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When should I be alert that I could have breast cancer?

After puberty, it is recommended that all women do a self-breast examination and report if they feel any abnormalities in their breasts as breast cancer can occur even in very young women who are in their 20s. The abnormalities in their breasts that women should look for are

Lumps in the breast

Lump in the breast is the most common symptom of breast cancer. However, not all lumps are malignant. A significant proportion of lumps in the breast are benign. The decision on whether the lump in the breast is benign or malignant can be known by clinical examination by the doctor and additional investigations such as imaging and biopsy. Any new breast lump should be checked. Breast lumps that are malignant tend to be hard, rapidly growing in size, painless and not movable freely in the breast

Change in the size and shape of the breast

Compare the size and shape of both breasts in the standing position, sitting position, lying down position and with hands on both hips and above the shoulders. Any change in the size and shape of the breasts such as swelling in a particular area or retraction of the breast while doing any manoeuvre should alert you to see your doctor immediately.

Lumps in the axilla

Feel for any lumps in the armpits. lump and as well as the axilla, is highly suggestive of breast cancer,and you should go to your doctor immediately. However few non-palpable aggressive breast cancers may present with lymph node swellings in the axilla. These swellings are usually hard. At the same time lumps in the axilla can occur due to various reasons such as any minor infection in the upper limb, variety of systemic infections and leukaemia. Hence to be sure of your problem consult your doctor.

Bloody nipple discharge

Breast cancers may present with bloody nipple discharge. Nipple discharges which are of other colours could represent other benign breast disorders and should be checked by your doctor.

Changes in the nipple

Recent changes in the nipple such as nipple inversion, retraction of the nipple, scaliness of the nipple could be associated with breast cancer and should alert you to see your doctor.

Changes over the skin of the breast

Breast cancer could be associated with changes in the skin such as dimpling, puckering, thickening, reddening, ulcers or indentation. Any change over the skin of the breast should alert you to see your doctor.

Breast Pain

Only 10% of pain in the breast is due to breast cancer. Breast cancer is usually painless and hence ignored by many women. However, if there is pain and redness of the breast, it could be due to a severe form of cancer known as the inflammatory breast cancer.

No symptoms and signs

Early breast cancers do not present with any signs and symptoms. It is best to diagnose breast cancer at this stage as this will improve the chances of survival a lot and the patient may not need certain modes of treatment such as chemotherapy and radiotherapy. For this, the patient should have frequent screening of the breast.

How do I do Self Breast Examination?

The self-breast examination is to be done every month after puberty. This is to be done regularly every month around 4 to 10 days after periods when the breast is least painful. Performing the self-breast examination regularly at the same time will enable the women to know whether there was any change in her breast as breasts can differ due to hormonal changes with regards to when the breasts are examined in their menstrual cycle.

Self Breast Examination is done by the woman uncovering her upper torso and looking in the mirror specifically for change in the size and shape of the breast and nipple. Any change in the nipple or the skin overlying the breast should also be noted. Then the breast is palpated from the nipple, concentrically outwards over both the breasts with the flat palmar aspect of the hand. After palpating the breasts, both armpits are also to be palpated to look out for swellings in the axilla. With both arms over the hips and above both shoulders, any change in the size and shape over the breasts, skin changes and nipple changes are to be noted. With the person lying down this procedure is repeated to feel for any lumps in the breast. Any abnormality felt should make you visit your doctor to rule out breast cancer.

How helpful is Self Breast Examination?

Identifying any abnormality in the breast early can help us diagnose and treat the breast cancer early which will improve the chances of survival and the patient may not need certain modes of treatment such as chemotherapy and radiotherapy.

If I have any of the above signs and symptoms what is the next thing that I should do?

The next thing that you should do is to immediately consult your doctor who would examine you and might do some investigations to find out the presence of breast cancer.

What happens if I ignore these symptoms?

Ignoring these symptoms might make your breast cancer become larger and may increase the chances of spread. This might decrease your chances of survival and you might present late.