Diagnosis
Early detection helps to prevent the spread of cancer and increases the chances of a cure. The earliest way of detecting breast cancer is through a mammography. Your doctor may also want you to undertake other diagnostic tests.
Regular self examination might help you detect the presence of cancer. If you think any of the symptoms are present visit an oncologist.
Self Examination
If you are in the high risk group please perform the following examination periodically. All women above forty should be alert to breast cancer symptoms. Examine yourself 7 to 8 days after your menstrual period.
- Remove you clothing above the waist, and then sit or stand in front of a mirror. Let you arms hang loosely by your sides. Examine your breasts carefully in the mirror, looking for any changes in size or shape. Look also for any dimpling or puckering of the skin, and for any changes in the outline of the breasts.
- Raise both arms above your head. Examine your breasts from different angles: look for any changes since your last self examination. Checks the nipples, too, for any signs of discharge or bleeding.
- Now lie down on your bed with your head on a pillow. Put a folded towel or small pillow under your right shoulder, and put your left hand behind your head. Use your right hand to examine your left breast. Keep your fingers together and use the flat part of the fingers, not the tips, to feel the breast tissues.
Imagine the breast as having four quarters and start by examining the upper, inner quarter as shown in the photograph. Starting at the breast-bone, press gently but firmly and use small circular motions with your hand, looking for any lump or thickening or anything unusual. Work your way slowly to the nipple. Examine the area all around the nipple, too.
- To examine the right breast, put the folded towel under you right shoulder, and place your right hand behind your head. Use your left hand to explore your right breast quarter by quarter, just as you did for your left breast. Start with the upper inner quarter, and work your way around the circle. Don’t forget to move your right arm down to your side before examining the outer half of the breast.
Mammography
Breast cancer takes many years to develop.
Mammography is the only reliable method of detecting breast cancer before a lump can be felt by a patient.
It is like an x ray examination of the breast. Modern techniques give high quality results with low radiation exposure.
You will be expected to undress above the waist. You will have to remove all neck ornaments. The procedure will take about 20 minutes and you will get the results on the same day, or the next.
Women in high risk groups should go in for yearly exams after the age of 20. All other women are advised to go for yearly screening after the age 40.
Other Diagnostic Tests
Ductography
This test is advised especially if there is discharge from the nipple.Ductography is a type of x ray taken after a dye has been injected. The dye shows if there are blocks in the ducts in the breasts.
Breast Ultrasound
This method uses high frequency sound waves to outline a part of a body. A breast ultrasound is advised in some cases (as in where breast tissue is dense).
Biopsy
The above methods can detect masses, calcification or other abnormalities. But to know if any of these is cancerous, a biopsy has to be performed.
In a biopsy, a small incision is made or the breast is pierced with a needle and a sliver of the tissue and fluid is extracted. A pathologist examines this under a microscope to confirm the presence or absence of cancer.
Staging
Cancer treatment and outcome depend on the stage the disease has progressed to.
The conventional staging system known as the TNM (Tumour, Node, Metastasis) system is used to indicate the spread of breast cancer.
The following chart indicates the stages in breast cancer. (Letters on the left are the code letters for each stage.)
Size and Spread of Tumour
Depending on the size of the tumour, nodal involvement and metastasis the following stages have been defined by the American Joint Committee on Cancer.
Lobular carcinoma in situ (LCIS) is also called lobular neoplasia. Abnormal cells grow within the lobules or milk-producing glands, but they do not penetrate through the wall of these lobules.
Treatment
If treated, patients at Stage 0 have a very good chance of cure. The five year survival rate for patients treated at this stage is 100%.
Curative treatment is advised for stages I and II. A part of the breast where the lump is present or the entire breast and some of the chest tissue might be removed surgically. Radiation and chemotherapy may also be given.
For advanced stages, like stage III B and IV and for recurrent disease, treatment focuses and reducing the damage and the progress of the disease. Here too, surgery, chemo and radiation therapy may be advised.
Follow up
Patients who have been treated for breast cancer should be followed for life. The follow up should be once in three months for first three years. The later visits may be done every six months for five years. As most patients develop recurrence in the opposite breast the follow up visits should concentrate on the screening for this.
Women who have undergone mastectomy (removal of breast) may want to undergo breast reconstruction surgery performed by plastic surgeons. Reconstruction can be with your own tissues or with implants.
Breast cancer cannot be “prevented” as some diseases can, by a vaccine or medicines. However, the changes that take place leading to cancer, if detected early enough, can be treated in the pre cancerous stage. Early detection and treatment can prevent the spread of cancer. It may even save the patient from mutilating surgery.
The responsibility for detecting breast cancer lies primarily on the woman herself.Today, reconstruction of the breast is not a problem, if a breast cancer patient desires it. Loss of breast to cure cancer may be tragedy, but loss of life is more tragic.
