Breast cancer is the most common malignant tumor in women worldwide, accounting for 28% of all cancers. Moreover, it is typical of developed countries. Currently one woman in eight will develop breast cancer, throughout her life,.
The risk of developing it increases progressively as the woman’s age increases; Thus, a woman of 70 years presents a risk almost 10 times greater than the one of 40 years.
The finding of a lump, nodule or mass of hard consistency is the most frequent manifestation of breast cancer (80%). Another manifestation of it, although rarer (5%), is bloody discharge from the nipple.
The detection of an early stage tumor leads to a better prognosis and greater survival; In addition, in the case of mammary tumors, its early detection allows surgical procedures to be performed less mutilating and with fewer sequelae.
Detection of breast cancer
The three most important tests for the early detection of breast cancer we currently have are:
- Breast self-examination.
- The clinical examination by the gynecologist.
- The mammogram.
Few women perform well their breast self-examination, which allows early detection of any alteration. You should consult your gynecologist if you observe:
- Nipple disorders.
- Skin alterations.
- Existence of a package.
Breast self-examination consists of the periodic examination of the breast by the woman herself in order to detect any alteration that makes the presence of a tumor suspect.
It is a simple test that presents no risks and low cost, although for its correct application requires a previous training of the interested.
Every woman should know the morphology and texture of her breasts, so that she can discover any change in them as soon as possible.
Breast self-exam lasts for a few minutes, 4 or 5 at the most. In case the woman still has menstruation she should practice it the day after finishing the cycle. If the woman is in the menopause she must perform the self-exploration the same day every month, to acquire and establish a permanent habit. The ideal would be to begin the self-examination since the young woman begins to have her first rules.
The woman will stand in front of the mirror, her arms dangling along her body, naked from the waist up, with her breasts completely uncovered and with good lighting (figure 1).
In this position you will observe:
- It should not be alarmed if one of the breasts is lower than the other or one is larger than the other, which may be normal.
- If there are depressions or abnormal elevations of the skin in the breasts.
- If there are color changes in it.
- If the shape of the breast or nipple is different.
- If there are crusts or retractions in the areola or the nipple.
- Any change in relation to previous months.
Raising the arms towards the roof, the woman will turn the trunk to the right and left to check for any of the alterations indicated above (figure 2). Then place your hands on your hips, pressing against your own body and proceed to the mammary observation indicated in the first point.
Lying on the bed face up, you should put your left hand under your head and use your right hand to feel the left breast, with your fingers together but not stiff (figure 3). Try to see if lumps or hard lumps are touched or there are painful areas. To do this, the chest is a perfect circle divided into 4 quadrants: first the inner superior quadrant is palpated from top to bottom or from the center of the thorax to the periphery, then the inner inferior quadrant, then the outer inferior quadrant and then The outer upper (figure 4). Finish the areola and nipple, so that there is no region of the breast without exploring.
With your arm extended along your body you will feel the armpit gap by sliding your hand over the ribs from top to bottom (Figure 5) to check for nodes that will jump as you move your hand.
Finally the nipple will be squeezed lightly between the fingers and you will see if any secretions appear, and then look at their color and characteristics.
In the same way, the right breast will be explored, placing the right hand under his head and using his left hand to feel.
The guideline to be followed is the following:
- A visual examination in front of a mirror
- A manual examination of both breasts and armpits.
Although the presence of lumps or secretions by the nipples can be due to many causes, in addition to breast cancer, on appearance the woman should consult the specialist. Through this examination it is possible to discover
- Nipple disorders: if reversed or withdrawn, if there is any erosion or injury to the skin.
- Serous or bloody discharge from the nipple spontaneously or caused by pressure.
- Redness of the skin of the breast, increase of heat or appearance of “orange peel”.
- Presence of a lump in the breast, fixed or mobile, of concrete or little defined limits.
- Retraction of the skin by fixation of a tumor beneath it.
Disadvantages of breast self-exploration
Breast self-examination has a number of drawbacks:
- Its use has not been shown to decrease breast cancer mortality. Although this is probably a consequence of a poor application of the technique and a low follow-up of the technique, i.e., few women perform well, in a complete and periodic way, their self-exploration.
- It can generate anxiety situations for many women, because of the psychic burden of their involvement in the diagnosis of cancer.
- For the possibility, especially in young women, of finding multiple nodules that will finally have no significance.
Today, mammography is the ideal method for early diagnosis of breast cancer, since it allows the detection of small or deep non-palpable tumors; In addition it has been demonstrated that the accomplishment of periodic mammograms to women over 50 years reduces breast cancer mortality by 20-30%.
Nevertheless, despite the above, breast self-examination may be a method that should be considered when there are no organized programs of early detection by mammography and in selected groups of women with no symptoms who are not supposed to do so An emotional overload and can adopt it as a routine hygienic habit.