Breast Self-Examination

Breast cancer has become a big killer in women and its incidence is growing, from one woman in 50 back in the 1950’s to one in 7 today. But, if it is caught early then the chances of survival improve dramatically.

Still, many women, even highly educated, never bother to check. Why? At the initial stages there is no pain, no fever, no discomfort of any kind, so why worry? Even to find the damn thing may be hard! Besides, you may not want to put scary thoughts in your mind… But this will not exorcise the devil away…

Apart from regular mammograms, another weapon in early detection is breast self examination. At the bottom is a video demonstrating how to do it. Important points are:

When to do it: The beginning of the cycle after a period is best, when hormones, and the lumps they cause are at their lowest. Right before a period there may be lumps but they may disappear on their own.

Check with the whole palm at first: The tumor may have diffuse edges and be soft or located deeper in the breast, so you may miss it if you check with your fingertips only. Move the tissue around. This is demonstrated very well in the video.

It is better to check for tumors in the shower. This is because then the fingers slide on the skin. If the skin is dry then the fingers may skip on the skin and miss a tumor.

Check while lying down also, with a small cushion under your shoulder, so that the breast tissue is spread well. Then it is easier to feel any anomalies.

After checking with your whole palm, check with your fingertips too. Lift the skin and feel the tissue in between your fingertips. If the tumor is close to the surface, then you can detect it even if it is the size of a grain of rice. That’s how I found mine… It was close to the surface, if I pressed with three fingers it went deeper, I could not feel it. But I could grab it with my fingers.

Last but not least: If you have lots of lumps making it hard to tell, then look for a change. If a lump shows up where it was not before, or if it got bigger, or changed shape or mobility. My breasts used to be like bags of beans, so that finding a bean that moved was hard. But, have to make a mental map of what they feel like and where the lumps are, as if your life depended on it. Because it might…

I had given up checking. Too many beans… How I found the lump? Some angel, in the form of a puppy gave me some fleas to bite me close to the lump 8 years ago. As I was scratching the rash I caught something, the size of a pea and two lentils in a row. It was small but a nasty variety, “pleomorphic lobular” described in the literature as a “particularly lethal variant”. Luckily, it got operated quickly and hopefully I won’t need to think of it again. I bless my luck and I am immensely grateful to the surgeon who was operating till 1 in the morning that day to fit me in his schedule. I owe him my life!

If you do detect a change of some kind in your breasts, ask for an appointment with your family doctor and have a mammogram.If your breasts are dense, better have an ultrasound or MRI, because the mammogram cannot detect the cancer-lump in the middle of the normal, ie breast-density-lumps. If the results of the mammogram are not clear, then get a biopsy. Depending on staffing and backlog, it may take a few days to get the results of the biopsy from the Pathologist. Since a few years now you can get your results as soon they are available from records at KGH (across from the X-ray department, ground floor), no need to go back to the ordering physician. Before the decision to operate or not is made and to decide on the type and urgency of surgery, you will need a biopsy anyway in most cases. If it is nasty, ie invasive carcinoma, then get operated quick!

Since its inception 25 years ago BCAK has been advocating for breast self examination and is giving away kits with a model of a breast with lumps, to practice detecting them.