Breast cancer is a common and widespread non communicable health concern for the society, increasing burden over the health care sector expenses. In sub Saharan Africa , current reports reveals an increasing number of breast cancer cases diagnosed in ages 35-49 years with many presenting at advanced late stage disease. Average incidence rate for sub Saharan Africa including Uganda and northern Africa estimates about 25 per 100000 women population mostly presenting in advanced stages requiring different modalities of treatment simultaneously with less cure rate.
To address the challenge of reducing economical burden and to get better cure rate in African population, early detection has been targeted for breast cancer which includes:
- Self breast examination(SBE)
- Screening program-
- History & clinical examination
- Imaging ( Mammography or sonography)
- Pathology( FNAC /Biopsy)
Why to do SBE:
- It helps to understand the normal feel and look of the breast regarding shape, size and texture &
- To detect any abnormal changes in earlier compared to previous normal looking breast.
- So that a female gets advantage of early detection of breast disease including cancer without expenses.
Disclaimer: Although it is clinically less beneficial but economically more effective than other technique for early detection & to approach your tumor specialist at the earliest.
When to do SBE:
- Pre menopausal women: After one week of their monthly menstrual cycle ends.
- Post menopausal: Any certain day of each month
“There is no particular age limit determined to start self breast examination in females but I have seen breast cancer diagnosed at age of 15 years and at age of 85 years as well. So I personally recommend starting self breast examination as soon as puberty is achieved and girls are able to understand the process of self breast examination especially if they have family history of cancers of breast, uterus or ovaries.”
- Using the pads of your fingers, not the
tips, inspect your breasts while lying down and again in the shower. Th e water and soap in the shower will a llow your fingers to glide easily over your skin.
- Using varying pressure a nd taking your time, massage your fingers over your breasts in a spiral pattern starting at the nipple. Make your way up to the top of your breast near the collarbone, to the ceenter by your breastbone, and to the sides near your armpits.
Do this by putting one ar m over your head while massaging your breast with the other hand.
- Lastly, gently squeeze y our nipples to check for discharge.
Contact your doctor if any of these found:
- A hard lump or knot near your underarm
- Changes in the way your breasts look or feel, including thickening or prominent fullness that is different from the surrounding tissue
- Dimples, puckers, bulgess or ridges on the skin of your breast
- A recent change in a nipple to become pushed in (inverted) instead of sticking out
- Redness, warmth, swelling or pain
- Itching, scales, sores or rashes
- Bloody nipple discharge
Further management will be decided by tumor specialist/ cancer specialist doctors.
Dr VIKAS JAIN
UMC VICTORIA HOSPITAL, KAMPALA
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