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
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