Breast Cancer Information Guide

What is Breast Cancer?

Breast cancer is a tumour (a mass of abnormal tissue) within the breast tissue. Most breast cancers begin in the milk ducts (intraductal cancers), however a small number starts in the milk sacs or lobes (lobular cancers).

What are the signs and symptoms of Breast Cancer?

In majority of women, breast cancer is first noticed as a lump in the breast. There are however, other signs and symptoms which are important.

– Change in shape or size of the breast
– Change in appearance of the skin in a particular area of the breast
– Dimpling or puckering of the skin on the breast
– A lump or thickening inside the breast
– Discharge from the nipple
– Rash on the nipple or surrounding area
– Inversion or turning in of the nipple
– Swelling of the upper arm
– Swelling or lump in the armpit

Who is at risk?

All women are at risk of developing breast cancer. There are a number of factors that put some women at a greater risk. These are:
– Women whose mothers, grandmothers, aunts or sisters have had breast cancer, have an increased risk of developing breast cancer.
– Chances of developing breast cancer increase as women grow older.
– Women who have already had breast cancer have a slightly higher chance of developing cancer in the other breast.
– Early onset of periods (before the age of 12).
– Late menopause (after the age of 50).
– Women who have never had children and those who delay giving birth until they are over 30.

Breast Self-Examination

Getting to know what your breasts look like and feel like is in the interest of good health.
It is important to know what is normal for you, so that you can detect any changes.
The best way to become familiar with your breasts is to perform monthly Breast Self-Examination (BSE). Regular BSE takes about 5 minutes and if done correctly, may detect a breast problem. When you become familiar with how your breasts normally look and feel, it will become easier for you to detect any changes. Remember that nine out of ten lumps or changes are harmless. There are many myths and stories about what causes breast cancer.
However, if you notice any change in your breast appearance, contact your doctor.

When should I be breast aware?

– There is no specific time. It is up to you.
– The best time to check your breasts is 2-3 days after your period ends.
– If you become pregnant, you should still check your breasts regularly, changes in size and texture are quite normal.
– If you no longer have periods, choose a particular day such as the first day of the month which is the easiest date to remind yourself to do the Breast Self-Examination.

How often should I check myself?

– Check your breasts regularly, once every month.
– Do not examine your breasts more frequently than once each month. You may not detect subtle or small changes.

How should I carry out Breast Self-Examination?

There are two steps of Breast Self-Examination and Awareness:
– Looking
– Feeling

Find a place or room in which you feel comfortable that is also well-lit:
1. Stand in front of a mirror; inspect both breasts for anything unusual such as any discharge from the nipples or puckering, dimpling or scaling of the skin.
2. Watching closely in the mirror, clasp your hands behind your head and press your hands forward.
3. Next, press your hands firmly on your hips and bow slightly towards your mirror as you pull your shoulders and elbows forward. Some women prefer to do the next part of the examination in the shower because fingers glide over soapy skin, making it easy to concentrate on the texture underneath.
4. Raise your left arm. Use three or four fingers of your right hand to explore your left breast firmly, carefully and thoroughly. Beginning at the outer edge, press the flat part of your fingers in small circles, moving the circles slowly around the breast. Gradually work towards the nipple. Be sure to cover the entire breast. Pay special attention to the area between the breast and the underarm, including the underarm itself. Feel for any unusual lump under the skin.
5. Gently squeeze the nipple and look for a discharge (if you have any discharge during the month, whether or not it is during Breast Self-Examination, consult your doctor). Repeat steps 4 and 5 on your right breast.
6. Steps 4 and 5 should also be repeated lying down. Lie flat on your back with your left arm over your head and a pillow or folded towel under your left shoulder.

This position flattens the breast and makes it easier to examine. Use the same circular motion described earlier. Repeat the exam on your right breast.

What am I looking for?

– Changes in the size, outline or shape of the breast causing flattening of the skin.
– Dimpling, creasing or puckering of the skin.
– A change in direction of the nipple or if it has started to draw in.
– Nipple discharge (some women produce a clear or milky discharge which is normal for them).
– New veins which stand out, particularly on one breast and not the other.
– Any skin changes on the breast or nipple.

What am I feeling for?

– Any areas of thickening.
– Any lumps whatever their shape or form.
– Any lumpy areas.
– New or persistent pain or tenderness within the breasts.

Any changes you find that are new for you must be checked by your doctor.

Mammography

Mammography is a special x-ray of the breast and gives more information about the lump.

Where can I get help?

If you have any queries or problems related to your health, please contact Shaukat Khanum Memorial Cancer Hospital and Research Centre.