BREAST CANCER AWARENESS
AND BREAST SELF
EXAMINATION
DR ALIYA SHAIMA
Assistant Professor Surgery
Allied Hospital Faisalabad
ٱلر ِح ِيم
ٱلر ْح َم ٰـ ِن ه ِب ْس ِم ه ِ
ٱَّلل ه
AIM
To aquaint the house about
common female breast
problems and and how to
detect and deal with them
SCHEME
BREAST PROBLEMS
➢ What is breast made of
➢ Why is breast awareness so important
➢ Significant common problems
➢ What can we do
➢ To learn breast self examination
Q&A
WHAT IS BREAST TISSUE?
covers an area
from your
collarbone to
under your arm
and includes your
breast mounds
WHAT IS BREAST TISSUE MADE OF?
• consists of
fibrous, glandular
and fatty tissue
• breast tissue
changes
throughout your
lifetime
WHY IS BREAST AWARENESS
SO IMPORTANT?
•Most common cancer in females (35%)
•Most common cause of death
in females (27%)
•Most curable cancer of females (95%)
if detected early
SHAUKAT KHANUM HOSPITAL RECORDS
WHAT CAN WE DO?
• Gain as much information as possible
• Make action
• Early detection is the best protection
CHANGE
IS THE
MOST IMPORTANT
FACTOR
IN BREAST AWARENESS
Significant common
Problems / changes
WHAT CHANGES SHOULD YOU
BE AWARE OF?
Any change in the
shape or size of
the breast
WHAT CHANGES SHOULD YOU
BE AWARE OF?
A
breast
lump
WHAT CHANGES SHOULD YOU
BE AWARE OF?
Lumpiness
in
the breast
WHAT CHANGES SHOULD YOU
BE AWARE OF?
A change to your
nipple such as in
the shape or
colour
WHAT CHANGES SHOULD YOU
BE AWARE OF?
A change to
your nipple
such as flaking
skin
WHAT CHANGES SHOULD YOU
BE AWARE OF?
Weeping
from the
nipple
WHAT CHANGES SHOULD YOU
BE AWARE OF?
Dimpling or
puckering of the
skin
WHAT CHANGES SHOULD YOU
BE AWARE OF?
A pain in the breast
that will not go away
WHAT CHANGES SHOULD YOU
BE AWARE OF?
An area on
one breast
that feels hot
WHAT CHANGES SHOULD YOU
BE AWARE OF?
An area that looks like
the skin of an orange
MOST CHANGES
FOUND IN THE BREAST
ARE NOT BREAST CANCER
WHAT IS BREAST CANCER?
• Cells that grow much faster than other
normal cells
• It is a change that grows in your breast
tissue
• It can spread to other parts of the body if
left untreated
HOW DOES BREAST CANCER
DEVELOP ?
Normal Hyperplasia Atypia Low/Interm Invasive
DCIS Cancer
milk duct too many cells cancer cells cells spread
cells becoming inside the out of the duct
abnormal ducts
WHAT CAUSES BREAST
CANCER?
• We do not know what causes breast
cancer exactly
• we cannot stop it from starting to grow
• we do know that a woman’s best
protection is to find it early, have it
removed and treated
WHAT CAN WE DO?
We do know that there are some
RISK FACTORS
Which increase the chance of getting
breast cancer
WHAT ARE THE MAIN
RISK FACTORS?
• Being a woman
• Growing older
39- 49 yrs (asia)
49 -59 yrs (world wide)
• Family history
• Breast problems including a previous history of
breast cancer
OTHER RISK FACTORS
• Having a child later than age 30 or not
having any children
• Getting your periods early and going
through the ‘change of life’ later
• Use of contraceptives pills
• Being overweight
• Hormone replacement therapy (hrt)
OTHER RISK FACTORS
• Marriage to first and second cousins
• Life style
• Consumption of more fats
SAFETY FACTORS
“BREAST FEEDING”
“AVOID EXPOSURE TO
RADIATION IN TEENAGE”
WHAT ARE SOME OF THE
MYTHS?
• Knock or bump to the breast
• Wearing a bra
• Wearing deodorant
• Breast size
HOW CAN YOU LOOK AFTER
YOUR BREASTS?
HOW CAN YOU LOOK AFTER YOUR
BREASTS?
• Check your breasts regularly your self(bsf)
• Have a breast examination by your doctor every
year
• If aged 40 – 64 having a mammogram if advised
by your doctor
Physical examination
• Includes inspection and palpation of breast
• Inspect for lumps, asymmetry, or skin dimpling
• Palpated to evaluate texture and detection of masses
Ultrasound
• Imaging modality of choice to assess a breast lump or localised change
• breast consistency
• Can be safely used in pregnancy
• Sensitivity and specificity unaltered by pregnancy
Mammogram
• Used to rule out multicentricity and contralateral disease
• Sensitivity of approximately 86% during pregnancy
• The foetal radiation exposure from mammography with abdominal shielding is low
(0.004 Gy)
MRI
• Preferred for hepatic and bone metastases
• Technically difficult after 20 weeks as required to lie face down
• Increased blood flow to breasts will decrease sensitivity and specificity developing
embryo is susceptible to injury from various physical agents.
• Associated with risks of heating and cavitation to the fetus
Biopsy
• Core biopsy is the preferred procedure
• Fine needle aspiration is unreliable due to possibility of false positive
diagnosis of malignancies and should not be preferred
Diagnosis
Physical examination
Ultrasound exam
Mammogram
MRI
Biopsy
Barton et al. JAMA 1999;282:1270-80.
Kulshrestha M. Journal of South Asian Federation Obstetrics and Gynecology. 2011;3:1-5.
Diagnostic work-up
Breast mass palpated
Breast ultrasound
Benign Suspicious
Mammogram &
Core biopsy
Keyser et al. Rev Obstet Gynecol. 2012;5(2):94-9.
TREATMENT
• Surgery
– Breast saving surgery
– MRM
• Chemotherapy
• Radiotherapy
• Harmonaltherapy
REMEMBER
•Regularly check your own breast
•Regular breast check by your doctor
•Mammogram if advised by your doctor
REMEMBER
EARLY DETECTION IS YOUR
BEST PROTECTION
If you notice any change
SEE YOUR DOCTOR WITHOUT
DELAY
Questions & Answers
IF AT ANY TIME YOU
NOTICE ANY CHANGE
IN YOUR BREASTS
……..
SEE YOUR DOCTOR
WITHOUT DELAY!!
Thank you
BREAST SELF EXAMINATION
• Who is supposed to do it
• When to do it
• How to do it
• Which findings to note down