Taking care of your breasts
by Dr. Heather Smith
habits today can save your life
your New Millennium’s resolution? Whether it’s eating less fat or hitting
the gym more, most women have a combined goal in mind: losing weight and
feeling good about themselves. Besides working on looking shapely and feeling
healthier, however, you should make it a habit — if you haven’t already
— to pay extra-close attention to a very intimate female bodypart: your
you don’t worry about breast cancer because you think you’re too young,
you probably should. Younger women can be affected, too. Besides, your
good habits today may prevent dire consequences in the coming years. Early
detection can save not only your life but your breasts; treatment for early-stage
cancer often involves a simple lumpectomy (removal of the suspicious lump)
instead of a painful and disfiguring mastectomy (removal of the entire
breast and often significant surrounding tissue).
the risk is relatively low for young women: Approximately one of every
100,000 women in their early 20s is diagnosed with breast cancer each year.
But what if you’re one of the unlucky few? Several of our young friends
have been diagnosed with the disease lately, reminding us very painfully
that it could happen to any of us. So taking the time to perform a serious
self-exam monthly is certainly worthwhile.
Best Defense: Early Detection
bad news: The American Cancer Society says about 175,000 new cases of invasive
breast cancer were diagnosed among women in the United States in 1999,
and more than 43,000 deaths occurred from the disease. The good news: Breast-cancer
mortality rates have been decreasing due to increased screening of women
and more advanced techniques, such as digital mammography.
— a specialized X-ray of the breast — is currently the most effective way
to detect breast cancer. “It’s possible for mammograms to miss lumps deep
inside the breast, but mammography has proven to be the only screening
method that really reduces deaths from breast cancer because it can find
small abnormalities in earlier breast cancers,” says Lawrence W. Bassett,
MD, FACR, director of the Iris Cantor Center for Breast Imaging at the
UCLA Jonsson Comprehensive Cancer Center and chairman of the Breast Task
Force of the American College of Radiology. “I rarely see a patient with
advanced breast cancer today, and when I do, it’s a matter of neglect or
denial,” he notes.
though younger women generally don’t get mammograms, they can be vigilant
about monthly self-exams. “If a woman in that age group notices something
in her breast, she should go see a doctor,” Bassett advises, noting that
such lumps are usually benign and just need to be checked with a simple
needle biopsy. But for the exceptions, the lumps that turn out to be cancer,
early detection is more critical for younger women. The Breast Cancer Research
Foundation says younger women have a lower survival rate than older breast-cancer
patients because their tumors are more aggressive and respond less to hormonal
detection is the best defense. “If you start teaching somebody early, like
at 18, to do monthly breast exams 7–10 days after their period, they become
familiar with their breasts,” states Sherry Goldman, the nurse practitioner
at the Revlon/UCLA Breast Center and an assistant clinical professor.
How to Improve Your Odds
may not be able to prevent breast cancer, but you can improve your odds
of not getting it. Two key strategies: Eat a diet rich in fruits and vegetables,
and be physically active. Premenopausal woman who exercise regularly have
a lower risk of breast cancer, says Trudy Harris, the fitness consultant
to the Revlon/UCLA Breast Center’s High-Risk Program. “Exercise, an essential
component in weight maintenance, is particularly important because studies
indicate that the risk for breast cancer increases with weight gain over
a woman’s lifetime,” she explains. Eating soy foods, such as tofu and soy
protein, may decrease your risk. Excess alcohol consumption may increase
Implants: Do They Increase Your Risk?
absolutely no evidence that breast implants increase the risk of breast
cancer,” says David P. Rapaport, MD, a board-certified plastic surgeon
based in Manhattan, New York. Yet he suggests, “If you’re having breast
implants done and you’re 35 or older, you should have a mammogram first.”
continues: “It’s better [for the implant] to go under the muscle because
your breast looks more natural and you get a better mammogram. Breast implants
probably make regular self-breast exams easier because there is something
behind the breast sort of pushing it forward so it’s easier to feel your
complications of implants include rupture, infection, shifting of the implant,
changes in nipple and breast sensation and sometimes interference with
mammography. “All implants block a little bit of the breast on the mammogram,”
Rapaport explains. “If you have an implant that’s behind the muscle, it
blocks a lot less, so that’s another reason to go behind the muscle.” He
adds that women with a strong history of breast cancer probably shouldn’t
have the operation.
bottom line is that you want to preserve your breasts and live a healthy
life. Be smart: Get to know your breasts and learn about the best possible
mammograms. Never be afraid to talk to your doctor — or friends and family
members — about your breast health. Fear and denial can lead to a deadly
women at usual risk for breast cancer, the American Cancer Society recommends
the following guidelines for early detection:
a breast self-exam each month
a clinical breast exam every three years.
a mammogram every year (it can reveal small breast cancers up to two years
before they can be felt)
a clinical breast exam by a health-care professional every year close to
your scheduled mammogram
a breast self-exam each month.
40 and over
to Do a Breast Self-Exam
woman 18 and older should conduct a breast self-exam (BSE) each month 7–10
days after her period. To do it right, follow these American Cancer
down with a pillow under your right shoulder and place your right arm behind
the finger pads of the three middle fingers on your left hand to feel for
lumps in your right breast.
firmly enough to know how your breast feels. A firm ridge in the lower
curve of each breast is normal.
around your breast in a circular pattern. Make sure you do it the same
way every time, checking the entire breast area. Remember how your breast
feels from month to month.
the pillow under your left shoulder and repeat the exam on your left breast,
using the finger pads of your right hand.
examining both breasts while standing, with one arm behind your head. The
upright position makes it easier to check the upper and outer part of your
breasts (toward your armpit). This is where about half of all breast cancers
are found. You may also want to do the standing part of the BSE while in
the shower; some breast changes can be felt more easily when the skin is
wet and soapy.
breast cancer usually doesn’t cause pain. In fact, you may have no symptoms
at all when breast cancer first develops, but as the cancer grows, it can
cause changes that you should be aware of:
lump or thickening in or near the breast or in the underarm area
change in the size or shape of the breast
discharge from the nipple
change in the color or feel of the skin of the breast, areola or nipple;
it may be dimpled, puckered or scaly.