She was such a young and pretty lady of 24years of age.I tell you the truth she was really well endowed especially at the chest level.She walked up to me at the clinic and requested to consult with me.I took her into my office and tried to find out what was wrong with her.She told me that her breasts were the problem. I was astonished. ‘’What do you mean?’’. She informed me that some few years back she noticed a lump or hardness in one of her breast, but was too shy to tell anyone, not even her parents, but instead of the hardness going soft, it increased in size and number, affecting the second breast, then became really painful.Because she was still embarrassed to show them to anyone, she kept quiet hoping the problem will go away as they came. The embarrassment was so much that she could not keep a boyfriend.The situation got worse, until recently when she started noticing brownish bloody discharge from her nipples that she really got scared. ‘’Lucky me’’, she decided to talk to me.I did an ultrasound of her breasts and found so many masses in them, which were latter comfirmed to be cancerous.An xray of her chest was done , we found out that the cancer has eaten into her lungs and her backbones.It was a sorry state, it was too late. This young pretty lady have just a short time to live, because the cancer have spread extensively.After some months she died. What a tragic end?This is the situation with many young girls to mature ladies in Nigeria, we have a social stigma problem that make it difficult for us to complain early and save lives. If that young lady had complained many years ago when she noticed the first lump, she would have lived. In this article I am going to really write long , because this is a very serious issue, it is killing our sisters, wives, mothers and grandmothers. I am very concerned because that young lady is not the only one I knew that died of breast cancer. I want this to stop, so I must sound a serious warning to you ladies that read this blog‘’BREAST CANCER KILLS. TAKE YOUR BREAST SERIOUS’’In this article we are going to look at the causes, symptoms, screening tests, diagnosis, treatments and your own participation.
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DEFINITION
Breast cancer is a cancer that starts in the breast, usually in the inner lining of the milk ducts or lobules.Breast cancer is the most common causes of cancer in women and the second most common cause of cancer death of women in Nigeria. Breast cancer can affect ladies of all ages that have developed breasts.I know that when we talk of breast , it is as if only women are affected. The truth is that men do also have breast cancer.However breast cancer is about 100 times more frequent among women as among men.
SIGNS AND SYMPTOMS
The first symptom or subjective sign of breast cancer is typically a lump that feels different from the surrounding breast tissues. More than 80% of breast cancer cases are discovered when the woman feels a lump.The first medical sign or objective indication of breast cancer as detected by a physician is discovered by mammography [xray] and sonomammography [ultrasound of the breasts].Lumps found in lymph nodes located in the armpits can also indicate breast cancer. Indications of breast cancer other than a lump may include changes in breast size and shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain is an unreliable tool in determining the presence or absence of breast cancer , but may be indicative of other breast health symptoms
SYMPTOMS
[1] Lumps in breasts
[2] Increase in breast size
[3] Change in breast shape
[4] Skin dimpling of the breast
[5] Nipple inversion
[6] Spontaneous single-nipple discharge
[7] Pain
[8] Skin inflammation which includes pain, swelling, warmth, redness as well as an orange-peel texture of the skin.
[9] Tingling, itching, increased sensitivity and burning Most symptoms of breast disorder do not turn out to represent underlying breast cancer. Benign breast diseases such as mastitis and fibroadenoma of the breast are more common causes of breast disorders.
