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Understanding breast cancer.

Breast cancer is the leading cause of cancer related death in females worldwide. Though it occurs mostly in women, men can also be diagnosed with cancer of this form. Nearly 50 per cent of the women with breast cancer belong to developing countries, where they present at a younger age and advanced-stage disease. Breast cancer is the most common cancer diagnosed in Omani women. In the last reported study in Sultan Qaboos University Hospital, we found that compared to the western world, Omani women are diagnosis at a younger age and the majority of patients present at advanced stages of disease.

The human body is made up of tiny building blocks called cells. These cells grow and divide in a controlled manner which helps in the process of growth, healing and repair. When cells grow in uncontrolled manner they become abnormal and form a lump called a tumor, but all lumps are not cancerous. A lump which is benign (non-cancerous) cannot spread to other parts of the body, whereas a malignant tumor can invade surrounding tissues or spread to distant parts of the body.

Risk factors for breast cancer

The risk factors which increase the chances of getting breast cancer include being female, increasing age, genetic makeup of body, positive personal or family history for breast cancer, exposure to certain hormonal treatments, body weight, alcohol drinking and physical activity. Certain risk factors are modifiable while others are beyond our control.

Although people have risk factors, it does not mean that they will get the disease and it is hard to determine to what extend these factors contribute to developing cancer. Certain risk factors like gender, aging, genetics, family history of breast cancer, dense breast tissue and menstrual periods are not modifiable, while birth control, use of hormone therapy, breast-feeding, more vegetables and fruits in the diet, drinking alcohol, obesity and regular physical activity are modifiable risk factors which can help reduce the risk for most cancers including breast cancer.

Signs and symptoms of breast cancer

The most common symptom of breast cancer is a painless, hard irregular lump or mass. But some breast cancers can be tender, soft or rounded and may sometimes be painful. Other possible signs of breast cancer include swelling of all or part of a breast (even if no distinct lump is felt), skin irritation or dimpling, breast or nipple pain, nipple retraction (turning inward), redness, scaliness or thickening of the nipple or breast skin and nipple discharge other than breast milk.

Can breast cancer be detected early?

It is possible to detect breast cancer early by undergoing breast screening exams at recommended intervals even though you don't have any symptoms. Screening exams can often detect breast cancers when they are small and still confined to the breast. The American Cancer Society recommends that women at the age of 40 and above should have a mammogram every year. Women in their 20s and 30s should have a clinical breast examination done by a health professional every three years, and for women after 40, it should be done every year. Also, Breast Self-Examination is an option for women starting in their 20s and they should report any changes in her breasts to their health professional right away. Women who are at high risk of breast cancer, mainly those who have strong family history of breast cancer, should see a doctor for risk assessment.

Clinical breast exam

A clinical breast exam is an examination of a patient's breasts by a health professional such as a doctor and/or nurse. During this, the health professional will first look at the breasts for abnormalities in size or shape, or changes in the skin of the breasts or nipples. Then, using the pads of the fingers, the examiner will gently feel the breasts. Special attention will be given to the shape and texture of the breasts, location of any lumps, and whether such lumps are attached to the skin or to deeper tissues. The area under both arms are also be examined.

Breast Self-Examination and what you should do if you have any symptoms

Women who are menstruating regularly must do the breast self-exam 2-5 days after the last day (when normal premenstrual swelling is gone), while those no longer menstruating regularly can choose a specific day of the month to do the examination.

Stand in front of a well-lit mirror. Look at your breast and underarm in the mirror. Tell your doctor immediately if you notice any of the changes listed below:

Swelling or lumps, change in the size or shape of the breast, thickening of the skin, and redness or change in skin colour. Touching may be done more accurately and easily in the shower with soap on your hands or out of the shower using body lotion. With two fingers together, press the area gently using small circular motions. Check the chest wall with three or four fingers together, use a sweeping motion to check the chest wall. Tell your doctor immediately if you feel any of the changes. It is very important to your health that you approach immediately and tell your health care provider if you notice any changes.

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Publication:The Week (Muscat, Oman)
Date:Oct 29, 2015
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