Breast Self-Examination

What is BSE

Breast self-examination (BSE) is a scheduled or regular check-up performed personally by women, who are normally over 20 years, to detect any signs of abnormaility (difference) in their entire breast area (see picture) and to become familiar with their personal assets. BSE allows the individual to be aware of unnatural changes within their breast tissue and to be prepared, with any signs of change, to be examined by their doctor for a second opinion. Note that your doctor relies on you to tell him/her what is normal for you and what has changed, so make it your priority to check your breast at least once a month, preferably just after your period or just before the end of your period, and 'stay on top' of your bodily changes. After the age of 40, ensure you have a yearly breast exam and mammogram.

How To Carry Out A BSE

• First, stand up before a mirror that allows you to see at least from your collar bone to your 'bra line' (just below your breasts). Hands at your side, look at your entire breast area. Notice the size and shape of your breasts. Then, hands akimbo (on your hips), look at your breasts again. Lean slightly forward and look.
• Now assume your initial position with your hands at your side and raise your arms straight in the air and look once more. While still looking in the mirror, squeeze each nipple between your index finger and your thumb and check for any signs of unnatural nipple discharge (bloody or watery with a red, pink or brown colour or sticky and clear in colour or brown to black in colour).
  
  
• Lie on your back with the palm of your hand resting under the middle top region of your back, and possibly some support from a soft pillow or towel, use your index, middle and 'ring' fingers, of the other hand, together to gently feel your entire breast area moving from the region under your armpit to the middle of your chest, in a vertical up-and-down pattern. Increasing slightly the pressure of your touch, repeat this two more times. Then, repeat with the other breast.

• Finally, make a note of any changes you've noticed. If you've noticed a change but you are skeptical about seeing a doctor, wait a few weeks and redo the BSE. Note changes again and compare them to the one(s) you've noted initially. Then decide whether or not you need to see a physician. Always remember, most changes seen or felt are benign (non-cancerous) so don't you worry.

So Ladies and Gents (who have a woman or women in their lives, e.g. mother, daughter, wife, girlfriend) encourage each other in this fight for well-being. Make it your business and routine to have your breasts checked as often as possible, and take care of yourselves. It's well worth it!

Click Here To See One of The Best Videos I've Seen On BSE

~KIP~

Least Common Types of Breast Cancer

Although most types of breast cancer are localized in a lobule or duct of the breast, not all of them do. In fact, there are a number of types that are much less common in men and women than ductal or lobular carcinoma. These include but are not limited to: adenoid cystic carcinoma, inflammatory breast cancer (discussed in an earlier post), medullary carcinoma, metaplastic carcinoma, micropapillary carcinoma, mucinous carcinoma, and paget's disease of the breast.

Adenoid Cystic Carcinoma (ACC)

ACC is a relative rare form of cancer which has a tendency to develop in specific sites of the body, e.g. salivary glands, or less commonly in the skin, breast, prostate gland in men, and some other areas. It may be confused with intraductal carcinoma and invasive ductal carcinoma with a sieve-like pattern. ACC is recognised mainly by small basaloid cells (a basaloid cell is a cell usually of the epidermis resembling a basal cell) either with solid, cribriform (perforated like a sieve) or tubular growth patterns which may be mixed but any one may occur more regularly than another. ACC tumors are slow-growing and tend to become progressively worse but are are more likely to be detected than other forms of breast cancer. Fortunately, this type of breast cancer does not usually affect the lymph nodes and is unlikely to spread. There have been reported cases of ACC of the breast ranging from the ages of 19 through 90, in both males and females.

Click here to see images of adenoid cystic carcinoma of the breast.

Medullary Carcinoma

Medullary breast cancer is a special type of invasive breast cancer which has a distinct boundary between normal tissue and tumor (also spelt tumour) tissue. It is also defined by the presence of white cells, also known as immune system cells, which surround the borders of its significantly large cancer cells. This variant of breast cancer has an incidence of 5 in 100 breast cancers and is likely to spread to other areas of the body. Like ACC, medullary carcinoma of the breast may be difficult to distinguish from invasive ductal carcinoma and is treated similarly.

