ANSWERS TO MOST OF THE QUESTIONS THAT HAVE ARE EXCITING TO US, we are all used to searching online. In this series of articles, we ask just such questions – burning, unexpected or common – to professionals in a variety of fields.
There is a popular opinion that you need to regularly examine and feel your breasts yourself in order to identify dangerous changes in time. You can even find detailed instructions with pictures on the Internet, but does such an examination replace a visit to the doctor? How should you monitor your breast health? We asked these questions to a specialist.
There is an opinion that if you regularly examine your breasts yourself, you can catch breast cancer at an early stage. The problem is that in this way you can grope for a mass at least a centimeter in size, and the focus of breast cancer at first may be limited to a few millimeters. Therefore, it is important to remember that self-examination is not a substitute for a preventive visit to the doctor. Unfortunately, there are times when a woman thinks that an ultrasound scan is not needed, because when feeling, she does not find anything unusual – as a result, the disease may not be detected in time. One of the most reputable cancer organizations in the world, the American Society of Clinical Oncology , recommends that doctors, teaching patients self-examination, explain its possible harm. Women who regularly examine their breasts on their own may be overly optimistic and skip scheduled ultrasounds or mammograms.
Self-examination of the mammary glands is ineffective for diagnosing cancer at an early stage. In addition, it leads to significantly more biopsies with negative results (without detecting cancer). This is traumatic both for the psyche of a woman who is nervous in anticipation of a response, and physically, because any puncture can lead to the formation of hematomas and inflammatory processes. Numerous studies and meta-analyzes have shown that breast self-examination does not reduce breast cancer mortality.
Nevertheless, you need to examine your breasts yourself. At the same time, a woman has to answer herself only one question: “Is everything in my chest like it was last month?” The most frequent manifestations that should strain are the presence of a node, a change in the skin above it, swelling of the skin, retraction of the nipple, swollen lymph nodes in the armpit, blood from the nipple. Any formation in the breast or discharge from the nipple is an unconditional reason to go to a mammologist, oncologist or at least a gynecologist, without postponing the visit until better times.
When conducting self-examination, do not panic: “What if I find something?” Rest assured and calm: “If I find anything, I can get help in time.” It’s just a preventive procedure like brushing your teeth. Most of the changes found in the mammary gland are benign, such as mastopathy. It can be diffuse when there is no clear knot in the chest, but there is a general heterogeneity. This is due, as a rule, to an imbalance in the hormonal background, when fibrous, glandular and adipose tissues are in the wrong proportions. The formation of cysts is also associated with hormonal imbalance, and mastodynia – swelling in the second phase of the cycle, the so-called engorgement of the glands before menstruation. All of these conditions are not dangerous, but they can cause discomfort and cause further problems. Any abnormal breast conditions, including cysts, pain and engorgement before menstruation, should be discussed with a specialist and treated.
Don’t panic: “What if I find something?” Rest assured and calm: “If I find something, I can get help in time.”
Another, more dangerous manifestation of mastopathy is the nodular form; it is potentially dangerous and requires close medical supervision. The presence of fibroadenoma, confirmed by ultrasound, mammography and cytology, requires mandatory annual monitoring. Nodules up to two centimeters that grow slowly are treated with drugs, and tumors that are larger or growing rapidly need to be surgically treated. After removing the node, its composition is examined under a microscope; in this case, it is possible to identify atypical cells, that is, a precancerous condition.
Even if you regularly examine your breasts and nothing bothers you, you should still consult a doctor for prevention. Women from nineteen to thirty-five years old need to do an ultrasound examination of the breast and regional lymph nodes once a year. After thirty-five and up to forty-five years, in addition to the annual ultrasound, a mammogram should be done every two years. Then the density of the mammary gland decreases, and an ultrasound is no longer needed – an annual mammogram is enough. After these examinations, it is imperative to see a mammologist.
It is important that there is no need to do tests for tumor markers as part of a clinical examination. As for heredity, if a woman’s family (in any line) had cancer of the breast, ovaries, endometrium, stomach, colon, it makes sense to consult an oncogenetist at any major oncological or genetic center and in his direction to do an analysis for mutations some genes. Separately, I note that more and more often pregnant women are becoming patients of oncologists . Be aware that a doctor should not dismiss breast problems in women during pregnancy or lactation and blame everything on lactostasis and hormonal burst.
Of course, there should be a measure in everything. Carcinophobia (fear of cancer) can take the form of two extremes: hypochondria, when a person finds all possible and impossible diagnoses, and “ostrich syndrome”, when, on the contrary, even obvious changes in the body are denied. Stick to the golden mean: time to consult a doctor and a timely pass obs research.