Dear Doctor,

I have breast cancer in my family history and I hear it’s inherited. But after asking around, I realised one can do a proper home breast examination. I now know that through this check-up, lumps and anomalies can be detected early, please give me a walk-through on how to do this so that I don’t suffer the same fate.

Louise

Dear Louise,

If thereis a history of breast cancer in the family, your risk of having it is increased. The other risk factors are not having a baby, not breastfeeding a baby, hormonal therapy or contraception early menarche, weight gain, late menopause, alcohol use, use of very tight brassieres, and etcetera. In early stages it is very well curable. Hence, it is advisable to do self-examination of breast regularly. In your case, as risk factor exists, it can be done once every month.

For self-examination of breast, it is advisable to stand erect, topless in front of a mirror with arms at side initially. Observe any change in breast size, visible lump, discolouration of skin or wound on any part of the breast, puckering in of nipple. Keeping pads of fingers flat on the breast, one should then gently feel the breasts from top to bottom (from shoulder bone to top of belly) and side to side, till margin of under arm. The fingers should be moved in a clockwise direction.

Similar examination can be done in a lying down position or when in a shower. The wet skin in a shower facilitates the fingers to move smoothly.

Most of the lumps felt are non-cancerous. But this can be ascertained by a biopsy only. Hence after self-examination of the breast, a biopsy is needed to know the nature of the lump detected. A computerised tomography (C.T scan) of the breast helps in identifying the extent of the tumour in breast tissue and whether it has spread to adjoining lymph nodes and or axilla. C.T scan of other body parts like liver, backbone, lungs, helps to determine whether the malignancy has spread there or not.

With advanced imaging techniques like mammography and various scans, self-examination is now said to be optional. However, it still remains the easiest, most economical tool for detecting breast cancer in early stages.

Dr Rachna is a specialist in internal medicine  at Ruhengeri Hospital

rachna212002@yahoo.co.uk