Generality
Self-examination is the first tool to "prevent" breast cancer.
This simple self-assessment test allows you to learn about the structure and general appearance of the udder, thus allowing you to catch any unusual changes with respect to the basic physiognomy of the breast.
If performed correctly and regularly, self-examination of the breast can limit the risk of diagnosing advanced cancer.
What is it for?
Periodic self-examination allows us to know the normal appearance of our breasts and to notice any changes and possible irregularities.
The signal that most frequently leads to the discovery of a tumor is, in fact, the presence of a nodule. Usually, this lesion is not painful, but palpable or even visible.
To identify unusual alterations early, attention must also be paid to the appearance of the nipple (which can retract, become more protruding or secrete fluid) and the skin, especially when these concern only one breast.
This simple gesture makes it possible to keep the breast tissue under control and to check regularly whether this is homogeneous or has nodular hardenings never encountered in the previous self-payments.
Breast cancer
- Breast cancer (or breast cancer) is the most common cancer in the female population.
- The neoplastic process derives from the uncontrolled and anomalous growth of some breast cells, in which the genetic material is "damaged"; the set of these "clones" forms a tumor mass within the mammary gland.
- The nature of the tumor can be benign (fibroadenomas or cysts) or malignant (carcinomas). The latter injuries are the most dangerous, as they can progress and become "infiltrating" or "invasive", ie they can involve tissues next to the breast or other parts of the body.
- An early diagnosis is possible above all for the large-scale dissemination of mammography screening programs. Furthermore, it is advisable to regularly undergo the checks indicated by your doctor based on age and personal history.
- The possibilities of cure and healing depend, in fact, on the stage in which the neoplasm is found at the time of diagnosis (localized, diffuse or metastatic) and its biological characteristics (benign or malignant nature): different types of breast cancer, in fact, have growth rates and responses to different therapies.
- Currently available breast cancer treatments include surgery (such as quadrantectomy), chemotherapy, radiation therapy, hormone therapy and biological therapies. These therapeutic approaches can be used alone or in combination, based on the characteristics of the patient and the disease.
When you run
From the age of 20, breast self-examination should be performed once a month, between the seventh and fourteenth day of the menstrual cycle (if the latter is regular, it is advisable to fix a stable day).
The structure of the breast is susceptible, in fact, to the variations of the hormonal levels that occur monthly: knowing your own body allows to distinguish which changes are to be considered "normal" and to avoid, in some cases, confusion or false alarms.
A week or so after the end of the cycle, the breast is less painful and turgid, therefore certain changes affecting the breasts are more easily perceived; if you are pregnant or in menopause, the time at which it is indicated to perform self-examination is irrelevant.
It should be remembered that other signs such as retractions or changes in the skin, fluid secretions from the nipple or changes in the shape of the breast must also lead to consulting a doctor.
There are also cases in which the disease is not associated with obvious signs and recognizable changes. Therefore, self-examination must be combined with regular breast examinations and more precise instrumental examinations, such as breast ultrasound (generally recommended from the age of 30) and mammography (from the age of 40).
How to do it
Self-examination takes place in two phases: observation and actual palpation.
Observation
During this phase it is necessary to observe if there are irregularities in the shape of the breast, changes in the color of the skin, cracks in the nipple, ulcerations of the skin or dimples; rarely the two breasts are identical in every detail, but, usually, they are symmetrical and have a regular profile.
The self-examination begins in front of a mirror in a well-lit environment. With the torso upright, the shoulders relaxed and the arms at your sides you can see the shape of the breast and the nipple, both in front and from the side.
The observation must be repeated with the arms raised, stretched over the head, in search of possible irregularities of the breasts. The operation must be performed again by joining the hands in front of the forehead and contracting the pectoral muscles.
Palpation
The palpation phase is performed in an upright position, bending the arm corresponding to the breast to be examined behind the neck. The breast must be examined by sliding the inner part of three joined fingertips of one hand (index, middle and ring) with small concentric movements. These "spiral" maneuvers must be repeated for each quadrant of the breast.
By moving the fingers in a circular direction, with increasing pressure, it is possible to catch any nodules or hardening of the breast tissue.
Then, movements are performed with the hand from top to bottom and, again, in a radial sense (from the outside towards the nipple, drawing a sort of star). Palpation from the axillary cavity continues around the curve of the breast, not leaving out the part near the sternum.
The same maneuvers must be repeated in a supine position, with the arm corresponding to the breast to be examined at the top, bent under the head.
In the last phase, gently press the nipple between the index and thumb to check for possible leakage of liquid (serum or blood); during this evaluation, it is possible to use a handkerchief to check the color of the secretion.
Note : if during the self-examination a lump, a sinking or a secretion were found, there is no need to be alarmed, as it could be a harmless response. In any case, it is important to inform the doctor that he can indicate the appropriate instrumental tests to ascertain the actual state of health.
What to pay attention to
During breast self-examination, it is necessary to pay attention to:
- Changes in the shape and size of one or both breasts;
- Thickening or protuberances in the breast or underarm area;
- Losses of blood or fluid from the nipples, which cannot be connected to pregnancy or lactation (serous or blood secretions);
- Depressions, wrinkles, reliefs or pits on the surface of the skin;
- Strange sensations (especially if they concern only one breast).
Other possible changes and unusual signs to be reckoned with are:
- One or more nodules of the breast (taking into account that the breast is by nature nodular and that, nine times out of ten, these formations are not worrying);
- Variations in the appearance of the nipple (contours, size or position) or retraction of the same;
- Inflammations or eruptions of the skin and areola (orange peel skin, swelling, redness or sensation of heat);
- Unjustified pain in the breast or armpit.
Self-examination in no way replaces breast examination or instrumental examinations, such as mammography (useful for detecting the presence of nodules, micro-calcifications or other indirect signs of a possible neoplasm) and ultrasonography (indicated to confirm the presence and the solid or liquid nature of a nodular lesion).
However, it should be pointed out that proper and regular self-examination of the breast can allow cancer to be diagnosed early, limiting the risk that this may be at an advanced stage.
Therefore, in the event that one or more of these symptoms were evident at sight or present to the touch, it is advisable to contact your doctor or a specialist, to receive as soon as possible reassurances or indications about the diagnostic tests considered most suitable to dispel any doubt.
