Self-breast examination – Know yourself

Epidemiological transition is occurring over the past few years in such a way that there is a reduction in the occurrence of various communicable diseases and a significant rise in non-communicable diseases (NCDs) in the forms of hypertension, diabetes as well as cancer. Cancer causes about one in every six deaths worldwide, more than AIDS tuberculosis and malaria combined. Today it is the second most leading cause of death following cardiovascular diseases. According to GLOBOCAN by 2040, the global burden is expected to increase to 27.5 million new cancer cases and 16.3 million cancer deaths.

Breast cancer is an emerging public health problem in both developed and developing countries. It is the most common cancer diagnosed among women in the world, regardless of race or ethnicity. Globally in 2018 there were approximately 2 million new cases of cancer breast and approximately 15% of all cancer deaths among women.

In India too cancer breast has become a disease of alarm as it has overtaken cancer cervix. It has been observed that generally, 1 in 28 women is likely to develop breast cancer during her lifetime. It is matter of concern that though it can be picked at an initial stage just by self breast examination by the women herself , still 50-70% of the women reach the health centre only in stage III and IV.

The significant risk factors for cancer breast are reproductive factors which is related with prolonged exposure to endogenous estrogens such as early menarche, late menopause, and late age at first childbirth. Other factors are oral contraceptive pills and hormone replacement therapy users. Breastfeeding has a protective effect on carcinoma breast.

As most of them are non modifiable risk factors nothing much can be done therefore regular screening for cancer breast is recommended to allow early case detection and thereby prevent death from breast cancer. Regular screening consists of breast self-examination (BSE), clinical breast examination, and mammography.

A breast self-exam (BSE) is a safer and simpler way to examine breasts on a regular basis to look for any changes. This important aspect has been emphasized in the national program related to non-communicable diseases also.

BSE implies being acquainted with how your breasts generally look (inspection) and feel (palpation). It’s important to use pads of your middle three fingers , not tips of fingers while palpating the breast.

If one notices following changes in breasts such as –

• A hard lump near your underarm
• Changes in the way your breasts look or feel
• Dimples, puckers, bulges or ridges on the skin of your breast
• Inverted nipple
  Redness, warmth, swelling or pain
• Itching, scales, sores or rashes
• Bloody nipple discharge

Do Not panic rather visit a doctor to confirm diagnosis. Every lump is not cancerous.

Important points to remember –

1. Self-breast examination should be started at the age of 20 years
2. Once a month
3. 7 days after first day of your menstruation
4. Or same date of every month if you are not menstruating
5. All quadrants of breast should be palpated

The realistic fact that it occurs at a location which can be easily noticed hence early detection and timely treatment is the keystone to improve better outcome and survival from breast cancer.

Therefore creating a consciousness among women about breast self-examination (BSE) is the most feasible and workable choice available for early detection.