Breast cancer awareness

I was thinking to start blogging for long time now. And yesterday when I was checking my breast as my routine self check for any lumps, I was thinking that I should tell my sisters too to make it a habit. It is breast cancer awareness month too so, I decided to do a write up for them and the same write up I am posting as my first blog post.

Please let me know if something is not clear or if I should edit some part.
I have to add pictures and some more information here, would be doing it sometime later.

Note: The information in this post is just from my own monthly self-checkups, conversations with my doctor whom I go for yearly physicals now and conversations with some friends about it. It cannot be taken as a main check-point incase you detect any lumps. You must visit your doctor.

Around 3-4 years back, I did not even know that there is something like that exists. One of my close ones got it and it would have been better if found earlier. It was the first time I got to know the term and then found some more information about it. And I think it might be the case with many of my acquaintances especially in India. I plan to convert it into Hindi later.

What is breast cancer ?
It’s a kind of malignant tumor (kind of swelling) that happens in breast. It happens mostly to women but can happen to men too. Many lumps may just be non-malignant but if it is cancerous, it is better to find it early. So, keep doing your monthly check-ups.

In my blog here, I am only writing about how to check a women’s breast for possible tumor but I do not know about how to check for men. If I find from any of my friends later, I will update it here. I am guessing it should be similar procedure.

Typical symptoms of breast cancer:
- Malignant tumor or lumps
- Liquid discharge from nipples
- Breast pain (Some people get it due to gastric too so do not confuse the two. It has to be in combination with some other symptoms)
- Redness around breast area
- Pulling-in of the nipples.


Who all need to do monthly breast checkups?
It is recommended for both men and women older than 20 years and must if you are near or above 30.

How often to check breast for tumors at home?
I have known from my family doctor that we should check our breasts every month. It is suggested to check it one week after your monthly.

What kind of lumps we are looking for and How to check breast for tumors at home ?
We are looking for tiny or large hard balls in breast. It can be very tiny hard ball may be less than 0.5 cm diameter too. First of all before starting your check-up, you must know that at an early stage it is very difficult to differentiate between natural breast texture and any possible tumors because when you touch your breast hard with your two fingers, it all feels like tiny balls

There are multiple ways to make you understand the difference:
1) Most breast care doctors have a spongy ball that represents a breast and they have samples of tumors in these balls. Tumor replications in these balls feel very much like as it would feel in real breast. You can ask your doctor to show you the sample so that you can get educated about how it feels like and what you must be checking for when you do your regular check up.
2) If you know someone who had (I wish not) then you can ask them for your awareness. I do not feel anything wrong in asking as it will only educate more people but someone may not like it. So, judge from your senses before you ask someone.

Or you can think of it as a hard tiny ball as I remember they had in bicycle chains. This only holds true for early stages, they grow in later stages.

The difference in normal tiny balls or non-malignant tumor in breast and cancer areas is that the cancer areas are so hard that if you press them from sides, they do not move. They are deep in tissues and stay at their place. All other balls or growth in the breast can be pushed around. You can even hold them with your fingers and move around.

How to self-check:
- Lie on a flat surface like floor or on bed without pillow.
- Place your one hand behind your head so that your breast stretches and elbow is tight and is slightly pushing upwards and away (lets say we lifted left hand).
- Now start examining your left breast using index and middle fingers of your right hand. Start from a spot and keep going in circles till you cover the whole breast.
- Position your fingers on the breast spot you chose and then press down hard enough that you feel you have passed all the fat in your breast and then feel that area for any lumps.
- Then keeping your fingers in place and pressing hard, move your fingers in clockwise and anticlockwise circles to sense lumps.
- Now, move to the next spot for examining the next area. Try not to lift your fingers and just slide them to adjacent area and keep doing it.

Repeat the process for your right breast placing right hand behind your head and using left hand for examination.

Professional checkups:

There are multiple ways of professional checkups but usual is
- Mammogram
- Ultrasound
- Biopsy

Who should go for professional check-ups?
If you detected any kind of lump that does not seem like your normal breast tissue then you should head for professional check-ups. But do not panic. Most lumps are not cancer especially in younger women. Also women on a plumper side may have lumps in their breast due to the fat in the body. Sometimes when you are close to your monthly, you get a lump and it fades away in a month or couple of months. But at the same time, do not ignore. I would recommend to talk to a doctor, if you detect any lumps.

When you go to the doctor and the doctor also finds something abnormal as you did then (s)he will recommend you to either mammogram or ultrasound or may be both mammogram and then ultrasound. One can get mammogram done even if they do not find any abnormal lumps but most doctors know how to find abnormal lumps by hand. They usually check when you go for yearly physicals.

Mammogram
X-rays are used in mammogram to look inside the breast and find abnormal structures.

Mammogram does not give that much information. It only reinforces the findings, if exists. It just checks if there is any abnormal tissue or not same as you did with hand but with clear pictures and you get approximate size and location of the lump. It does not distinguish if that lump is malignant or not.

Steps they do in mammogram:
1) First they make you wear X-ray protective cover below your breast upto your legs or upto knees
2) They place one of your breast inside two plates and press hard and take picture. It is painful for a moment, pain also depends on your breast. Then they place the plates vertical and may be some more angles to take some more pictures.
3) Then they do the same step 2) for other breast.

Personally, I do not like any kind of X-rays around me J. I would prefer ultrasound anytime over mammogram.

Ultrasound
Sound pressure is used in ultrasound to get a film of the area. They apply a gel on the area to be tested and then rub a small moving camera to capture the film. You can see the area being checked live in the attached computer.

Ultrasound is usually used to monitor the growth of lump over time. If a lump is growing over time then it may be cancer but if it stays the same size then it is most probably not cancer. So, they measure the lump every 6 months to see how it grows.

Biopsy
Biopsy is 99% sure way to detect if the found lump is cancer or not.
If a doctor suggests to do a biopsy, its not necessary it’s a cancer. Doctor just is not very clear from above results and hence suggesting for biopsy. There are two kinds of biopsy – one to test and another to remove the lump. The one that is used to test the tissue is called core needle biopsy. A small part of lump is taken by injecting a needle to analyze the tissue in that particular area. Its your choice if you want to take anesthesia for making the area numb. The needle used for core needle biopsy is little bit thick – it’s a hollow needle. They take 2 or more samples. It makes a pop sound when they take the sample. Then they analyze this sample in the lab. It might take few days before you get the results. In this result, they will be able to tell you the state of lump.