Breast Cancer Awareness

Many women do not have a chance to learn much about breast health or physiology unless they begin breastfeeding their children or develop a problem that needs medical attention. Most people know that breasts change in appearance throughout life and that the breasts are composed of fat, but they are actually much more complex than that. The breasts are made up of a complicated network of milk-producing sacs, passageways for carrying milk, supporting tissue, lymph nodes, glands, tiny muscles and fat. Throughout puberty and menopause, not only does the appearance of the breasts change but also the composition and workings of the breast tissue.

Becoming familiar with breast anatomy and physiology can help individuals understand the normal changes in their bodies that they experience throughout their lifetimes. This knowledge is also an important starting place for understanding health problems and diseases that affect the breasts including breast cancer.

How Can I Prevent Breast Cancer?

The causes of breast cancer are not fully understood, although it is clear that a woman’s age, gender and lifetime exposure to estrogen and her age at the time of her first childbirth play an important role. Because no one knows exactly what causes breast cancer, there are no sure ways to prevent it. However, there are steps that every woman can take that may make developing breast cancer less likely. These include eating healthy, maintaining a healthy weight, exercising regularly and limiting the amount of alcohol you drink. Leading a healthy lifestyle will not eliminate your chance of getting breast cancer, but it may help reduce your risk. For women at higher risk, the antiestrogen drug tamoxifen can also help to reduce the risk of developing breast cancer.

How Do I Know if I am at Risk for Breast Cancer?

All women are at risk for breast cancer. Known risk factors like having a family history of breast cancer, starting menopause after age 55 or never having children account for only a small number of new breast cancer cases every year. That means that most women who get breast cancer have no known risk factors except being a woman and getting older.

Organizations such as the American Cancer Society and the Susan G. Komen Foundation recommend that you:

• Talk to your family to learn about your family health history
• Talk to your provider about your personal risk of breast cancer
• Ask your doctor which screening tests are right for you if you are at higher risk
• Have a mammogram every year starting at age 40 if you are at average risk
• Know how your breasts look and feel and report any changes to your health care provider right away
• Make healthy lifestyle choices that may reduce your risk of breast cancer, such as maintaining a healthy weight, exercising and limiting alcohol intake

Breast Self-Exam (BSE) Instructional Tool

Breast self-exam (BSE) is a tool that may help you learn what is normal for you. BSE involves looking at and feeling your breasts. Women who practice BSE should also be sure to get mammograms and clinical breast exams at the appropriate age. BSE should not be substituted for these screening tests.

These steps may be repeated while bathing or showering using soapy hands. Look for any changes from normal. Inspect your breasts in four steps:

• Hold arms at your side
• Hold arms over your head
• Press your hands on your hips and tighten your chest muscles
• Bend forward with your hands on your hips

***The signs of breast cancer are not the same for all women. In fact, some women have no signs that they can see. If you notice any of these breast changes, see your health care provider right away:

• A lump, hard knot or thickening
• Swelling, warmth, redness, or darkening
• Change in the size or shape of the breast
• Dimpling or puckering of the skin
• Itchy, scaly sore or rash on the nipple
• Pulling in of your nipple or other parts of the breast
• Nipple discharge that starts suddenly
• New pain in one spot that does not go away

It is important to discuss any of these symptoms with a health care provider as soon as possible so that if breast cancer is present, it is more likely to be diagnosed at an early stage when it is most treatable.

Early Detection and Screening

Due to the increased use of mammography, most women are diagnosed at very early stages of breast cancer before symptoms appear. Mammography is a technique that uses X-rays to provide an image of the breast. These images, called mammograms, are used to find potential signs of breast cancer such as tumors, small clusters of calcium and abnormal changes in the skin. Overall, mammography is the best screening tool for breast cancer available today. It can find cancers at an early stage, when they are small and most responsive to treatment. Mammograms are usually done in a certified general radiology center or in a clinic set up expressly for mammography. During the procedure, which usually takes about 15 minutes, each breast is compressed between two plates, and an X-ray image is made.

Breast Implants and Mammography

Mammography is a safe and effective screening tool for women who have breast implants. However, it is important for a woman with implants to inform the radiologist before the procedure is performed so that the mammography machine can be specially positioned to avoid full compression of the implant. Additional views called Eklund views help the radiologist to see the breast tissue as the implant is pushed toward the chest wall away from the breast tissue.

Low-Cost and Free Mammography

Most insurance companies cover the cost of mammograms. In addition, in many areas of the country, low-cost or free mammograms are provided as part of the National Breast and Cervical Cancer Control Program or through community organizations, such as the YWCA. In October each year, during Breast Cancer Awareness Month, many radiology facilities offer mammography at reduced rates. To find out how to get a low-cost or free mammogram or to find a certified radiology center in your area, call Susan G. Komen for the Cure’s Breast Care Helpline at 1-800 I’M AWARE (1-800-462-9273), or visit the FDA website to search a list of certified radiology centers.

Helpful Links

• American Cancer Society
• ACS Reach to Recovery
• Susan G. Komen Foundation Race for the Cure
• Living Beyond Breast Cancer
• National Women’s Health Resource Center