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CAUSES
No one knows the exact causes of breast cancer. Doctors often cannot explain why one woman develops breast cancer and another does not. They do know that bumping, bruising, or touching the breast does not cause cancer. And breast cancer is not contagious. You cannot "catch" it from another person.Research has shown that women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of developing a disease.Studies have found the following risk factors for breast cancer:Age: The chance of getting breast cancer goes up as a woman gets older. Most cases of breast cancer occur in women over 60. This disease is not common before menopause.Personal history of breast cancer: A woman who had breast cancer in one breast has an increased risk of getting cancer in her other breast.Family history: A woman's risk of breast cancer is higher if her mother, sister, or daughter had breast cancer. The risk is higher if her family member got breast cancer before age 40. Having other relatives with breast cancer (in either her mother's or father's family) may also increase a woman's risk.Certain breast changes: Some women have cells in the breast that look abnormal under a microscope. Having certain types of abnormal cells (atypical hyperplasia and lobular carcinoma in situ [LCIS]) increases the risk of breast cancer.Gene changes: Changes in certain genes increase the risk of breast cancer. These genes include BRCA1, BRCA2, and others. Tests can sometimes show the presence of specific gene changes in families with many women who have had breast cancer. Health care providers may suggest ways to try to reduce the risk of breast cancer, or to improve the detection of this disease in women who have these changes in their genes.Reproductive and menstrual history:The older a woman is when she has her first child, the greater her chance of breast cancer.Women who had their first menstrual period before age 12 are at an increased risk of breast cancer.Women who went through menopause after age 55 are at an increased risk of breast cancer.Women who never had children are at an increased risk of breast cancer.Women who take menopausal hormone therapy with estrogen plus progestin after menopause also appear to have an increased risk of breast cancer.Large, well-designed studies have shown no link between abortion or miscarriage and breast cancer.Race: Breast cancer is diagnosed more often in white women than Latina, Asian, or African American women.Radiation therapy to the chest: Women who had radiation therapy to the chest (including breasts) before age 30 are at an increased risk of breast cancer. This includes women treated with radiation for Hodgkin's lymphoma. Studies show that the younger a woman was when she received radiation treatment, the higher her risk of breast cancer later in life.Breast density: Breast tissue may be dense or fatty. Older women whose mammograms (breast x-rays) show more dense tissue are at increased risk of breast cancer.Taking DES (diethylstilbestrol): DES was given to some pregnant women in the United States between about 1940 and 1971. (It is no longer given to pregnant women.) Women who took DES during pregnancy may have a slightly increased risk of breast cancer. The possible effects on their daughters are under study.Being overweight or obese after menopause: The chance of getting breast cancer after menopause is higher in women who are overweight or obese.Lack of physical activity: Women who are physically inactive throughout life may have an increased risk of breast cancer. Being active may help reduce risk by preventing weight gain and obesity .Drinking alcohol: Studies suggest that the more alcohol a woman drinks, the greater her risk of breast cancer.Other possible risk factors are under study. Researchers are studying the effect of diet, physical activity, and genetics on breast cancer risk. They are also studying whether certain substances in the environment can increase the risk of breast cancer.Many risk factors can be avoided. Others, such as family history, cannot be avoided. Women can help protect themselves by staying away from known risk factors whenever possible. But it is also important to keep in mind that most women who have known risk factors do not get breast cancer. Also, most women with breast cancer do not have a family history of the disease. In fact, except for growing older, most women with breast cancer have no clear risk factors. If you think you may be at risk, you should discuss this concern with your doctor. Your doctor may be able to suggest ways to reduce your risk and can plan a schedule for checkups.
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SCREENING
Breast self-examYou may perform monthly breast self-exams to check for any changes in your breasts. It is important to remember that changes can occur because of aging, your menstrual cycle, pregnancy , menopause, or taking birth control pills or other hormones. It is normal for breasts to feel a little lumpy and uneven. Also, it is common for your breasts to be swollen and tender right before or during your menstrual period. You should contact your health care provider if you notice any unusual changes in your breasts. Breast self-exams cannot replace regular screening mammograms and clinical breast exams. Studies have not shown that breast self-exams alone reduce the number of deaths from breast cancer. Clinical breast examDuring a clinical breast exam, your health care provider checks your breasts. You may be asked to raise your arms over your head, let them hang by your sides, or press your hands against your hips. Your health care provider looks for differences in size or shape between your breasts. The skin of your breasts is checked for a rash , dimpling, or other abnormal signs. Your nipples may be squeezed to check for fluid. Using the pads of the fingers to feel for lumps, your health care provider checks your entire breast, underarm, and collarbone area. A lump is generally the size of a pea before anyone can feel it. The exam is done on one side, then the other. Your health care provider checks the lymph nodes near the breast to see if they are enlarged. A thorough clinical breast exam may take about 10 minutesScreening mammogramTo find breast cancer early, NCI recommends that:Women in their 40s and older should have mammograms every 1 to 2 years. A mammogram is a picture of the breast made with x-rays.Women who are younger than 40 and have risk factors for breast cancer should ask their health care provider whether to have mammograms and how often to have them.Mammograms can often show a breast lump before it can be felt. They also can show a cluster of tiny specks of calcium. These specks are called microcalcifications. Lumps or specks can be from cancer, precancerous cells, or other conditions. Further tests are needed to find out if abnormal cells are present.If an abnormal area shows up on your mammogram, you may need to have more x-rays. You also may need a biopsy . A biopsy is the only way to tell for sure if cancer is present.Mammograms are the best tool doctors have to find breast cancer early. However, mammograms are not perfect:A mammogram may miss some cancers. (The result is called a "false negative.")A mammogram may show things that turn out not to be cancer. (The result is called a "false positive.")Some fast-growing tumors may grow large or spread to other parts of the body before a mammogram detects them.Mammograms (as well as dental x-rays, and other routine x-rays) use very small doses of radiation. The risk of any harm is very slight, but repeated x-rays could cause problems. The benefits nearly always outweigh the risk. You should talk with your health care provider about the need for each x-ray. You should also ask for shields to protect parts of your body that are not in the picture.
