WOMEN IN ACTION

Women lead busy and demanding lives – often putting others’ needs before their own. CANSA is encouraging all women to invest in their health by learning how to detect women’s cancers early, as part of its women’s health campaign for September and October.

Invest in your health – Detect women’s cancers early

“Cancer is one of the most serious diseases women face. We want all women to care for themselves and, by breast self-examination (BSE) and screening tests, help detect female cancers early, when treatment is more effective” said Sue Janse van Rensburg , CEO of CANSA. “Being proactive against cancer is the greatest gift women can give themselves and their families”.

Reduce your cancer risk – maintain a healthy balanced lifestyle by:

•Not using any tobacco products

•Eating high fibre and low fat foods

•Drinking lots of fresh clean water

•Getting plenty of exercise

•Watching your weight

BREAST CANCER

One in 29 women in South Africa will be diagnosed with breast cancer; the good news is if it’s detected early there is an excellent chance of recovery. That is why every woman needs to examine her breasts and underarms regularly every month, to check for any changes such as a difference in size, lumps, unusual swellings, puckering of the skin, sores, pain or discharge. If you have these symptoms go to a health professional without delay. Many breast lumps are harmless but they all must be checked. If you are over 40, ask your doctor how often to go for a mammogram (a special x-ray to detect lumps in the breast).

What Is Breast Cancer?

Breast cancer is a malignant (cancer) tumor that starts from cells of the breast. It is found mostly in women, but men can get breast cancer, too.

A woman’s breast is made up of glands that make breast milk (called lobules), ducts (small tubes that carry milk from the lobules to the nipple), fatty and connective tissue, blood vessels, and lymph (pronounced limf) vessels. Most breast cancers begin in the cells that line the ducts (ductal cancer), some begin in the lobules (lobular cancer), and a small number start in other tissues.

The lymph system

The lymph system is important because it is one of the ways in which breast cancers can spread. This system has several parts. Lymph nodes are small, bean-shaped collections of immune system cells (cells that are important in fighting infections) that are connected by lymphatic vessels. Lymphatic vessels are like small veins, except that they carry a clear fluid called lymph (instead of blood) away from the breast.

Breast cancer cells can enter lymphatic vessels and begin to grow in lymph nodes. Most lymph vessels of the breast lead to lymph nodes under the arm. These are called axillary nodes. If breast cancer cells reach the underarm lymph nodes and continue to grow, they cause the nodes to swell. It is important to know whether cancer cells have spread to lymph nodes because if they have, there is a higher chance that the cells have also gotten into the bloodstream and spread to other places in the body. This could affect the treatment plan.

Benign breast lumps

Most breast lumps are benign, this means they are not cancer. Benign breast tumours are abnormal growths, but they do not spread outside of the breast and they are not life threatening. But some benign breast lumps can increase a woman’s risk of getting breast cancer. Most lumps are caused by fibrocystic changes. Cysts are fluid-filled sacs. Fibrosis is the formation of scar-like tissue. These changes can cause breast swelling and pain. They often happen just before a period is about to begin. The breasts may feel lumpy, and sometimes there  is a clear or slightly cloudy nipple discharge.

What Causes Breast Cancer?

Certain changes in DNA can cause normal breast cells to become cancerous. DNA is the chemical in each of our cells that makes up our genes – the instructions for how our cells work. Some inherited DNA changes can increase the risk for developing cancer and are responsible for the cancers that run in some families. Certain risk factors are linked to the disease. A risk factor is anything that affects a person’s chance of getting a disease such as cancer. Some risk factors, such as smoking, drinking, and diet are linked to things a person does. Others, like a person’s age, or family history, can’t be changed.

Having a risk factor, or even several, doesn’t mean that a person will get the disease. Some women who have one or more risk factors never get breast cancer and most women who do get breast cancer don’t have any risk factors. While all women are at risk for breast cancer, the factors listed below can increase a woman’s chances of having the disease.

Breast cancer risk and lifestyle choices

Alcohol: Use of alcohol is clearly linked to an increased risk of getting breast cancer. CANSA suggests limiting the amount you drink to one drink a day, if at all.

Being overweight or obese: Being overweight or obese is linked to a higher risk of breast cancer, especially for women after change of life and if the weight gain took place during adulthood. Also, the risk seems to be higher if the extra fat is in the waist area. The link between weight and breast cancer risk is complex. CANSA recommends women maintain a healthy weight throughout life.

