Breast cancer - be aware this October

A GP or gynaecologist will show you how to do this simple and quick self-examination, and women over 40 should also do an annual mammogram to pick up any problems.

Most women know about these measures, but not enough make the time to do them. And even fewer think beyond the terrible moment where they discover a lump. Fortunately, 80% of breast lumps are benign, so finding one doesn't necessarily mean that it is malignant.

There are three types of non-malignant breast lumps:

• Cysts - These are benign, fluid-filled lumps of tissue.
  
• Fibroadenomas - Benign groups of cells supporting other cells in your breasts.
  
• Breast Pseudolumps - These can be scar tissue, dead fat or compressed breast tissue.

What is breast cancer?

Actual breast cancer is a malignant tumour that forms in the breast cells. From there it can spread to the lymphatic system, usually by spreading from the breast tissue to lymph nodes under the arm. If a lump is found under the arm, it usually means that the cancer cells have entered the bloodstream and could have spread to other parts of the body. This will influence decisions about treatment.

Early breast malignancies usually take the form of painless, hard masses, but can also be tender to the touch, soft or rounded, so any new mass or lump should always be checked by a doctor. According to the Cancer Association of South Africa (CANSA), there are other symptoms that can also indicate the presence of breast cancer:

• swelling of all or part of the breast
  
• skin irritation or dimpling of the breast
  
• breast pain
  
• nipple pain or the nipple turning inward
  
• redness, scaliness, or thickening of the nipple or breast skin
  
• a nipple discharge other than breast milk
  
• a lump in the underarm area.

How is breast cancer diagnosed?

If a breast lump is detected in a self-examination or with a mammogram, your doctor will discuss the next step with you. Any combination of diagnostic steps can be taken, including MRIs, ultrasounds, mammograms (if one has not already been done), ductograms to test the source of any discharge from the nipple, fine needle aspirations or other biopsies.

Any material drawn in a biopsy can then be examined under a microscope or in a laboratory. With a needle biopsy, clear fluid usually indicates a benign cyst. Bloody or cloudy fluid can either mean a benign cyst or, rarely, cancer. If the lump is solid, pieces of tissue will be drawn, which will then be examined to determine if they are cancer. If there is any doubt about what kind of a lump it is, further tests will be ordered.

How is breast cancer treated?

If cancer is diagnosed, the type and extent of the cancer will determine the treatment options. Any combination of surgery, radiation, chemotherapy, hormone therapy and immunotherapy may be used. While none of these options are pleasant, it's important to remember that there is a very good recovery rate from breast cancer.

How can I avoid getting breast cancer?

While there are a number of unavoidable genetic, age and hormonal factors that can predispose a woman to breast cancer, there are some risk factors that CANSA says increase your chances of getting breast cancer. These are:

• Not having children or having them later in life (after 30)
  
• Using birth control pills
  
• Not breastfeeding
  
• Using alcohol
  
• Being overweight or obese
  
• Not exercising
  
• High-fat diets
  
• Tobacco smoke

While staying healthy and fit are the best forms of defence against any disease, awareness is your most powerful tool against breast cancer. Make use of any diagnostic tools you have available and carry out your self-examination to give yourself the benefits of early detection and treatment if you do have breast cancer.