Taking Breast Exams Into One’s Hands

Posted by: Medical Observer

BETTER to get early signs of breast cancer detected than be sorry later at getting the entire chest carved out, cancer-wracked portions scraped off. In its early stage, breast cancer can be cured — and the key to early detection is in your hands.

A woman’s familiarity with her breast tops the list of tools used in early detection of anomalies. These tools for detection include “breast awareness, physical examination, risk assessment, screening mammography, and in select cases, magnetic resonance imaging (MRI),” cites Dr. Shiela Macalindong, consultant at the Philippine General Hospital’s Department of Surgery.

“We advise that the exam be done a few days after menstruation to maintain breast sensitivity. With menses, there is a tendency for the breast to be tender, engorged, and quite nodular on palpation.

Start with the visual exam, facing a mirror and with one hand pressing down on the breast—this movement is important because contraction of the underlying muscles will enhance only subtle changes in the breasts. (Be wary of subtle changes in) size, shape, contour, any change in skin color, texture, any change in the nipple and areola area.

“You can also do the exam with both hands behind your head; any subtle changes can be detected with movement. Changes may be a lot more subtle especially in the beginning stages (of disease). Changes in the nipples may sometimes appear as eczema lesions but they can turn out to be early stage breast cancer,” Dr. Macalindong relates.

After visual inspection, palpate the breasts while lying down. In a supine position, “the breasts are relatively flatter and more amenable to palpation. We use the three middle fingers, index to ring finger, to palpate. Some would use a circular motion from the nipple going outward; others prefer vertical movement, going up to down, down to up. More important is to cover the entire breast area.

“Equally important to cover the armpit area, best done with hands down rather than above the head, so that the tissues can be sensed by touch— the first metastatic signs for breast cancer will be an enlarged lymph node in the axillary area.

“Too, inspect the nipple for discharge, and this requires squeezing the nipple side to side to see if there’s any discharge.

“Changes (that have turned up) in the breast examination ought to prompt one to seek medical consult. Most of the things that the exam turns up would be benign, but it is just important to have it verified by a health practitioner,” she counsels.

Dr. Macalindong also points up the importance of screening mammography in early breast cancer detection: “In the Philippines, mammography screening is started at age 50. Studies show that since the initiation of mammogram screening, breast cancer deaths have been reduced by about 33%. Cancer is detected two years earlier than a clinical breast exam. But mammogram findings does not necessarily mean a patient has cancer.

“And of these 3-4 patients, two will actually mark early stage cancer; majority would be ductal carcinoma in situ which are non-invasive types of breast cancer,” she concludes.

“What we are trying to say with early detection is that breast cancer is not… definitely not a death sentence—it is very curable, hence, early detection is the key to be able to ensure such an outcome,” she adds.

- Dong Delos Reyes, Medical Observer