Breast exam, literally, is a brief process involving observation and maneuvers intended to elicit anomalies in a breast. This can be done by a doctor, the person their self (self breast exam) or by an individual one is comfortable with, typically a spouse (they are usually more than eager to help out!). Our discussion here focuses on breast exams outside a health care setting, primarily, the breast self-exam. So, we’ll neglect the rest from here on.
Breasts are known to change in size, composure, and/or function along with the menstrual cycle, thus, with any other related hormonal changes’ whether normal (like pregnancy and breast feeding) or abnormal. This makes the whole process of screening for abnormalities challenging, especially in the face of unskillfulness. Therefore, it’s helpful to identify the time at which there are unlikely to be insignificant changes’ in breast tissue. This falls at just about 10 days from the first day of the last menstrual period. Thus, it’s recommended breast exams be done in the first few days just after periods. This also tends to be the time of greatest comfort since, in some women, periods are associated with breast tenderness. Breast exams should be carried out right from when they have fully developed (right after puberty), identifiable with well-marked areola and small growth in the surrounding (Montgomery tubercles), and throughout adulthood. Greater vigilance is needed at ages 40 and above.
So, we’ve been discussing about periods and things of the sort. Does this mean the males are excluded? Not at all! Men too, need to carry out breast exams especially if there are concerning changes’ (including the tendency of the breast to appear feminine) and if they have a family history of breast cancer. It might be rear (~1% of all breast cancer cases) but it surely exists and tends to be very aggressive in males.
How often should Breast self-Exam exam be done.
For females; breast self-exams should be done monthly along the menstrual cycle as discussed above and in cycles as determined by the woman after menopause. Women in their 20s and 30s should obtain a Doctors breast exam every 2 to 3 years, at age 40 and above, yearly. If they are of a “high risk category”, preferably, be enrolled in follow up programs.
Men; should examine themselves for lumps as often as possible. Any lump should draw attention in this case! The same applies to them if they fall in the high risk category.
High risk category; Those with family history of breast cancer (includes 1st and 2nd degree relatives), Family history of ovarian cancer, personal history of treated ovarian or breast cancer, multiple cancers at an early age and age above 50.
What should one pay attention to during a breast exam?
When carrying out a breast self-exam, look out for:
- abnormal discharge from the nipples ( scanty colorless discharge occurring occasionally, without accompanying anomalies is normal, pregnant women might have pale white/straw-coloured discharge)
- lumps, especially new onset (lactating women should be cautious, they commonly have benign lumps)
- changes’ in skin (peau d’orange) or nipple itself (especially retraction)
- the difference in size between breasts ( minor size and nipple level differences are insignificant)
- always examine all quadrants including the tail, check for any swollen nodes in the axilla (arm pit) and just below the clavicle before the shoulder joint.
Any changes’ in line with the above should preempt a doctor’s consultation.
New developments in self breast examination.
In a few years to come, the traditional “feeling for a lump” will be completely replaced by the breast light (also called home breast scan) device, thanks to advancements in science and technology. The device can be used by an individual at home and uses a special form of bright light to reveal changes’ within the breast. It is generally safe and easy to use. This helps users to easily and more accurately tell when to see the Doctor. The only change this brings to the Breast self-exam is use of hands for examination. Otherwise, the recommended schedules and frequencies still stand.
How to use the Breast light:
- First you need the device, a lubricant gel, a large mirror (dressing mirror) and a dark room.
- Its preferable to wash hands and breasts then dry them. Apply the lubricant gel.
- Get before a mirror and black out the room (create darkness).
- Turn on the device and move it in a pattern similar to that of the physical exam, covering all quadrants, including the axillary tail. The normal breast appears bright orange. Black spots or shadowing are abnormal unless previously determined to be of no concern. With time every woman will get to know what’s normal to her.
- The light gets brighter when pressed against the breast, and can be set to brighter settings (about 4 levels)
- Report any New changes’ to the doctor.
To wrap it up…
Breast self exam is a procedure set in place, primarily, to hunt for breast cancer, a devastating and deadly illness. It’s the second most common cancer in women. If caught early, can be curable, except for some rare types. Thus, should be given the attention it deserves. Breast lights are a noteworthy game changer in helping identify the problem at the earliest stages. Said otherwise, are pivotal in improving the chances of recovery and quality life in regard to breast cancer.