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What is Mammography [BREAST X-RAY] ?
Mammography is a specific type of imaging that uses a low-dose x-ray system to examine breasts. A mammography exam, called a mammogram, is used to aid in the early detection and diagnosis of breast diseases.
What are some common uses of the procedure?
Mammograms are used as a screening tool to detect early breast cancer in women experiencing no symptoms and to detect and diagnose breast disease in women experiencing symptoms such as a lump, pain or nipple discharge.
Screening Mammography
Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or practitioner can feel them.
Diagnostic Mammography
Diagnostic mammography is used to evaluate a patient with abnormal clinical findings - such as a breast lump or lumps - that have been found by the woman or her practitioner. Diagnostic mammography may also be done after an abnormal screening mammography in order to evaluate the area of concern on the screening exam.
How safe is it?
The dose of radiation needed for a mammogram is very low. The health risk is less than if you smoked one cigarette a year. The benefits far outweigh such minimal risk.
What will I experience during and after the procedure?
You may experience some temporary discomfort. In order to achieve the clearest picture, we compress the breast. The procedure takes only a few seconds for each breast. Any tightness or discomfort you may feel usually disappears immediately after the compression is released. The compression does not harm the breast tissue.
Abnormalities on your x-ray don't necessarily mean cancer
In 80 to 90% of women, second examinations confirm that the breast tissue is normal. After the radiologist has a chance to thoroughly study your x-rays, the results will be sent to your referring practitioner.
Many breast lumps are not cancerous
About 85% of the lumps detected by mammography are not cancerous. They're referred to as benign and usually require no treatment unless they are painful. If there is cancer, the sooner it is found the better your chances for successful treatment.
Early diagnosis also allows you and your referring practitioner to choose from a variety of treatment alternatives.
Mastalgia/Breast pain
Breast pain is one of the most common breast problems and affects up to 70% of women at some time in their life.
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SONOMAMMOGRAPHY [BREAST ULTRASOUND]
Sonomammography is ultrasound of the breasts. It is used as a complimentary test to mammography in patients with dense breasts or even in patients with breast lumps. It is done quite regularly with mammographyX-ray mammography has been the role to detect breast cancer. That gave rise to a "X-rayed way" to look for Cancer.
However another good option working since the early 50s: Breast ultrasound or sonomammography.
1. Breast Ultrasound can detect whether a lump is a malignant mass or a benign cyst. While there are a few exceptions, ultrasound can do it while mammography cannot.
2. Ultrasound It is relatively inexpensive and most mammograms must be complemented with ultrasound. As ultrasound is already used for diagnosis, we could skip one step and use it for screening and diagnosis.
3. Sonomammography is painless. Many patients say mammography hurts
4. Sonomammography scans the whole breast. Mammography scans almost all the breast
5. Ultrasound is safer: mechanical waves with very low power and very short exposition time. Mammography uses X-rays whose adverse effects are cumulative
6. Ultrasound works for dense breast. Mammography does not.
7. Modern Ultrasound devices are digital and can use computer-aided detection systems very easily.
DIAGNOSTIC TESTS
Further testing is necessary to confirm whether a lump detected on screening is cancer, as opposed to a benign alternative such as a simple cyst.In a clinical setting, breast cancer is commonly diagnosed using a "triple test" of clinical breast examination (breast examination by a trained medical practitioner), mammography/sonomammography, and fine needle aspiration cytology.Both mammography/sonomammography and clinical breast exam, also used for screening, can indicate an approximate likelihood that a lump is cancer, and may also identify any other lesions.Fine Needle Aspiration and Cytology (FNAC), which may be done in a GP's office using local anaesthetic if required, involves attempting to extract a small portion of fluid from the lump. Clear fluid makes the lump highly unlikely to be cancerous, but bloody fluid may be sent off for inspection under a microscope for cancerous cells. Together, these three tools can be used to diagnose breast cancer with a good degree of accuracy.Other options for biopsy include core biopsy, where a section of the breast lump is removed, and an excisional biopsy, where the entire lump is removed.
PREVENTION
Regular exercise, weight loss, avoidance of alcohol, stressors, toxic chemicals and environmental pollutants are all helpful measures in the prevention of breast cancer. Dietary inclusion of dried beans, cruciferous vegetables , and whole grains have also proven beneficial. Brazil nuts, rich in the mineral selenium , when combined with natural vitamin E as found in almonds and walnuts are also highly effective in reducing cancer risk.
TREATMENT
The mainstay of breast cancer treatment is surgery when the tumor is localized, with possible adjuvant hormonal therapy (with tamoxifen or an aromatase inhibitor], chemotherapy, and/or radiotherapy.
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