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HomeMy WebLinkAboutThe Wingham Advance-Times, 1984-03-26, Page 39HOPE Page 10 breast cancer is curable - detect: early Every year some 9,000 Canadian women develop breast cancer. It rarely affects men, but approximately 1 in 12 women liv- ing in this country will develop breast cancer in the course of her lifetime. Although curable, particularly when detected early, breast cancer kills almost 3,500 Canadians a year and is the major caufse of cancer deaths among women. It is I the leading cause of death in women from all causes between the ages of 35 and 54. Also, because it tends to occur earlier in life than other cancers and than other major causes of death; such as cardiovascular disease, it has been shown to be the greatest cause of years' of life lost by Canadian women. Clearly it is a major health pro- blem. WHAT IS CANCER OF THE BREAST? Cancer of the breast can have all the' features which are characteristic of cancers in general. The tumor usually arises from the cells of milk sacs or milk ducts, although malignant tumors occasionally arise from the supporting structure. Even a cancer arising from the sacs or ducts may show variation. It may grow into the duct canal and signal its presence early with bleeding from the nipple. Alternatively, it may grow into the breast tissue as a mass which is usually very hard, but may, with some kinds of tumors, be soft. Cancer of the breast oc- curs almost exclusively in women — in fact, it is one hundred times more common in women than men. It is also rare in women under 30 years old, and becomes more com- mon after age 40. RISK FACTORS IN BREAST CANCER We do not yet know the causes of breast cancer but research is adding to our knowledge every year. Studies of large numbers of women with the disease have permitted the identification of a number df risk factors which increase their chances of developing breast cancer. They are: Previoos`b st ancer. self• examinaton (2/ Sit or stand In front of your mirror, with your arms relaxed at your sides, and examine your breasts carefully for any changes in size and shape. Look for any puckering or dimpling of the ® skin, and for any discharge or change in the nipples. 2 2. Strong family history of breast cancer. Cancer of the breast is common enough that 4 not unusual to have such a family history of the disease by mere chance. However, if more than one first degree relative (mother, sister) has had breast cancer, then an in- dividual should consider herself at increas- ed risk of developing the disease. 3. Age at first pregnancy. The younger a woman at the time of her first pregnancy, especially before age 25, the greater her protection against getting breast cancer. However, women who became pregnant for the first time at age 30 have about the same risk of getting breast cancer as women who never have children. First pregnancy after age 30 is associated with a slightly increased risk of breast cancer compar d to women who have never borne clultheen. 4. Diet. Rats fed a high fat diet show an in- creased incidence of breast cancer and some comparative studies suggest that overweight women, particularly after the menopause, and women whose diet includes an excess of fats, particularly animal fats, may have a higher incidence of breast cancer. 5. Benign breast disease. There is some evidence that benign breast disease (chronic cystic mastitis) increases the risk of cancer. However, whether this is true or not, the woman with granular breasts from this disease should follow a careful breast surveillance regime since, if nothing else, it will make the early diagnosis of breast cancer more difficult. 6. Menstruation. Early beginning of the menstrual periods (menarche) and late cessation of menstrual periods (menopause), probably because both are associated with the prolonged influence of stimulatory hormones, have been associated with a slightly increased risk of breast cancer. • 7. Multiple pregnancies. Multiple pregnancies do appear to provide some pro- tection apart from the fact that they are often associated with early age of first pregnancy..., In addition to the risk factors mentioned, the administration of female sex hormones (estrogen) is associated with the increased occurrence of breast cancer in laboratory animals. In women of childbearing age, however, extensive studies on the effect of the birth control pill (which contains female sex hormones) have failed to demonstrate any increased risk of breast cancer. Unfor- tunately, this is not true of studies in which estrogens have been administered to women following the menopause for the control of menopausal symptoms. In the latter situa- Raise both your arms over your head, and look for exactly the same things. See if there's been any change since you last examined your breasts. Lie on your bed, put a pillow or a bath towel 'under your left shoulder and your left hand under your head, (From this Step through Step 8, you should feel for a lump or thickening.) With the fingers of your right hand held together flat, press gently but firmly with small circular motions to feel the inner, upper quarter of your left breast, starting at your breast -bone and going outward toward the nipple line: Also -i the nipple. Now bring your left arm down to your side, and still using the flat part of your fingers, feel under your armpit Use the same gentle pressure to feel the upper, outer quarter of your breast from the nipple line to where your arm is resting. • And finally, feel the lower' outer section of your breast, going from the outer part to the nip With the same