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Taking Care Of my Body (Breast Self-Examination)

Hi! Girls,

Hope you have read my first article on 'The Female Reproductive System' and I am sure you are quite familiar with your body. The Female Reproductive System, can you remember!!!, it is divided into three groups:
  • The external organs of reproduction (vulva)
  • The internal organs of reproduction
  • The mammary glands (breast) are also considered part of the female reproductive system

Breast enlargement in girls is caused by the hormones estrogen and progesterone. The breast enlargement enables the production of milk. The breasts are covered by fat on the outside and milk glands on the inside.

Breast enlargement occurs in stages, beginning at 8 or 9 years of age. It can occur later in some individuals. The first change that occurs is the darkening (from light pinkish to dark brown) and thickening of the areola, the area around the nipple. Some hairs may grow around it. The areola contracts during cold weather, when touched, stroked or sexually excited. The nipples get larger before the breasts start to form.

Hi! feel free to review the diagrams in the previous article. It is advised that girls should start doing breast self-examination from the time, you girls, get your first period to exclude any breast lumps.

Let us now understand more deeply why early detection of Breast Cancer is so important and how we can do Breast Self-Examination (BSE).

What is Breast cancer?

Breast cancer is the most common cancer in women. Cancer of the breast is the number one cause of cancer deaths amongst Malaysian women. Cancer of the breast is the result of an uncontrolled growth of cells within the breast tissue. Cancer of the breast usually begins as a growth within a milk duct and spreads into the fatty tissues of the breast. If detected early, breast cancer can usually be cured. If not detected early and treated promptly, breast cancer can spread to the lymph glands and to other parts of the body such as the bones, lungs and liver.

Who is likely to get Breast cancer?

The exact cause of breast cancer is not known. Any women aged 20 and above is at risk of getting breast cancer. Some women are at higher risk of developing breast cancer than others. Breast cancer is more common in women over the age of 40 years and in those who:
  • Already had cancer in one breast
  • Have a close relative (mother, sister or daughter) with breast cancer especially, cancer in both breasts, or breast and ovarian cancer
  • Have never been pregnant or who only had their first child after the age of 30 years
  • Started having their menstrual periods at a young age (before age 12), or who have a late menopause (after age 50)
  • Have certain types of breast disease
  • Have diet high in animal fats

What are the warning signs?

Warning signs may include one or more of the following:
  • A painless lump in the breast or armpit (the most common sign)
  • A persistent rash around the nipple
  • Bleeding or any unusual discharge from the nipple
  • Skin over the breast is swollen and thickened
  • Skin over the breast is dimpled or puckered (unusual wrinkling)
  • The nipple is 'pulled' in i.e. retracted
Inform your parent and see your doctor if you have any of these warning signs. Do not wait till you feel pain as the early stages of breast cancer are usually painless.

Most lumps or changes in the breast are not cancerous. However, all lumps should be treated with suspicion and it is important that you see your doctor about them right away.

Prevention of Breast cancer

There is no primary prevention of breast cancer. However, control of breast cancer largely depends on early detection.
  • Have breast examination done by health professionals.
  • Women aged 20 years and above should do breast self-examination every month throughout their lifetime.
  • All women aged 30 and above should also visit a doctor for an annual breast examination.
  • Women aged 50 years and above and if recommended by a doctor, should get a mammogram done.
Women with family history of breast cancer should have a baseline mammogram examination at age 40 and repeat every two years.

Maintain a healthy body weight and exercise regularly. Breast cancer is curable if detected and treated early. Breast cancer is one of the cancers that is easily detected.

How to do a Breast Self -Examination?

Breast Self-Examination can be done by yourself by visual inspection in front of a mirror and feeling for changes while lying down. Refer to illustration for details.

All women above 20 years of age should learn to do BSE and practice it regularly. BSE helps you detect any change in your breast so that you have a better chance of detecting cancer early.

1. Look for changes to your breast in front of a mirror.

At each of the following positions:
  • arms at your sides
  • arms raised above or behind head
  • hands on hips and chest muscles tensed
  • gently squeeze nipple for any discharge
Look for changes:
  • in size and shape of breast dimpling of the skin
  • change in the appearance on the nipples
2. Feel for changes lying dow
  • Place pillow under right shoulder with right hand under head
  • Use middle three fingers of your left hand (hold fingers flat) to examine your right breast
  • Press firmly on breast tissues using a rubbing motion to feel for lumps or changes
  • Start from the outside circle of the breast than inward in smaller circles
  • Check the entire breast including the armpit and behind the nipple
  • Repeat these steps using your right hand to examine your left breast
3. In the Shower
  • Raise right arm behind head
  • Soap left hand and check right breast as described in the "lying down" position
  • Repeat these steps using your right hand to examine your left breast
A breast self-examination could save your breast and save your life. Most breast lumps are found by women themselves, but in fact, most lumps in the breast are not cancerous. Be safe, be sure.

When to do Breast Self-Examination: The best time to do breast self-examination is right after your period (about a week after the start of each menstrual period), when breasts are not tender or swollen. If you do not have regular periods or sometimes skip a month, do BSE on the same day every month (eg. 1st of every month).

1. FFPAM RHAM Module
2. Pamphlet: Breast Cancer Welfare Association
3. Pamphlet: Health Promotion Board, Singapore
4. Pamphlet: Ministry of Health

P. Sarada Devi, Family Planning & Reproductive Health Officer

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