Breast cancer: Risks, preventative care, and the importance of self-exams

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AMMAN — October marks breast cancer awareness month across the globe. Internationally, breast cancer is the most common cancer in women and second most common type of cancer overall. Jordan is no exception to this trend.اضافة اعلان

According to the Ministry of Health’s cancer incidence report for 2014, breast cancer accounted for 39.4 percent of all cancers in women. To fully understand the gravity of this disease, the second most common cancer in women is colorectal cancer at only 9.6 percent.

Contrary to popular belief, breast cancer is not exclusive to women. Men can also develop breast cancer and in Jordan it has accounted for 0.5 percent of cancer cases in men.

Due to the disproportionally high prevalence rate of breast cancer, it is the number one most common form of cancer, accounting for 20.8 percent of all cases, followed by colorectal cancer at 11.6 percent.

Along with a high prevalence rate, breast cancer also has a high mortality rate, making it the third leading cause of cancer mortality at 10.2 percent.

What is breast cancer?

Breast cancer is like other cancers in that it is a disease that results from tissues within the breast growing out of control. There are different forms of breast cancer, all of which are dependent on the type of tissue involved.

Although the anatomy of the breast is identical in males and females, there are slight differences which account for the risk of different types of breast cancer. The two most common types are infiltrating (or invasive) ductal carcinoma (IDC) and infiltrating (or invasive) lobal carcinoma (ILC).

IDC is the most common type of breast cancer in both men and women. The tissue responsible for this type of cancer are the ducts. The mammary (milk) ducts of the breast are tubes that connect the milk producing glands, known as lobules, to the nipple. Although functionally useless in males, the male breasts still contain ducts.

The second most common type of breast cancer is ILC, but it is exceedingly rare in men. This type of breast cancer develops within the lobules. Similar to ducts, men also have these glands even though they are underdeveloped and functionally useless.

Who is at risk?

Breast cancer and cancer in general is a multifactorial disease, typically without a single cause. As is the case with nearly any cancer, age is a risk factor with breast cancer. As we get older, it becomes harder for our body to regulate tissue growth and therefore the risk of tissue growing out of control increases. In breast cancer, most diagnoses are after the age of 50
In addition, genetics plays a large role in cancer development.

Genetic mutations can be hereditary, as is the case with mutations to the BRCA1 and BRCA2 genes. Due to the hereditary nature of cancer, individuals with a family history of breast cancer, typically within immediate family members, are at greater risk. Similarly, women with a personal history of hormone irregularities concerning reproductivity are also at increased risk.

Other factors that may increase your risk of developing breast cancer include having dense breasts made up of more connective tissue than fat, previous treatment with radiation therapy, and taking certain drugs like diethylstilbestrol.

What should you do?

Although seemingly healthy individuals may still develop cancer, there are things you can do to reduce your risk of developing breast cancer. First and foremost is being physically active. Those who live a sedentary lifestyle are at greater risk of developing breast cancer. Furthermore, being overweight or obese, especially post-menopause, further increases your risk.

Certain medications can increase your risk of developing cancer, particularly some forms of hormone replacement therapy (HRT). Some HRT regimens for post-menopausal women may increase your risk when taken for more than five years. Similarly, some oral contraceptives (have also been linked to an increased risk). Always consult your healthcare provider and avoid taking such pills unless otherwise indicated by your physician.

Additionally, certain reproductive practices or incidences may increase your risk. Women who have their first child after the age of 30, do not breastfeed, or never carry a baby to full-term, have an increased risk of developing breast cancer.

If you are concerned about breast cancer due to being an individual at higher risk or simply want to make sure you are healthy, early screening and detection can drastically reduce mortality and improve the odds of beating cancer.

The Jordan Breast Cancer Program (JBCP) is led and supported by the King Hussein Cancer Foundation and their website provides services and education relating to breast cancer. Based on their guidelines, it is recommended that women between the ages of 25-39 perform breast self-exams monthly and clinical breast exams annually. For women 40 and up, it is recommended that breast self-exams be performed monthly and clinical breast exams, as well as a mammogram be performed yearly.

How to perform a breast self-exam

The purpose of a breast self-exam is to find lumps or masses within the breasts. These lumps may be benign or non-cancerous masses but there is no definitive method to be sure without further screening. The self-breast exam will help individuals keep an eye on worrisome masses and allow for patients to bring them to the attention of their healthcare professional.

The self-exam is quick and easy to perform in five steps. The first step in to simply stand in front of a mirror with your shoulders straight and hands on your hips. The purpose is to ensure that your breasts are the usual size, shape, and color compared to previous exams. If you notice any dimpling/puckering (waves or grooves formed on the skin) or bulging of the skin, changes in the position of the nipple or an inverted nipple (pushed in instead of sticking out), or redness, soreness, rash, or swelling, it is important to consult with your doctor. The second step is to look for the same changes with your arms raised above your head.

The third step is to look for any fluid or discharge from one or both nipples. The discharge may be watery, milky, yellow in color, or even bloody. The fourth step is to feel for lumps in the breast while lying down. Raise the arm of the breast you would like to examine (e.g., raise your left arm to examine your left breast) and use the opposite hand to examine. You should use the pads of two or three fingers to feel in a circular motion. Follow a pattern to ensure the entire area of both breasts are examined. Be sure to use varying firmness of pressure to deep tissue.

The fifth step is to perform the same actions described in step 4 but while standing or sitting upright. Many find this easiest to perform in the shower as it reduces friction.

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