gentle pressure,. feel the lower inner part of your breast. Incidentally, in this area. . you will feel a ridge of firm tissue or. flesh. Don't be alarmed. This is perfectly normal, Repeat the entire procedure on the right breast. Your own doctor, may want you to use a slightly different method of examination. Ask. him to teach you that method. Examine your breasts ev^ry month, just after your period. Be sure to continue these checkups after your change of life. If you find a lump or thickening leave it alone until :you see your doctor. Don't be frightened. Most breast lumps or changes are not cancer, but only your doctor can tell. tion there appears to be a moderate in- crease in the risk of breast cancer develop- ment after an interval of many years. Although there is a common misconcep- tion that an injury to the breast is a common cause of the breast cancer, this is not true. There is no evidence that an injury can cause breast cancer, although it may be what first draws a woman's attention to a cancer which is already present. There is also no truth to the myth that breast feeding can protect against breast cancer. HOW CAN YOU PROTECT YOURSELF FROM BREAST CANCER? While proof isa.lacking that the following may decrease your risk of developing breast cancer, you are probably wise to: 1. eat a prudent diet, avoid an excess of fats, avoid becoming obese, and 2. take medication containing sex hor- mones only if required and in the smallest possible dose which will achieve the desired effect. Another important positive action is regular breast self-examination (BSE). BREAST SELF-EXAMINATION Every Canadian woman should practice breast self-examination (BSE) once a mon- th. The basic priciples behind BSE are to ex- amine all of your breast tissue and under your arm, using the flat of your fingers. The Canadian Cancer Society will provide you with information on how to perform BSE and some Units of the Society conduct teaching clinics at which you can receive personal instruction in this important, easy and painless early diagnostic procedure. You can also ask your doctor to teach you BSE, as well as giving you breast examina- tions as part of a regular check-up. What Are You Looking For? The most common sign of breast cancer is a mass or 'lump in the breast which is discovered by the woman herself. The mass is rarely painful: Bleeding from the nipple may occur with cancers that grow into the duct system. Changes in the contour of the breast, such as differences between the size or shape of the two breasts not present previously, in- drawing of a nipple which previously was everted, or pulling in of the skin so as to cause a dimple, are also important signs. You should remember, however, that some of these signs of cancer are four times more likely to be due to a non -cancerous disease. Therefore, while you certainly should see your doctor immediately if you discover any of these signs, you should remember that the most likely diagnosis will be simple, easily treated disease rather than cancer. BREAST CANCER SURVEILLANCE If you are over 35 years of age and any of the risk factors. apply to yo -a, you would -be - wise, in addition to practicing monthly BSE, to discuss a program of breast cancer surveillance with your doctor. This might involve periodic physical examination by your physician. Some other programs are described below. 1. Mammography (or Xeromam- mography ) eromammography) — a special x-ray examination of the breast which uses very small amounts of radiation. Following the menopause this technique, in combination with physical ex - 'amination, leads to earlier diagnosis of breast cancer and significant improvement in survival, In premenopausal women, the same combination, using older x-ray techni- ques, has not proven of benefit. However, a very large Canadian study, the National Breast Screening Study, is now under way to answer the question as to whether newer techniques can obtain improved diagnosis and survival of premenopausal women, as well as whether the use of Mammography adds a significant additional benefit to an- nual physical examinations. 2. Thermography — examination of the breast by a machine designed to show areas of increased heat. Thermography is less,, precise and less accurate; than mam- mography and is no longer used in some medical centres. 3. Ultrasonography ,,(Ultrasound) — ex- amination by directing sound waves into the breast and detecting them as they bounce back off breast structures of different densi- ty. This procedure, in so far as the breast is concerned, is experimental. 4. Biochemical and immunological tests off the blood. Much study is going on in this area at the present time, but no accurate tests of the blood currently exist for the diagnosis of breast cancer.] DIAGNOSIS What -happens -if -you-find-a-lu_mp_n .your:_.. breast? After obtaining a history from you regarding how the lump was discovered, and whether you have other related syrnp- toms, your doctor willexamine the breast as well as perform a more general physical ex- amination. Depending on the findings, addi- tional laboratory studies May be suggested, perhaps mammography or ultrasonography. If a true mass does exist, one of two courses of action may be followed. 1. If it appears to be a cyst (a sac filled with fluid) your physician may insert a nee- dle into the cyst, after `freezing' the area with a local anaesthestic, and remove the fluid. If it proves to be non -cancerous, nothing further than this simple treatment usually need be done. 2. If the mass appears to be solid, a biopsy will probably be carried out. It may require Turn to page 11 •