Breast care for all

Everyone has a story to tell about breasts; the baby’s sucking experience to men who are unable to keep their eyes off a good pair of breasts and in between women who may even admire a rival’s pair. Breasts seem to generate a lot of enthusiasm wherever they are mentioned yet in many developing countries we still struggle with early detection of breast cancer. One would have thought that for something that draws so much attention, we will all do our bit to ensure it remains healthy.

Breasts come in all shapes and sizes and most women will admit that shopping for an ideal bra is probably one of the most frustrating experiences. These shapes and sizes are dictated to a large extent by the fatty tissue contained within. Over the years, the picture of “a good looking” breast has gone through cycles and currently many of us are swayed by the “implant inspired” ideal. 


Know these about your breast


• The size and shape


• Any areas that appear swollen


• What the skin looks like – any colour changes, any skin changes such as areas looking like an orange peel/skin, ulcers/sores


• Consistency or what the breast feels like; are there any lumps?


• Is the nipple pointed or retracted. Is there a nipple discharge?


Risk factors for breast cancer


We still do not know exactly what causes breast cancer but certain things have been associated with these cancers and they include:


• Age – the older you are the greater the risk


• Gender – being a woman automatically puts you at more risk.


• Family History – our risk increases when a close family member has the cancer


• Personal History – when we have cancer in one breast the chance of it occurring in the other or even the same breast is increased


• Menstruation – Having first menses at an early age and reaching menopause late

• Race – white women at an increased risk but blacks have more aggressive varieties


• Alcohol use and fatty or cholesterol-laden foods increase the risk


• Having no children or the first child after 35yrs increases risk (not a reason to encourage teen-age pregnancies)


• Exposure to chest radiation


• Being overweight or obese increases risk


• Certain hormone therapies may increase risk


• Beware of breast implants


Some good news though;


• Breast feeding for one and a half to two years (can you imagine the number of men who cursed when they read this line?) may marginally reduce your risk. Current work schedules, fashion and spouse preferences may make this a difficult hurdle to overcome.


• Exercise pops up again as being a great way to reduce our risk


• “Let your food be your medicine, and your medicine be your food” – Hippocrates. I do think he made a point that is still relevant today. Healthy eating makes a world of difference. Many theories exist but do not complicate your life with deciding if walnuts or mushrooms are better or if garlic reputed to drive away vampires is the magic wand for breast cancer. Eat your fruits, vegetables (vary the colours), increase fish (source of Omega-3 fatty acids) intake and you will strengthen your immune system.


Diagnosing Breast Cancer


There are different types of breast cancer and their management may also vary. Some people know a lot about their breasts and the awareness of breast cancer is so high that the smallest change in their breast is reported to a health professional. In our part of the world ignorance, poverty and fear may delay detection to the point that the breast is sometimes “mutilated” beyond recognition and the odour emanating from the breast could relieve you of your chronic sinusitis before one presents at a hospital. Prior to this some may have tried all sorts of concoctions including applying suspicious herbs and driving away evil spirits.


The following steps may help:

• Physician and/or self-breast exam


o Always better if done as a routine exam


o Look out for lumps, changes in breast shape and sizes, skin changes in colour and dimpling, 


o Itching of breast (do not panic. This is rarely an indication of breast cancer)


o Nipple discharge or changes


o DO NOT WAIT FOR PAIN IN YOUR BREAST BEFORE TAKING ACTION


• Mammography


• Ultra sound scan of the breasts


• Biopsy – taking out a suspicious growth in the breast and examining


Other tests such as PET CT, MRI and the CT scan will also help detect spread if they are available.


“Your mammogram is suspicious for breast cancer” or “your biopsy was positive for breast cancer” are two of the many phrases that cause panic and fear in every man or woman. Yes laughter has been described as the best medicine but a late diagnosis of breast cancer is no laughing matter. Let us take steps now to detect breast cancer early so that we can “overcome’ it.


Can you imagine what goes through the mind of someone who is diagnosed of breast cancer especially without adequate counseling? 


We elicit multiple fears including:


• Fear of surgery

• Fear of death


• Loss of body image


• Loss of sexuality


Statistics that make you cringe


• “A total of one woman is diagnosed of breast cancer worldwide every three minutes”. About two people will have been diagnosed with breast cancer by the time you finish bathing today. I am assuming your bath duration does not rival a labour ward event.


• “Breast cancer is the second commonest cancer among women in Ghana. It accounts for 15% of all cancers and 40% of female cancers in Ghana”


• “Majority of breast cancer cases in Ghana are between the ages of 40 – 45 years”


Medical science is unable to pinpoint the cause of breast cancer so our best options are EARLY DETECTION and REDUCING OUR RISK FACTORS. 


Finally dear reader let’s put the following in action


• Early detection is great so women should do monthly self exam and probably examination by a healthcare professional yearly. Men should make sure we examine our breasts occasionally because though the risk of breast cancer is extremely low, it may still occur. Don’t be a statistic!


• All women should get a baseline mammogram between 35 – 40 years, 40-50 years mammogram every other year and yearly after 50 years. Yes there are arguments about this frequency but after all is said and done it is a safer option. If there is a high incidence of breast cancer in your family, having a mammogram at 30 years will not be considered a sin.


• Exercise regularly


• Eat a healthy meal with a great portion of fruits, vegetables and omega -3 laden fish. But beware of fats and oil.


• If you intend to start a family, maybe you should before you are 30years and then breastfeed for as long as you can afford to.

• DEFINITELY make sure you alert at least one busy woman, one woman without access to information and one man, that breast cancer is real but a lot can be done when detected early.


Together we can all work to reduce the incidence of advanced breast cancer.


AS ALWAYS LAUGH OFTEN, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)


Dr. Kojo Cobba Essel


Moms’ Health Club


(dressel@healthclubsgh.com)


*Dr Essel is a medical doctor, holds an MBA and is ISSA certified in exercise therapy and fitness nutrition.


Thought for the week – 75% of all breast cancers present with a lump most frequently in the upper outer quadrant of the breast BUT in general 90% of breast lumps are benign.”


References:


1. Breast Cancer Course for Health Professionals


2. www.mayoclinic.com


3. www.medicinenet.com/breast_cancer


4. Citifmonline


5. Mosby’s Ace the Boards