Metaplastic Carcinoma

Metaplastic carcinoma is a very rare variant of invasive ductal carcinoma where its cancer cells may be of two or more cell types. Some types of cells present are not indicative of other breast cancer types. These cancer cells tend to remain localized. Metaplastic carcinoma of the breast is also treated similarly to invasive ductal carcinoma but tends not to be sensitive to hormone therapy.

Click here to get an idea of what these cells look like.

Micropapillary Carcinoma

Micropapillary carcinoma is a rare variant of invasive ductal carcinoma which is characterised by small, tightly cohesive tumor cell clusters within clear spaces resembling lymphatic vessels. This type of breast carcinoma is aggressive and favours to spread to the lymphatic system in most cases. Micropapillary growth is normally associated with invasive ductal carcinoma and is rarely seen separately.

Mucinous (Colloid) Carcinoma

Mucinous carcinoma is another rare type of invasive breast cancer which involves mucus-producing cancer cells which grow into a jelly-like tumor. This variant grows quite slow and is very unlikely to spread to the lymph nodes. It has an incidence of about 2 in 100 breast cancers and once treated, further treatment may not be required.

Paget's Disease of the Breast

This begins in the milk ducts of the breast as either an in situ or invasive cancer and spreads to the skin of the nipple before affecting the areola (dark circle around nipple). It appears similar to eczema. The skin of the nipple and areola may look crusted, scaly and red and there may be possible bleeding. The area may also become sore or itchy or may burn. Paget's disease affects 1 or 2 out of 100 women with breast cancer and is usually diagnosed in women aged 50-59.

Common Types of Breast Cancer

Breast cancer normally originates in the ducts or lobules of the breast. If the cancer cells spread outside the ducts or lobules of the breast into the surrounding tissue, this is called invasive (infiltrating) breast cancer.

The two major types of breast cancer are:

• In situ breast cancer / Pre-Invasive Breast Cancer

- This refers to a type of cancer in which the cancer cells remain confined to site of origin and have not invaded surrounding breast tissue around the duct or lobule. There are two types of in situ breast cancer, depending on site of origin:

+ Ductal carcinoma in situ (DCIS) results as a result of abnormal cells in the lining of a milk duct that have not invaded the surrounding breast tissue. Because this is an early stage, when left untreated it may eventually develop into invasive breast cancer.

+ Lobular carcinoma in situ (LCIS) involves abnormal cells contained within a lobule of the breast, without invading surrounding tissue. With LCIS, there is an increased risk of developing breast cancer in either breast in the future.

• Invasive breast cancer

- This includes breast cancers that begun to invade surrounding tissues that support the ducts and lobules of the breast. The cancer cells are able to travel to other parts of the body. There are generally two types of invasive breast cancer:

+ Invasive ductal carcinoma (IDC) accounts for the majority of invasive breast cancers. Here, cancer cells form in the lining of the milk duct and eventually break free of the ductal wall to invade surrounding breast tissue. Cancer cells may remain near the origin or spread throughout the body via blood vessels or the lymphatic system.

+ Invasive lobular carcinoma (ILC) is less common than IDC but acts in a similar manner. ILC begins in the milk-producing lobule and then spreads to the surrounding breast tissue and, furthermore, any part of the body. Sometimes a lump is not detected instead you may feel a thickening or you may sense that your breast tissue feels different. Unfortunately, as it is hard to detect by touch, one could understand the likelihood of it being detected using a mammogram.

Inflammatory Breast Cancer

The image above is an example of obvious signs and symptoms of Inflammatory Breast Cancer displaying the swollen breast, redness, inverted nipple and peau d'orange (orange-peel texture).

Inflammatory Breast Cancer (IBC) is one of the least common types of breast cancer which more commonly affects African Americans than any other ethnic group. IBC is an advanced and accelerated form of breast cancer usually not detected by mammograms or ultrasounds. It is, in fact, the most aggressive form of breast cancer. Treatment is different from the more common types of breast cancer, where surgery is usually performed with chemotherapy, prior to surgery, in order to reduce the size of the breast and eliminate other symptoms. Signs and symptoms observed closely resemble a benign (non-cancerous) infection like Mastitis than expected signs and symptoms of breast cancer types.

