Pink water bottles, t-shirts, hats, and even boxing gloves. Each October, thousands of organizations around the world take part in Breast Cancer Awareness Month. The initiative emphasizes the importance of breast cancer awareness, education, and research. Whether you proudly sport your pink ribbon, participate in a breast cancer awareness walk, or donate to the Canadian Cancer Society, there’s one more critical step to take. It’s time to learn how to perform at-home screenings.
The unfortunate reality is that most of us will be or will know someone impacted by breast cancer. 1 in 8 Canadian women will be diagnosed with breast cancer at some point in their lifetime—approximately 26,300 women. Five thousand of them will not survive their diagnosis. And men aren’t exempt either. While breast cancer in men is rare (accounting for approximately 1% of all cancer cases), it can impact anyone with breast tissue (AKA, everyone). Around 220 men receive a breast cancer diagnosis each year.
What is breast cancer?
Cells are the building blocks of life. And each cell has a unique blueprint, telling it how to grow. These blueprints, known as genes, are what help skin cells become skin, and liver cells become liver. Genes are composed of DNA (deoxyribonucleic acid), which can change, or mutate, over time. While some DNA changes are harmless, others cause diseases.
Cancer cells are “born” when mutated DNA tells certain cells to grow faster and behave more aggressively than usual. This uncontrolled cellular growth often results in a tumor—an accumulation of abnormal cells. If this tumor is cancerous (malignant), it grows into and destroys nearby tissue. Cancer can also metastasize, spreading to different parts of the body.
In breast cancer, these tumors typically grow in three places. The first, and most common, is invasive ductal carcinoma. This happens when tumors form in the breast ducts and spread into other tissues. Similarly, when tumors form in the lobules of the breast and spread to surrounding tissues, it’s known as invasive lobular carcinoma.
Less commonly, tumors will grow in the breast tissue itself. These rare types of breast cancer include inflammatory breast cancer, Paget disease of the breast, and triple negative breast cancer. Even rarer are non-Hodgkin lymphoma and soft tissue sarcoma.
Unfortunately, there’s not much you can do to prevent breast cancer. By being a woman and getting older, you increase your risk. A lot of the risk factors hinge on genetic and family predisposition. Women over 50 with a family history of breast cancer and dense breast tissue are automatically at high-risk for breast cancer.
Lifestyle factors that increase your risk include a lack of exercise, drinking alcohol, and taking hormones. This means both hormone replacement therapy for menopause and hormone-based contraceptives (AKA birth control).
BRCA1 and BRCA2
About 5-10% of breast cancer cases are hereditary or inherited. These cases are associated with mutations in two genes: BRCA1 (breast cancer gene one) and BRCA2 (breast cancer gene two). Everyone has these genes. Usually, they repair cell damage and keep breast tissue growing normally. But they can also function abnormally, leading to abnormal cell growth in breasts and ovaries.
According to a study conducted by the Current National Comprehensive Cancer Network (NCCN), you are more likely to have a genetic mutation linked to breast cancer if:
- You have blood relatives (grandmothers, mother, sisters, aunts) who had breast cancer diagnosed before age 50.
- There is both breast and ovarian cancer on the same side of the family or in a single individual.
- Women in your family have had cancer in both breasts.
- You have a relative or relatives with triple-negative breast cancer.
- There are other cancers in your family in addition to breast cancer, such as prostate, melanoma, pancreatic, stomach, uterine, thyroid, colon, or sarcoma.
- You are of Ashkenazi Jewish (Eastern European) heritage.
- You are African American and have been diagnosed with breast cancer at age 35 or younger.
- A man in your family has had breast cancer.
- There is a known abnormal breast cancer gene in your family.
One family member with a genetic mutation linked to breast cancer doesn’t necessarily mean that all family members will have it. However, it does raise the likelihood. For individuals at high risk, preventative measures are available, though many view them as extreme.
In 2013, Angelina Jolie’s op-ed in the New York Times stunned the world as she wrote about her own genetic predisposition for cancer. After emotionally recounting her mother’s struggle with cancer, Jolie went on to raise awareness around gene testing and preventative mastectomy. Her detailed account of the procedure played a substantial role in opening up the discussion for other women with high-risk genetics, and the preventative options available.
