Breast self-examination - what to look for?
During self-examination a woman can detect individual lumps or masses. You should become concerned if you notice any change to the shape or symmetry of your breasts. Most cancerous lesions occur in the form of organic, easily palpable and painless lumps. If the lump is no more than 2 cm wide and there are no lymph node metastases, there is a good chance it can be cured.
Do not underestimate breast self-examination
After all, if we don’t take care of ourselves, who will? Early detection of potential lesions provides a good chance for a complete cure. Unfortunately, many women still die because they do not get tested or perform self-examinations, and the lesions are detected too late. In this particular case, our health and often lives are literally in our hands. This is why it is so important for women to get into the habit of regularly self-examining their breasts as early as possible. According to statistics, approximately 80% of lesions are detected by women themselves or their partners. And as many as 75% of them are mild – such as are cysts, fibroids or lipomas. But still not enough women understand the benefits and perform this form of self-diagnosis.
Women are often afraid of performing breast self-examination because they feel that they have no influence on their body and health. They are afraid that they will find something, so they often don’t want to know. But even in the case of invasive changes, the smaller they are, the greater the chance that lymph node metastases does not occur, and thus there is a bigger chance of a cure, says Dr Tomasz Bieda, a gynaecological oncologist from the Clinic of Gynaecology and Oncology of the Cancer Centre in Kraków.
Certainly, not every lump is cancer, but any concerning change should be consulted with a doctor, he adds.
How often to perform breast self-examination?
According to doctors, self-examination is a better way to detect cancerous changes than an ultrasound or a mammogram. Regular breast self-examination minimises the risk of missing the disease. Of course, this method is less accurate than an ultrasound or a mammogram, however, with regular examination, the woman learns the structure of her own breasts and can detect relatively small irregularities. Examination by a gynaecologist is not a substitute for self-examination. During self-examination, a woman can detect changes even half the size of those detected by a gynaecologist, an ultrasound or a mammogram.
It is the woman who knows her body best, which is why through regular self-examination she can notice even the smallest changes and alert the doctor, explains Tomasz Bieda.
He explains that the cancer grows over many years, so we have plenty of time to notice changes in our body. It takes about 8 years for breast cancer to reach the size of 2 cm. The risk of cancer increases with age, and it is also greater in those with a genetic predisposition – about 5-10% of breast cancer cases have a genetic basis – in women with abnormal mutation in mainly the BRCA1 gene or CHEEK2 gene, in whom the risk of breast cancer is approx. 5-10 times higher than average.
Breast cancer affects more and more young women.
There are many factors at play here, including those related to lifestyle and diet - such as being overweight, smoking, abusing alcohol, chronic stress, lack of exercise, air pollution, consuming highly processed foods, and preservatives, says Tomasz Bieda.
Breast self-examination and breast cancer
A breast self-examination is the absolute least that we can do for ourselves, but it can often save our health or even life, as breast cancer, detected early enough, is almost 100% curable. Women who regularly examine their breasts can detect a lump about 1 cm in size. Lumps up to 2 cm, which can potentially be malignant, are almost 100% curable. Cancer in its first stage has almost 90% chance of a long-term cure. Women with this diagnosis are also usually eligible for breast-conserving treatment - without amputation.
Does every lump in the breast signify cancer?
Not every lump is cancer. A lump can either be benign or malignant.
Fortunately, most breast lumps, about 80 percent, are benign lesions, explains Tomasz Bieda.
The most common are benign changes, mainly due to hormonal disorders.
Such benign changes include: adenocarcinoma, found mainly in young women and adolescent girls, breast dysplasia – including breast cysts, hyperplasia of the glands and surrounding connective tissue, intraductal papillomas, i.e. excessive proliferation of epithelial cells, resulting in its stratification - papilla in the lumen of the ducts, as well as leafy tumours.
The above-mentioned mild changes are harmless, but there is always a risk that they can turn into malicious ones, therefore do not ignore any changes and consult a doctor, especially since no referral is required to see a gynaecologist, adds the doctor.
Self-examination does not mean you should not see a gynaecologist, or undergo a breast ultrasound or a mammogram, says the doctor, encouraging women to perform breast self-examinations and undergo screening tests, and to overcome fear, because cancer detected in an early stage is curable.
When and how to perform self-examination
This is approximately how long it takes to perform breast self-examination. It doesn’t take much effort to learn more about your own body and learn how to correctly perform breast self-examination. The first self-examination is best done under the supervision of a doctor, who will correct any errors and will instruct you on how to do it properly.
Self-examination should be performed from the age of 20, every month, on the same day of the cycle, preferably one week after menstruation, between the 6th and 9th day of the cycle (during menstruation, because of hormonal fluctuations, breasts can be sore and hypersensitive, and their tissue consistency may also be slightly different). Menopausal women should perform the test on the same day every month. Breast self-examination may be more difficult to perform on breasts with a dense, glandular structure, especially in young women, but even in such cases, thanks to performing the test regularly and becoming more familiar with one’s breasts, women may still detect potential changes.
How to perform breast self-examination?
Breast self-examination consists of two stages – visually examining the breast and the touch test. While standing in front of the mirror, look at your breasts to see if you notice any changes in size, shape, position, colour, or inversions.
In a standing position observe your breasts:
- while lifting your arms
- with your arms loose at your sides
- with your hands on your hips – press them hard enough to feel your chest muscles tighten – observe any changes
- squeeze the nipple and watch for any secretion
- don’t forget to look at the upper part of the breast under the armpit
- from the side – with interlocked fingers place your hands on the back of your head and turn to look at your breasts from the left side, and then from the right
- lean forward to check for any visible skin folds, changes in the shape of the breast or inverted nipples.
In the supine position - lying comfortably on your back, place your right hand behind your head, perform round, semi-circular movements, pressing on various spots on the breasts with flatly positioned fingers. Examine your left breast with your right hand and vice versa – repeat the entire process on the right breast. The last step is to examine the armpit for enlarged lymph nodes.
What changes should you look for in the breast?
Potential changes may concern: the skin, nipple and areola, and the flesh. Check for any changes to the tone or temperature of the skin, whether there are widened subcutaneous veins, folds, bulges, ulcers or the so-called orange peel effect. You should see a doctor if you observe any inversions, or other changes to the shape of the nipple, leakage, minor ulcers, slow healing wounds, or scabs around the nipple area. You should definitely seek medical attention if you experience any pain in the breast or its vicinity - spontaneous or to the touch, bilateral or unilateral, with varying severity.
The value of breast self‐examination
Breast self‐examination practices and breast cancer survival