Your Right to Know

BREAST CANCER

Today, one out of every eight American women will develop breast cancer at some point in her lifetime. (Male breast cancer incidence is small but it is important to know the disease can affect men.) The most important thing for you to remember is that breast cancer is best treated when found early. And total breast health is the key to early detection. Early detection of breast cancer is maximized through a combined approach of monthly self-examination, a thorough physical examination by a physician and mammograms. This information will help you understand certain things you need to know about breast cancer.

HOW SHOULD YOU LOOK FOR BREAST CANCER?

There are several ways to look for breast cancer.

Breast self-examination

Beginning at age 20, all women should check their breasts monthly. Look for—

• any lump or thickening in the breasts, or
• any change in skin texture or in breast size or shape, or a nipple discharge (fluid coming from the nipple).

The National Cancer Institute recommends that women follow these steps in doing monthly breast self-examinations:

1. Stand in front of a mirror that is large enough for you to see your breast clearly. Check each breast for anything unusual.

2. Watching closely in the mirror, raise your hands above your head.

3. Next, press your hands firmly on your hips and bend slightly toward the mirror as you pull your shoulders and elbows forward.

4. Raise one arm. Use the pads of the fingers of your other hand to check the breast and the surrounding area firmly, carefully and thoroughly. Some women like to use lotion or powder to help their fingers glide easily over the skin. Or, complete this step in the shower when your skin is soapy. Concentrate on feeling for any unusual lump or mass under the skin.

Feel the tissue by pressing your fingers in small, overlapping areas about the size of a dime. To be sure you cover your whole breast, take your time and follow a definite pattern: lines, circles or wedges.

Lines—Start in the underarm area and move your fingers downward little by little until they are below the breast. Then move your fingers slightly toward the middle and slowly move back up. Go up and down until you cover the whole area.

Circles—Beginning at the outer edge of your breast, move your fingers slowly around the whole breast in a circle. Move around the breast in smaller and smaller circles, gradually working toward the nipple. Do not forget to check the underarm and upper chest areas, too.

Wedges—Starting at the outer edge of the breast, move your fingers toward the nipple and back to the edge. Check your whole breast, covering one small wedge-shaped section at a time. Be sure to check the underarm area and the upper chest.

5. It is important to repeat step 4 while you are lying down. Lie flat on your back, with one arm over your head and a pillow or folded towel under your mid-back on the side you are examining. This position flattens the breast and makes it easier to check. Check each breast and the area around it very carefully using one of the patterns described above.

You should do a breast self-examination every month. If you still menstruate, the best time to do a breast self-examination is two or three days after a period. If you no longer menstruate, pick a certain day—such as the first day of each month—to do a breast self examination. Remember, a monthly breast self-examination is very important and should be part of your overall breast health care.

Mammogram or X-ray

A mammogram is a special breast x-ray that can detect most but not all breast cancers. They often can detect cancer even before a lump can be felt. While this makes mammograms a very important tool in the early detection of breast cancer, they are not perfect. Since they can miss some breast cancers, a woman should not ignore something she feels just because her mammogram is normal.

Mammograms may not be as effective in women with dense breasts. Breast density refers to the amount of fat and tissue in the breast as seen on a mammogram. A dense breast has more tissue than fat thus making it harder to see cancer on a mammogram. Younger women usually have dense breasts. As women get older, their breasts become less dense.

Although there is some disagreement in the medical community regarding appropriate ages for screening mammography, the American Cancer Society recommends that women have annual mammograms beginning at age 45. Be sure that your mammogram is done at a facility certified by the Illinois Emergency Management Agency or the U.S. Food and Drug Administration.

If you have questions about whether a facility is certified, call the Illinois Emergency Management Agency, 217-785-9923. You may also check out the FDA's website on the Internet at: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMQSA/mqsa.cfm for a list of FDA-certified mammography facilities.

Clinical Examination

Women should have their breasts checked by a health professional once each year. Women who need further information on breast examination procedures and instructions may contact the numbers listed below. It is important to remember that most lumps found in the breast are not cancer. However, any lump needs to be checked by a doctor as soon as it is found. Again, breast cancer can be treated best when it is diagnosed as early as possible.

IF YOU FIND A LUMP IN YOUR BREAST, HOW CAN YOU KNOW FOR SURE IF IT IS CANCER?

See your doctor!

Your doctor will probably want you to have a mammogram and possibly even a breast ultrasound or breast MRI.

Your doctor also may want you to have a biopsy. While a mammogram is very helpful in looking for breast cancer, a biopsy is the only way to determine whether a lump in your breast is cancerous. The procedure removes a small amount of tissue that is then tested to see if it is cancer.

In most instances, your doctor will want you to see a doctor who is specially trained to treat conditions of the breast for this procedure. Be sure to discuss with the specialist what kind of biopsy will be done. You and the specialist also need to decide what should be done if cancer is found.

If you do not have a doctor, call your medical society or one of the numbers listed below. Staff members will try to help find a doctor or breast cancer clinic close to where you live.