Breast cancer: What you need to know about self-examination


Breast cancer is said to be the commonest type of cancer afflicting women in both developed and developing countries.

According to the World Health Organisation, its frequency in developing world is on the rise, contrary to the belief that it is a disease of the developed world. For instance, the WHO said almost 50 per cent of cases and 58 per cent of deaths from breast cancer occur in developing countries.

Scientists say that cancer can strike almost any part of the body. Researchers have also said that cancerous cells were normal cells before undergoing some changes which made them cancerous.

The Chief Medical Director, Medical Art Centre, Professor Oladapo Ashiru, says toxins or carcinogens in the environment, as well as food and contraceptives can be linked to breast cancer.

In an article titled ‘What every woman needs to know about cancer’, Ashiru said, “Carcinogens linked to breast cancer include ethyl alcohol, tobacco smoke, aromatic amines in plastics and DES in contraceptives. Recently the wearing of bras with metallic supports has been linked to breast cancer.

“The study of toxins and ‘carcinogenesis’ (development of cancer) is a very complex and dynamic field as more and more toxins are discovered. As noted before, toxins can be in the water you drink, your food, immediate environment (work, schools, house and other places), pesticides, solvents and so on. Toxins are involved in carcinogenesis, a very complex and sometimes poorly understood topic. It is pertinent to note that cancer cells are usually normal cells at first that undergo certain changes that cause them to begin to divide in an uncontrollable manner and spread.’’

Prevention is still the best cure

With the disease and its grave effects on the rise, experts have said that prevention, through a monthly self-examination, is important in detecting the disease early and seeking treatment.

For instance, a Consultant Oncologist with the Lagos University Teaching Hospital, Prof. Remi Ajekigbe, says that women and girls need to learn the process of breast self-examination.

According to him, early detection is important in cutting mortality rate.

“The incidence of all cancers is increasing. But that of breast cancer is even worse. Unfortunately we are still seeing patients presenting late. Cancer of the breast is on the increase but this may be due to increasing awareness. Wea re tellign women to examine their breasts. It is your breast, you see it and touch it everyday. If you notice any change in the shape or you notice a discharge, come to the hospital immediately. Any liquid that comes out of the breast aside from breast milk should be sent to the pathologists for examination. The chances of surviving breast cancer increases when it is detected early. But most patients present late and this is why we need to improve on awareness. When it comes to any type of cancer, prevention is the best cure,’’ he says.

Self-examination

Breast cancer screening can be done through mammogram, magnetic resonance imaging, ultrasound scan and breast self-examination. But experts say the latter is the first in a long process of life-saving measures that can stop breast cancer in its tracks.

According to the Executive Director, Care, Organisation, Public Enlightenment, Mrs. Ebunola Anozie, the first symptom of breast cancer that most women notice is a lump or an area of thickened tissue in the breast. “Most lumps are not cancerous but it is always best to have them checked by your doctor,’’ she says.

Anozie, whose non-governmental organisation provides free breast screening and support for breast cancer patients and survivors respectively, says that BSE should ideally start with a visual inspection and then a manual inspection with the hands. She advises that women should first leave their hands out and check for lumps and depressions around the breasts and towards the armpits.

“In the privacy of your bathroom, strip to the waist and stand before a mirror. You will need to see both breasts at the same time. Stand with your hands on your hips and check the appearance of your breasts. Look at size, shape, and contour. Note changes, if any, in the skin color or texture. Look at the nipples and areolas, to see how healthy they look.

“Raise your left arm overhead and use your right-hand fingers to apply gentle pressure to the left breast. Stroke from the top to the bottom of the breast, moving across from the inside of the breast all the way into your armpit area. You can also use a circular motion, being sure to cover the entire breast area. Take note of any changes in texture, colour, or size. Switch sides and repeat. This is best done in the shower, as wet skin will have the least resistance to the friction of your fingers.

“Still facing the mirror, lower both arms. With the index and middle fingers of your right hand, gently squeeze the left nipple and pull forward. Does the nipple spring back into place? Does it pull back into the breast? Note whether or not any fluid leaks out. Reverse your hands and check the right nipple in the same way.

Place a pillow on the bed so that you can lie with both your head and shoulders on the pillow. Lie down and put your left hand behind your head. Use your right hand to stroke the breast and underarm.”

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