Early detection and at-home screening
While we cannot prevent breast cancer, early detection is key to a positive health outcome. Adult women of all ages are encouraged to do an at-home check every month, and women over 50 are encouraged to start annual or bi-annual mammograms.
Symptoms and signs of breast cancer
We’ve watched the same scene in countless movies and television shows: a woman discovers a lump in one of her breasts. She sees her doctor as soon as possible. The diagnosis? Breast cancer. And while that plays out well on the silver screen, the reality is that the warning signs are not the same for all women. In fact, according to the National Breast Cancer Foundation, 8 out of 10 lumps detected in at-home screenings are non-cancerous.
More common symptoms include a change in the look or feel of breast tissue, a difference in the look or feel of the nipple, or unusual nipple discharge. These changes to the breast tissue can be subtle. That’s why it’s important to get into the habit of checking your breasts regularly. Once you’re familiar with your breasts’ particular shape, firmness, and texture, you’ll more easily recognize even subtle changes.
How-to perform an at-home screening
The physicians here at Lumeca recommend performing an at-home breast exam at least once each month. The best time to check your breasts is typically the week after your period ends, as hormonal fluctuations associated with menstruation can cause breast swelling and tenderness. Plus, by doing your exam at the same time each month, you’ll add another level of consistency to your self-check practice. If you’ve gone through menopause, try to perform your breast exam on the same day each month.
The first step
Take a deep breath! Your first at-home exam can feel uncomfortable or even scary. But as you get more familiar with your own anatomy and comfortable with the movements, a breast exam can feel as routine as brushing your teeth.
Start with a mirror check
First, you’ll want to check for any visual changes. Choose a quiet and warm spot with good lighting, and strip down to a bare upper body. Stand in the mirror with your shoulders straight and your arms at your hips. During this visual exam, you’ll want to make sure your breasts are their usual size, shape, and color. You’ll also want to visually scan for unusual distortions or swelling in the breast tissue.
Note: there’s no need to compare your breasts with each other. Our bodies aren’t symmetrical, and it’s common for your breasts to look different from each other.
Next, raise your arms over your head. In this position, check for the same signs of dimpling, distortion, swelling, unusual shape, or changes in skin color. Make sure you also examine your armpit area for changes. If there are any noticeable visible changes, it’s time to consult your doctor.
Physical breast exam
A thorough breast exam means checking your breasts in different positions. We recommend doing a physical exam once while lying on your back, and once while standing or sitting upright. In either position, you’ll use the tips of your first three fingers—use your right hand to check your left breast, and your left hand to check your right breast. Keep fingers together and straight, applying smooth, even pressure.
There’s no right or wrong way to complete a breast exam, so long as you’re thorough. You can choose to start from the nipple and work out in a circular motion, or opt for an up-down approach. Choose the movement that feels most natural to you. What’s key is examining your entire chest, from collarbone to abdomen, and armpit to sternum.
While lying down
This is a quick, easy check you can make first thing in the morning, or right before bed. Lie flat on your back with one arm over your head. You can prop a pillow or towel under that shoulder if it’s more comfortable. While you’re lying flat, your breast tissue spreads evenly, making it easier to feel lumps and other changes.
While sitting or standing
Many doctors recommend doing standing breast exams in the shower, where water and soap help lubricate the skin and can make the exam more comfortable. You can also try using massage oil or baby oil if you prefer.
What to do if you notice changes
If you notice changes, contact your doctor to discuss whether or not further diagnostics are recommended. Lumeca’s team of physicians are also happy to discuss your findings. Through video chat, we can help you understand changes to breast tissue from the comfort and privacy of your own home.
It’s also important to keep in mind that self-examination doesn’t replace routine screenings with your doctor. They can supplement diagnostics, but don’t replace them.
Breast Cancer Awareness Month
In October, millions of people around the world will don their pink ribbons to raise awareness, support breast cancer survivors, and honor its victims. But it’s important to remember that good health starts at home. By helping you understand the early signs and encouraging regular at-home breast exams, Lumeca wants to give you the leg-up in the fight against breast cancer. Have questions? Our team of physicians is on-demand, 24/7 to help you understand your health.