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What You Should Know

About Your Body?

by Dr. Constance Borglow

Breast Cancer Awareness is something we can never get too much information on because it’s a disease that is running rampant through our communities.  Breast cancer among African-American women is on the rise and is deadlier than ever.  Studies show that this disease kills more African-American women than any other group in the country.  Breast Cancer is the leading cause of cancer deaths among African-American women. Many women are walking around undiagnosed out of a fear of being tested while others are suffering alone with a disease that can be totally debilitating.

Four years ago, I lost a friend to breast cancer.  She died sixteen months after being diagnosed.  She was one of those who avoided going to the doctor after discovering a lump in her breast.  She was 45 years of age and the mother of four children.  But there is hope…more than 1.6 million breast cancer survivors are alive in America today.  The earlier breast cancer is detected the less the cancer has spread, the more treatment options are available, and the chances for survival are much greater.

Breast cancer is the most common malignancy (other than skin cancer) among American women. 1 in 8 women will develop breast cancer in their lifetime. Although White women develop breast cancer at higher rates than African American women do, it is important to realize that African American women have a higher likelihood of dying from the disease. According to a National Cancer Institute study, African American women were 2.2 times more likely to die from breast cancer than their White counterparts.

The poorer outcomes with regard to breast cancer in African American women have been historically attributed to the more advanced stage of the disease at the time of presentation for medical attention. This, however, does not explain the differences. Factors that contribute to the risk of developing breast cancer and the poorer outcomes of African American women with the disease are not completely understood.

What is Breast Cancer?

The human breast is composed of milk-producing sacs (called lobules) and channels (called ducts) which drain to the nipple. Breast cancer is an abnormal growth of cells within the breast and is referred to as a malignant tumor.

What Are the Risk Factors for Developing Breast Cancer?

Risk Factor Effect on Developing Breast Cancer
Gender Simply being a woman puts you at risk. Breast cancer is 100 times more common among women than men.
Age The risk of breast cancer increases with age. 50% of women who get breast cancer have no identifiable risk factor beyond gender and age.
Hereditary/Genetic Factors Only 1-5% of breast cancer is hereditary, but there is an increased risk among women whose close relatives have had breast cancer. Women who are diagnosed at an earlier age are more likely to have a hereditary basis for their cancer.
Hormones Breast cancer is related to hormonal factors.

Early menstruation (age when your periods begin) and late menopause increase the risk of breast cancer.

There is no convincing evidence that the use of birth control pills increases the risk of breast cancer. Two recent analyses show a small but significant increase in the risk of breast cancer with the use of hormone replacement therapy after menopause. It is unclear whether this risk outweighs the benefits of hormone replacement therapy.

Nutrition   Specific studies of Black women show that high dietary fat and the tendency toward obesity may increase the risk of developing breast cancer. Excessive alcohol consumption increases the risk of developing breast cancer.
Environmental Factors Exposure to radiation, active or passive tobacco smoking and certain pesticides are all known to increase the risk of breast cancer.

How Can You Be Tested?     Mammography

Mammograms are X-rays focused on the breast. Mammography is most often used as a screening tool for breast cancer in a woman who has no symptoms. Though mammograms do not show every breast mass, it is a very good tool for initial screening. There is a general consensus that women age 50 and older should get a mammogram annually. There is some controversy as to how often women aged 40-50 should have a screening mammogram, but the American Cancer Society now recommends a mammogram every year for women over 40. During a mammogram, the breast is compressed or flattened and an X-ray is taken, producing a black-and-white image of the breast. A radiologist will then look at the X-ray focusing on areas of calcium deposits (also called calcifications or micro-calcifications) or masses.  Mammography can also be used as a diagnostic tool to evaluate changes in the breast found on examination.

Breast Self Exam (BSE)

Women discover most breast masses by themselves during the breast self-examination. This exam allows a woman to become more familiar with her breast, making the detection of subtle changes or abnormalities easier. It is important to remember that most masses discovered are not cancerous, but they should be brought to the attention of your healthcare provider.

How often and when should the BSE be done?

Experts recommend monthly self-examination of the breasts. The BSE should be done 7-10 days from the beginning of your menstrual cycle. If your periods are not regular, perform the BSE on the same day each month.

How is the BSE done?

  1. Start by standing in front of a mirror. Inspect each breast separately.
    Note any asymmetry of size, contour, color, or shape.
  2. Raise your hands over your head. Note any changes, particularly in the skin, such as wrinkling, dimpling, or retraction in a specific area.
  3. Lie down with a pillow under your right shoulder and place your right arm behind your head.
  4. Place the finger pads of the three middle fingers of the left hand on the outer part of your bare right breast.
  5. Using small dime-sized circular motions without lifting your fingers, press first with light pressure then with medium pressure, and finally with firm pressure. You should be able to feel different layers of breast tissue using these different pressures. Make note of any masses or abnormalities that you feel.
  6. In this same fashion, examine all areas of the breast and chest area from the collarbone to below the breast and including the armpit. You can do this by going in lines, circles around the nipple, or wedges from the nipple. Whichever method you choose, do it the same each time.
  7. Once you are finished examining the breast, gently squeeze the nipple and look for any discharge. (Note: Over-stimulation of the nipple may cause a normal discharge).
  8. Switch positions and examine the left side in the same way.

Clinical Breast Examination by Your Doctor or Health Care Provider

As part of routine screening, a thorough physical examination of the breasts by a physician or health care provider who is familiar with breast disease is recommended. This should be done annually for women over 40 and every three years for women 20-39.

Currently the American Cancer Society recommends an annual mammogram, clinical breast exam, and monthly BSE for women starting at age 40. Women between ages 20 and 39 are recommended to have a clinical breast exam every three years and monthly BSE.

What Happens if a Suspicious Lump is Found?

While a mammogram or examination can identify a suspicious lump or mass, neither test can establish with certainty the presence of cancer. Biopsy (obtaining cells or tissue from the tumor) is the only way to tell if cancer is present. In some cases, a more detailed mammogram or ultrasound may be completed before the biopsy.

Breast cancer is the most common malignancy (other than skin cancer) among American women.  It affects some women in our community each year.  While we cannot change two important risk factors for breast cancer (gender and age), there are things that we can do to reduce our risk:

  1. Avoid Smoking
  2. Avoid Excessive Alcohol Consumption
  3. Reduce Your Dietary Fat Intake.
  4. Please remember that screening is very important!  African American women often wait too long to get medical attention. Early detection leads to better outcomes.

If you are over 40, make sure you get an annual mammogram, clinical
breast exam, and do monthly breast self-exams.

If you are between 20 and 39, have a clinical breast exam every three
years and conduct monthly breast self-exams.

  • If you have been diagnosed with breast cancer, do not give up hope! Many cases of breast cancer can be successfully treated and there are numerous breast cancer survivors in our community. Knowledge is power!

For further resources of detailed treatment guidelines please see:

  1. National Comprehensive Cancer Network (NCCN): nccn.org or 1-800-909-NCCN
  2. American Cancer Society National Cancer Information Center cancer.org or 1-800-ACS-2345.
  3. National Cancer Institute: 1-800-4-CANCER.

Source:  BlackWomensHealth.com

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