Early Detection is the Best Prevention

All right, I want a raise of hands! How many of you have even thought about breast cancer? Better yet, how many of you have even thought about early detection? Not that many…I expected that. Well, just in case you are curious, here is the 411 on early detection of breast cancer.

As you should have already guessed, the best way to defeat breast cancer is to detect it at the early stages. When breast cancer is found and treated during the early stages, a woman’s survival rate increases. Much like yourself, however, many Native American women fail to considered breast cancer as a threat and seldom take part in early detection. Much of their inactive role in early detection can be attributed to the fact that most Native American women do not have access to mammography equipment nor do they have transportation to hospitals that have proper mammography equipment. It also has to do with their skepticism of the Indian Health Service (IHS). Anyway, just for your peace of mind, here are some early detection measures you can take in order to reduce the chance of letting breast cancer claim your life.

Figure 1. Picture of a mammography machine.

Screening Mammography(Figure 1)—This is basically a special kind of x-ray of the breast. It is often used to look for breast changes in women who have no signs of breast cancer and is considered to be one of the best early detection measures. This machine works by “firmly” squeezing the breast between two plates, compressing the breast tissue, and taking a x-ray of the breast at different angles.

Clinical Breast Examinations—For this exam the doctor, nurse, or health professional will examine the breasts for any changes in shape or size. They will also feel the breasts and the area under the arms. Women who are 40 or over should have this done every year. If you are between 20 and 39, you should have this done every three years.

Breast Self-Exams—Breast self-exams allow the woman to learn more about her breasts and what is normal regarding her breast size and texture. When a woman learns more about her breasts, it is easier for her to recognize changes or lumps. When doing this procedure, you should keep in mind that it is normal for breasts to feel a little lumpy and uneven. It should also be noted that the best time to do a breast exam is a week after your period ends. Here are a couple of ways of performing a breast exam.

Figure 2. Breast exam in the shower.

In the Shower—With your fingers flat, move over every part of each breast. Using your left hand to examine the right breast, check for any thickening, hard lump or knot. Repeat using the right hand to examine the left breast (Figure 2.)

Figure 3. Breast exam in front of a mirror.

In front of the mirror—With your arms at your sides, look for any swelling, dimpling, changes in the nipples or changes in the shape of each breast. Then, raising your arms over your head, look for the same signs as before. You should also gently squeeze both nipples to see if there is any discharge present (Figure 3).

Early breast cancer usually does not cause very many symptoms. But as the cancer grows, certain changes can occur that a woman should watch for. Below are a few of these symptoms:

Artwork by Dana Tiger

A lump or thickening in the breast or underarm area.

A change in size or shape of the breast.

Nipple discharge, tenderness, or the inversion of the nipple.

Ridges or pitting of skin of the breast to the point that the skin looks like the skin of an orange.

A change in the way the skin of the breast or nipple looks and feels. Check to see if the breast or nipple is warm, swollen, red, or scaly.

If any of these symptoms should occur, a woman should see her doctor. Although they do not always indicate cancer, it is important for any problems to be diagnosed and treated as early as possible.

If an abnormal area on a mammogram is found in the breast, the doctor may require a careful physical examination and information regarding the person’s personal and family medical history. In addition to checking the patient’s general signs of health, the doctor might require one of the following breast exams in order to learn more about the abnormal region:

Palpation—For this procedure the doctor will feel the lump and the surrounding tissue in order to learn more about the lump. The doctor will feel the size of the lump, the texture and whether the lump moves easily. Often, benign lumps feel differently from cancerous lumps.

Diagnostic Mammography—As mentioned before, this x-ray of the breast can give the doctor further information regarding the breast lump or abnormal region that has been detected in the breast. This particular procedure is used for women who already have some of the breast cancer symptoms that were mentioned earlier.

Ultrasonography—This procedure uses high-frequency waves in order to show whether a lump is solid or filled with fluid. This exam may be used along with a mammogram.

Sometimes, a doctor only needs to perform the three breast exams mentioned above in order to make a diagnosis. Often times, however, a woman’s doctor may send her to a health care professional or surgeon who has experience with breast diseases. In order to make a proper diagnosis, these specialists may extract fluid or tissue from the breast using one of the following techniques:

Figure 4. FNA of a fluid-filled cyst

Fine needle aspiration(FNA)—In this technique a thin needle is inserted into the breast and is used to remove fluid from the breast lump. This procedure allows the doctor to see whether the breast lump is a fluid-filled cyst (which means it is not cancer) or a solid mass (which could be cancer). Fluid removed from a cyst may not need to be checked by a lab (Figure 4).

Needle Biopsy—Somewhat like the fine needle aspiration, this procedure uses a needle to remove tissue from a suspicious area that has been found on a mammogram but cannot be felt. Tissue removed using the needle biopsy goes to a lab and is analyzed by a pathologist.

Surgical Biopsy—In this biopsy a surgeon removes all or just part of the lump in question. The lump tissue removed is then sent to a pathologist who looks under a microscope to check for cancer cells.

So, there you have it! The info on breast cancer. As you can see, with early detection a person can reduce their chances of dying from breast cancer.