Lack of exercise: Studies show that exercise reduces breast cancer risk. The only question is how much exercise is needed. CANSA suggests women exercise for at least 30 minutes every day.

High fat diets: Studies found that breast cancer is less common in countries where the typical diet is low in fat. CANSA recommends eating a healthy low fat diet that includes 5 or more servings of vegetables and fruits each day, choosing wholegrain products and limiting the amount of processed and red meats.

Tobacco Smoke: A possible link to breast cancer is another reason to stop smoking and avoid being around secondhand smoke.

Can Breast Cancer Be Prevented?

There are things all women can do that might reduce their risk and help increase the odds that if cancer does occur, it is found at an early, more treatable stage. You can lower your risk of breast cancer by changing those risk factors that can be changed. If you limit alcohol use, exercise regularly, and keep a healthy weight, you are decreasing your risk of getting breast cancer.

Genetic testing: There are tests that can tell if a woman has certain changed (mutated) genes linked to breast cancer. With this information, women can then take steps to reduce their risk. If you are thinking about genetic testing, you should talk to a genetic counsellor, nurse, or doctor qualified to explain the results of these tests. It is very important that you know what genetic testing can and can’t tell you, and to carefully weigh the benefits and risks of testing before these tests are done.

How Is Breast Cancer Found?

The term screening refers to tests and exams used to find a disease like cancer in people who do not have any symptoms. The earlier breast cancer is found, the better the chances that treatment will work. The goal is to find cancers before they start to cause symptoms. The size of a breast cancer and how far it has spread are the most important factors in predicting the outlook for the patient. Most doctors feel that early detection tests for breast cancer save many thousands of lives each year. Following the guidelines given here improves the chances that breast cancer can be found at an early stage and treated with success.

Breast self-exam (BSE): BSE is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any changes in how their breasts look or feel to their health professional right away. If you do BSE on a regular basis, you get to know how your breasts normally look and feel and can more easily notice changes.

Mammogram: Women age 40 and older should ask their doctors how often to go for mammograms. While mammograms can miss some cancers, they are still a very good way to find breast cancer.

Clinical breast exam: Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a regular exam by a health expert, at least every 3 years. After age 40, women should have a breast exam by a health expert every year.

What is a Mammograms

A mammogram is an x-ray of the breast. This test is used to look for breast disease in women who do not seem to have breast problems. It can also be used when women have symptoms such as a lump, skin change, or nipple discharge. During a mammogram, the breast is pressed between 2 plates to flatten and spread the tissue. The pressure lasts only for a few seconds. Although this may cause some discomfort for a moment, it is needed to get a good picture. Very low levels of radiation are used.

What is a Clinical breast exam

A clinical breast exam (CBE) is an exam of your breasts by a health expert such as a doctor, nurse practitioner, nurse, or physician assistant. For this exam, you undress from the waist up. The examiner will first look at your breasts for changes in size or shape. Then, using the pads of the fingers, she or he will gently feel your breasts for lumps. The area under both arms will also be checked. This is a good time to learn how to do breast self-exam if you don’t already know how.

Breast awareness and breast self-exam

Women should be aware of how their breasts normally look and feel and report any changes to their doctor right away. Finding a change does not mean that you have cancer. By being aware of how your own breasts look and feel, you are likely to notice any changes that might take place. You can also choose to use a step-by-step approach to checking your breasts on a set schedule. The best time to do breast self-examination (BSE) is when your breasts are not tender or swollen. The goal is to see your doctor right away if you notice any of these changes: a lump or swelling, skin irritation or dimpling, nipple pain or the nipple turning inward, redness or scaliness of the nipple or breast skin, or a discharge other than breast milk. But remember that most of the time these breast changes are not cancer.

Symptoms of breast cancer

The widespread use of screening mammograms has increased the number of breast cancers found before they cause any symptoms, but some are still missed. The most common sign of breast cancer is a new lump or mass. A lump that is painless, hard, and has uneven edges is more likely to be cancer. But some cancers are tender, soft, and rounded. So it’s important to have anything unusual checked by a doctor.

Other signs of breast cancer include the following:

• swelling of all or part of the breast

• skin irritation or dimpling

• breast pain

• nipple pain or the nipple turning inward

• redness, scaliness, or thickening of the nipple or breast skin

• a nipple discharge other than breast milk

• a lump in the underarm area

Source: American Cancer Society www.cancer.org