EXAMINATION IS NORMAL

• Make a habit of breast self examination at least once a month, ideally right after periods have finished .If you examine yourself before periods then it can be painful and difficult .The breast become more lumpy due to progesterone effect, there are chances of missing problems.
• Every woman should have yearly breast examination.

WHAT TO DO IF SOME FAMILY MEMBER HAD BREAST CANCER

• All women whose cousin, aunt, sister, mom or grandmother had cancer of breast ovary or uterus should report to doctor IMMEDIATELY, as all of these cancers are estrogen dependent tumors and are interlinked. There are proper screening programs for affected families In these programs early examination by specialist doctors ,non invasive tests like X-ray mammography, ultrasounds and invasive tests like needle tests and biopsy can detect the problems at an early stage. Treatment is also started earlier and saves lives.

A Woman should love her family, work and sacrifice for them BUT she should love and take care herself because if she were healthy then only she would be able to fulfill her role off a successful woman.