4 Real Things We Learned From Breast Cancer Awareness Month

Breasts come in all shape and sizes. How do you know whether they’re normal?
Breasts come in a wide range of shapes and sizes. No two people have breasts that look exactly the same. It depends on our genetic influence, weight, age and other factors such as pregnancy and breast-feeding. We should be concerned if there is a sudden change in the size or shape of our breasts or even sudden change in the appearance of the nipple or skin overlying the breast.

At what age should girls start performing breast exams?
Once a girl hits puberty, she should be encouraged to perform breast self-examination (BSE) regularly. Although there is no evidence on the effectiveness of BSE and it does not have a meaningful impact on breast cancer survival rates, the practice of BSE has been seen to empower women and encourage them to take responsibility of their own health.

How often should you get a breast examination?
Breast examination can be divided into 2 – breast self-examination (BSE) and clinical breast examination (CBE). BSE is usually performed by the woman herself. CBE, on the other hand, is an examination performed by health care providers. There are no specific guidelines recommending the frequency of breast examinations but women are encouraged to perform BSE monthly. There is insufficient evidence to support routine CBE in population-based screening. However, CBE plays an important role especially in women who fear mammograms or those who have limited access to mammography.

* One should also remember that a negative examination does not exclude the presence of breast cancer.

When is the best time to do it?
The best time to do a monthly BSE is about 3 to 5 days after our period starts as our breasts are not as tender or lumpy at this time. It should be performed at the same time every month so that it becomes a routine. For those who have undergone menopause, breast exam can be done on the same day every month.

How do I differentiate a breast gland from a lump?
Breasts contain tissues of varying consistency – including fatty, glandular and connective tissue. Breast related symptoms, such as tenderness or lumpiness, changes with our menstrual cycle. It is difficult to differentiate breast lumps from lumpy glandular breast tissue especially during breast self-examination. If there is any suspicion, do consult your doctor for further examination/ investigation.

Do all lumps translate to breast cancer?
Although breast cancer is the most common cancer found in women, most breast lumps detected during breast self-examination (BSE) or clinical breast examination (CBE) are benign in nature (non-cancerous). In fact, more than 80% of them are benign. Cancerous breast lumps tend to feel hard and irregular shaped, while many benign breast lumps are smooth or rubbery to touch.

Do breast implants raise your breast cancer risk?
There is a possible association between breast implants and the development of breast-implant associated anaplastic large cell lymphoma (BIA-ALCL), an uncommon cancer of the immune system. However, further research is required to understand better the relationship between this condition and breast implants. If you have breast implants, do visit your doctor for routine checkups and report any signs or symptoms promptly. If you are considering breast implants, discuss risks and benefits with your doctor.

What can one do to lower the chances of getting breast cancer?
In terms of reducing the chances of developing breast cancer, we should address our risk factors. Risk factors simply mean factors that increase our chance of developing breast cancer; which can be divided into two types: non-modifiable and modifiable risk factors.

Non-modifiable risk factors are factors that cannot be changed – it includes gender, family history of breast cancer and being a carrier of the BRCA1 and BRCA2 gene mutation. Hitting puberty early (<12 years old) and menopause later in life (>55 years old) increases the risk of developing breast cancer.

Modifiable risks come down to lifestyle choices such as sedentary habits, alcohol consumption, smoking and even long term intake of exogenous hormones in the form of oral contraceptive pills or hormone replacement therapy. Not bearing children, full-term pregnancy after the age of 30 as well as no breastfeeding increases the risk further.

Non-modifiable risks cannot be changed. However, the risk may be lowered for some patients; for example, prophylactic mastectomy can be performed to lower breast cancer risk in BRCA gene mutation carriers. In terms of modifiable risk factors, leading a healthy lifestyle, regular exercise and maintaining a healthy weight will not only reduce the risk of breast cancer but also reduces the risk of recurrence in survivors.

What are the things we keep doing that increases the risk of breast cancer?
Most of us are aware that excessive alcohol consumption, smoking and leading a sedentary lifestyle increases the risk of not only breast cancer but various other cancers. Hence, limiting the amount of alcohol consumption and cessation of smoking is important. Lead a healthy lifestyle, ladies!