Every woman’s worst nightmare

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Part 2

If you’re a woman and someone asks you about breast cancer, what comes into your mind immediately? Death sentence, that’s what.

But that should not be the case.  In fact, the earlier a cancerous lump is detected and removed, the bigger the chances of treating it, says Dr. Antonio Villalon, former president of the Philippine Society of Medical Oncology.

He advised that between 20 and 39 years old, every woman should have a clinical breast exam every three years; and after age 40 every woman should have a clinical breast exam done each year.

The Geneva-based World Health Organization (WHO) suggests that women should examine their breasts regularly—at least once a month.

“Women should check their breasts a week after the menstrual period,” advises The Woman Almanac. “After menopause, check your breasts on the first day of each month.  If you have had a hysterectomy (a surgical removal of the womb), check with your doctor or clinic for the appropriate time of the month to check your breasts.”

Here are the directions from the Philippine Cancer Society, Inc. (PCSI) on how to do the breast self-examination (BSE):

In the shower or while taking a bath: Examine your breasts.  Your hands will glide easily over wet skin.  Fingers flat, move gently over every part of each breast.   Use your right hand to examine the left breast, the left hand to examine the right.  Check for any lump, hard knot, or thickening.

Before a mirror: Inspect your breast with arms at your sides.  Next, raise your arms high overhead.  Look for any changes in contour of each breast– a swelling, dimpling of the skin, or changes in the nipple.  Then, rest palms on hips and press down firmly to flex your chest muscles.  Left and right breast will not exactly match — few women’s breasts do.  Regular inspection shows what is normal for you and will give you confidence in your examination.

Lying down: To examine your right breast, put a pillow or folded towel under your right shoulder.  Place right hand behind your head — this distributes breast tissue more evenly on the chest.  With the left hand, fingers flat, at the outermost top of your right breast, make small circular motions all the way around the outer edge of the breast until you reach the top again, pressing gently all the while. (Don’t panic if you find a ridge or firm tissue in the lower curve of each breast; it’s normal.)

Then move in an inch toward the nipple and repeat the procedure.  You will probably have to circle your breast three additional times so that every part—including the nipple—is examined.  Now, slowly repeat the whole procedure on your left breast with a pillow under your left shoulder and your left hand behind your head.  The whole time, take note of how your breast structure feels.  Finally, squeeze the nipple of each breast gently between the thumb and index finger.

However, women should not panic once they feel a lump on their breast.  After all, most breast lumps are harmless, with up to three of four lumps that are suspected of being cancerous turning out to be benign cysts, fibromas or lipomas.  To have peace of mind, a woman should have the lump screened by a doctor.

Unknowingly, there are more than one kind of breast cancer.  For instance, a few rare malignancies are so aggressive they’ll kill the victim even if they’re identified on a mammogram when they’re still small.  Other types are so “slow-growing” they won’t be fatal even if they’re not diagnosed for years.  Still, others start out as treatable tumors that can become more dangerous and difficult to treat as they grow.

Mammograms—a type of X-ray—are the chief way now to check for breast cancer.  However, a radioactive tracer that “lights up” cancer hiding inside dense breasts showed promise in its first big test against mammograms, revealing more tumors and giving fewer false alarms.  The experimental method—molecular breast imaging, or MBI—would not replace mammograms for women at average risk of the disease.

But it might become an additional tool for higher risk women with a lot of dense tissue that makes tumors hard to spot on mammograms, and it could be done at less cost than magnetic resonance imaging, according to the Mayo Clinic in Rochester, Minnesota, which has been working on it for six years.

If diagnosed with breast cancer,  Villalon said this can be treated by surgery, hormonal treatment, chemotherapy and radiotherapy.  In the United States, some researchers are exploring treatment with various forms of immunotherapy; by manipulating the body’s immune system, they hope to improve its natural resistance to cancer.

Men also get breast cancer, although it is rarer.  Less than 1 percent of cancer patients are male, according to Dr. Rachael Rosario, of the Philippine Cancer Society.  And men with breast cancer don’t survive as long as women.

“All people, whether male or female, are born with some breast cells and tissue.  Even though males do not develop milk-producing breasts, a man’s breast cells and tissue can still develop cancer,” explained the National Breast Cancer Foundation.

“Most males are diagnosed later because a lot of males are in denial that they have a breast disease, that there’s a lump that they feel,” Dr. Aldine Basa, a breast surgeon from The Medical City, was quoted as saying in a television show.  “They don’t see a doctor right away so by the time they see a doctor and it’s diagnosed, it’s usually in the late stage.”

The mere presence of a lump in the breast is already a sign of breast cancer.  “Men should not have lumps in the breast because they don’t have enough breast tissue,” Basa pointed out.  “So anytime that there is a lump in the breast, it should be immediately checked.”

Nipple discharge and breasts that misshapen or don’t match are also possible signs that should be checked out.

Although the causes of breast cancer in men are not well-studied yet, it has been found that those things that increase women’s chances for developing also affect men, including older age, cancer-linked gene mutations, a family history of the disease, and heavy drinking.