Despite its name, inflammatory breast cancer isn't caused by an inflammation or infection. Inflammatory breast cancer occurs when cancer cells clog the lymphatic vessels in the skin overlying the breast. The blockage in the lymphatic vessels causes the red, swollen and dimpled skin that's a known sign of inflammatory breast cancer.

Typical Symptoms of IBC:

• swelling, usually sudden, sometimes a cup size in a few days
• itching
• pink, red, or dark coloured area sometimes with texture similiar to the skin of an orange.
• a bruise that doesn't go away
• nipple retraction (nipple is drawn inwards).
• nipple discharge, may or may not be bloody.
• breast is warm to the touch
• breast pain (from a constant ache to stabbing pains).
• change in colour and texture of the areola.

Some women who have IBC may remain undiagnosed for long periods, even while seeing their doctor to learn the cause of her symptoms. The symptoms are similar to mastitis, a breast infection and some doctors, not recognizing IBC, will prescribe antibiotics. If there is no response to antibiotics after a week, a biopsy should be performed or you may be referred to a breast specialist.
IBC has been diagnosed in very young women. An unexpected portion of young women with IBC had their first symptoms during pregnancy and lactation. Although young women are normally at lower risk for breast cancer, the fact that IBC is more aggressive than most forms of breast cancer, this type of cancer progresses to about stage IV by the time of diagnosis, when the cancer has already began to spread.
Some reasons why IBC is not detected as soon as it should:

1. Each case of IBC is different in each individual so there may be some signs but not others.
2. Sign and symptoms are comparable to a relatively minor breast infection.
3. Some women and men who are diagnosed with IBC are misdiagnosed initially.
4. IBC can diffuse through the breast without palpable (capable of being touched or felt) mass.

Note:
Inflammatory Breast Cancer is typically abbreviated as IBC. Non-inflammatory breast cancer may include in its diagnosis the terms "in situ breast cancer," "infiltrating breast cancer," or "invasive breast cancer" all of which may be abbreviated with "ibc," but those terms alone do not specify inflammatory breast cancer. To add to the possible confusion, the diagnosis may include more that one kind of breast cancer; for example "inflammatory breast cancer, invasive ductal carcinoma, and mucinous carcinoma" all in the same breast. So if a person you know has been described as having IBC or ibc, it may be well to ask what that is abbreviating, since it may not be "inflammatory breast cancer" and therefore the symptoms and other information presented here may not apply.

Breast Cancer (Intro)

Breast cancer is the leading cause of death in women, apart from lung cancer. Every two minutes a woman is diagnosed with breast cancer while every twelve minutes a woman dies of it. Breast cancer is the most common cancer in the UK. One in every nine women in the UK will develop breast cancer at some point in her life. It is the leading cause of death for women aged 34 to 54. Breast cancer affects Caucasian women most often followed by African American, Asian American and Pacific Islander, Hispanic or Latinas, and Native American women.

Breast cancer, also known as breast carcinoma, is a cancer formed in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that produce milk). It occurs in both men and women, although male breast cancer is rare. No one knows why some women get cancer, but there are a number of risk factors. Risks that cannot be changed include:

• Age - the chances of developing breast cancer rises as a woman gets older.


• Genes - Most inherited cases of breast cancer have been associated with two genes: BRCA1, which stands for BReast CAncer gene one, and BRCA2, which stands for BReast CAncer gene two. The functions of these genes is to keep breast cells growing normally but when abnormalities, or mutations exist in these genes, they are associated with a greater breast cancer risk. Women diagnosed with breast cancer who have an abnormal BRCA1 or BRCA2 gene often have a family history of breast cancer, ovarian cancer, or both. However, research on these genes are still in progress.
• Personal factors - beginning periods before age 12 or going through menopause after 55.

Other risks include being overweight, using hormone replacement therapy, taking birth control pills, drinking alcohol, not having children, having your first child after age 35 or having dense breast.

Symptoms of breast cancer include a lump in the breast, a change in size or shape of the breast or discharge from a nipple. Treatment may consist of radiation, lumpectomy, mastectomy, chemotherapy and hormone therapy.

Women who were treated for Hodgkin's disease with radiation, or also endured frequent X-rays during treatment for scollosis at a young age are at higher risk.

Interesting fact:

Pregnancy seems to give some protection against breast cancer, and the protection is greater the younger a woman is at her first pregnancy.