Men's Articles

Breast Cancer


The majority of women discover a suspicious lump themselves. While many women are aware of breast self-examination, most find the lumps by accident. Although breast self-examination is safe, cheap, and strongly promoted by several medical organizations, only about one-fourth of all women regularly examine their breasts. Lumps more than an inch in diameter are easy to detect.

A tumor of this size contains one billion to two billion cancerous cells, A woman trained to do breast self-examination can find lumps that are a quarter of an inch in size. Women should make it a habit to do a breast self-examination once a month. Only about 10 minutes are needed to do the examination properly. Premenopausal women should examine their breasts 7 to 10 days after the beginning of their menstrual period. At this time, breasts are at their smallest and most easy to feel through.

Early Detection

In most cases, the spread of cancer can be stopped if detected early. By early detection doctors usually mean finding the cancer while it is small, no larger than 2.5 centimeters in diameter, and/or has not spread to the lymph nodes around the breast. When a tumor is 1 or 2 centimeters in diameter it already contains 1 billion to 2 billion cancerous cells and may have been in place for four to eight years. Some tumors may grow quite large without spreading, but in general, the larger the tumor, the greater the risk that malignant cells have reached the lymph nodes and spread through the body.

According to statistics, only 20 percent of the tumors less than 1 centimeter in diameter are associated with cancerous cells in the armpit lymph nodes. For tumors from 2 to 3 centimeters, malignant cells are present in the nodes in 45 percent of the cases, and for tumors greater than 5 centimeters in diameter, cancerous cells are present in the nodes in 70 percent of the cases. Therefore, if caught early, at least some breast tumors can be prevented from spreading. There are three major ways to detect breast cancer early: breast self-examination, examination by a physician, and mammography.

Others Screening Methods

Computerized Tomography

Computerized tomography, or CT scanning, consists of multiple X-ray examinations performed at different angles and used by the computer to create an image. This method is helpful in examining dense breasts that are difficult to screen with mammography. It is an expensive method and involves a higher radiation dose than regular mammography.

Immunocytochemistry

Immunocytochemical techniques have recently been developed to detect cancer cells that have spread from the breasts to the lymph nodes in the armpit. Monoclonal antibodies have been used, increasing the accuracy of the procedure. If the glands test negative, no further treatment or surgery is required.

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging (MRI), formerly known as nuclear magnetic resonance, is a relatively new procedure in the detection of breast cancer. An MRI scanner consists of a large electromagnet with a hole large enough for the patient to fit through, a radio-wave emitter, and a radio-wave detector. These instruments are arranged around the patient and are connected to a computer and a display screen. Radio waves and magnetic fields are used to produce the image, no radiation is involved. The images that are produced can locate cancers by detecting metal-bearing antibodies previously injected into the blood stream. These concentrate at the tumor site where they are recorded by the radiomagnetic signals. The procedure, however, is expensive and it produces a poor image of dense breast tissue, making it difficult to detect small cancers and calcifications.

Thermography

Thermography is a method in which infrared photography is used to measure heat patterns coming from the breasts. The procedure is based on the assumption that cancers generate heat because they grow fast and draw more blood than normal breast tissue. The breast tumors show up as "hot-spots" on the thermogram. The procedure appears to work for large tumors, which can be detected by palpation, but does not work as well for small, deeper tumors that do not generate as much heat. This method is rarely used, except in experimental studies.

Transillumination

Transillumination, or diaphanometry, is a technique that involves shining a light through the breast to outline its interior. Different types of tissue transmit and scatter light in distinct ways, enabling the doctor to more clearly perceive abnormalities. In the past, to distinguish a cyst from a solid tumor, doctors would sometimes take a patient into a dark room and direct a flashlight at the suspicious areas of the breast.

Some cysts would transilluminate, whereas a solid tumor would not. Today the procedure is performed with a specially designed light source and a tv monitor. It is not considered significantly accurate to replace biopsy or serve as a screening method for breast cancer. It is more commonly used to detect sinus problems.

Ultrasound

Ultrasound, or ultrasonography, is the most commonly used breast-imaging procedure after mammography. The method is based on the principle of sonar. High-frequency sounds are transmitted through the breast with a device called a transducer that is placed on the skin. The echoes are detected and displayed on a monitor screen, producing an anatomical outline of the breast and its tissue.

This method does not involve exposure to radiation, but is less reliable than mammography. In particular, it misses small cancers that sometimes cannot be felt by palpation but are discovered on mammography. Ultrasonography is predominantly used to determine if a structure is solid or liquid. For this type of procedure it is more than 90% accurate.

Your Breast Self-Examination 

Step 1

To begin breast self-examination stand before a mirror and look at both breasts to check for visual changes. Compare the two breasts. Many women have one breast that is larger than the other. If a breast suddenly increases in size and this can be seen or felt, it may mean a cyst has formed and filled with fluid or a solid growth may have increased in size and become noticeable.

Your doctor should be consulted. If the breast has become smaller on one side, it should be investigated also. Look at the skin of the breasts. Do you see any bumps or dimples? Do the breasts and nipples have their normal contour? If the previous round contour of the breast becomes concave at any point, developing a dimple, the depression may indicate a tumor. If the nipple changes direction, pointing inward instead of projecting, it may signal an embedded tumor. It can also be the result of fibrocystic disease or calcium deposits.

Do you notice redness to the skin or blotching? A rare form of cancer called inflammatory carcinoma can cause the skin of the breast to become blotchy and red as it would from infection or irritation. If the condition persists, it should be checked by your doctor and may require a biopsy for accurate diagnosis.

Step 2

While still watching in the mirror, raise your arms and clasp your hands behind your head. Tighten your arms and press your hands forward without bending your head, keeping your elbows in a straight line. When doing this, the chest muscles will tighten and thrust the breasts somewhat forward, allowing you to examine them in a somewhat different position. Again, check the contour of the breasts.

Do you notice any changes in the shape of the breasts? Look at the skin. Do you see any dimpling? Do you notice any changes in the direction of the nipples? Is there a discharge from the nipples? Only 5% of nipple discharges (bloody) are associated with cancer. The color of the discharge can be red, green, or black. This usually occurs if there are small growths within the ductal system of the mammary gland. You should see your doctor if this occurs. A clear or yellow discharge from the breast is quite common, but should be monitored.

Step 3

Put your hands on your hips and bend over toward the mirror while pulling your shoulders and elbows forward. This contracts the pectoral muscles. Look at your breasts in this position. Again, look at the contour of the breasts, the nipple and the skin. It is also important to check the areola, the pigmented skin around the nipple.

Any noticeable variation, such as puckering, swelling, or partial discoloration, of the areola is a warning signal and should be checked by your doctor. The left and right breasts may not exactly match, few women's do. Regular self-examination will show that this is normal and will give you confidence in your examination. It is important to become accustomed to looking at your breasts in front of a mirror, so that you can see changes just as they occur.

Step 4

Raise your left arm, and using three or four fingers of the right hand thoroughly examine your left breast. Use the pads of your fingers rather than the fingertips because the pads are more sensitive. Keep the fingers flat. This procedure is called breast palpation. Begin at the nipple and move outward in circles of increasing size, or start at the outer circle and gradually progress towards the nipple.

Make sure you cover the entire breast and include in the exam the armpits and the area surrounding the breast. It is important to include the surrounding areas because glandular tissue is also found beyond the breast. It often extends into the armpit, and its thin layer can reach the clavicle (collarbone), the sternum (breastbone), and the edge of the trapezius (back muscle). Check the tissue for any lump, hard knot, or thickening.

Most breast lumps are harmless, but new ones, especially those that are hard, fixed, and have rough edges, may indicate a tumor. Upon the completion of the palpable examination of the breast, the nipple and the subareolar tissue (the tissue under the areola) should be checked by gently squeezing it between the thumb and forefinger. Check for abnormal or bloody discharge from the nipple.

If there is any, you should consult your doctor. Fifteen percent of all carcinomas of the breast occur in the tissue underneath the areola. The tissue in this area is a collection of ductal endings and may feel different to the touch than the fatty and glandular tissue that constitutes most of the breast. This area is also more sensitive, especially when you press down through the thick layer of breast tissue beneath the areola to reach the chest wall. It is because of this sensitivity that the area is often skipped over.

Step 5

Lie down and repeat the previous step (step 4). To examine the left breast, lie flat on your back and place a pillow or folded towel under your left shoulder. This will shift your breast toward the center of your chest for easier examination. Raise your left arm above your head and place your left hand under your head. This flattens the breast and makes it easier to examine. Examine the breast with the opposite hand in the same symmetrical manner as when standing.

With the right hand, fingers flat and using the finger pads, press gently in small circular motions around an imaginary clock face. Make sure you cover the entire breast and use a consistent pattern. It is also important to include in the exam the armpits and the area surrounding the breast. In this position you may feel some cartilages or bony structures that are part of the rib cage but can be mistaken for lumps.

Any new or unusual lumps should be reported to your doctor. After you have examined the entire breast, check the nipple and the subareolar tissue by gently squeezing it between the thumb and forefinger. Any discharge, clear or bloody, should also be reported to your doctor.

Step 6

Repeat the entire process (steps 1 through 5) for the second breast. Compare what you feel in one breast with the other. If any unusual changes in contour occur, any unusual lumps are felt, or you notice anything unusual about your breasts, it is best to consult a doctor. Breast self-examination is still the single most important method for detecting breast disease, including cancer.

If you do find something unusual, don't panic. Rarely do swellings indicate the growth of new tissue, and even more rarely are they cancerous. However, it is important to consult your doctor of any changes because of the importance early detection plays in curing breast cancer.

 

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