DETECTION & DIAGNOSIS / TESTING
BREAST SELF-EXAM (BSE)
Importance of early detection: early detection saves life
Many studies proved that early detection of breast cancer reduces possibilities of death from cancer. We can cure around more than 90% of the early detected cases.
Why do we do early detection, and what are our goals?
We carry out early detection to discover tumors before they develop symptoms. To remove it and get cured from it.
What are the methods for early detection and when do we recommend them?
Breast Self-Exam (BSE):
once a month, on around the seventh day (between 5 - 7 days) after the beginning of the menstrual cycle, when the breast is less engorged, in every woman over the age of 20.
Clinical Breast Exam (CBE, by a physician or a trained nurse):
once every three years from the age of 20-40. Then once every year, for every woman above 40.
Mammography:
once every year: from the age of 40 years.
Breast Self-Exam (BSE) Instructions and Age
We recommend every woman over the age of 20 to examine her breast once every month. Every woman will notice that after a short period of time, this issue will become a routine. Thus, she will be able to detect any new changes that can occur in her breast. We usually recommend BSE after a shower while standing and while lying down. It is better that every woman get instructions from the family doctor, or she should take part in training and educational sessions to examine the breast in a correct way.
BSE Timing
-A woman should examine her breast when it is not engorged.
-For the woman below the age of 50, the best timing of BSE is seven days after the beginning of the menstrual cycle, when the breast is softer than other days.
-For a woman who takes contraceptive pills, she should examine her breast on the first day she starts taking the new pack of monthly pills.
-For a woman who is beyond menopause, she should set definite time dur- ing the month, either at its beginning or in its middle, to perform the self- exam.
Method of BSE
1- Looking
Looking, watching and noticing Before a woman starts palpations, she has to look at her breast in the mirror and verify the presence of any changes in size or any redness on the breast skin, or any other areas on the breast. She has to check if there was any ul- ceration on the nipple or any secretions.
2-Method of BSE AND HOW TO USE FINGERS:
We recommend not to examine the breast with finger tips. It is a wrong way, and it might give wrong conclusions. A breast should be examined by using the palm of the fingers.
3-BSE WHILE SHOWERING:
Many women say that they examine themselves while showering since it is an easy method. That is okay; however, examining the breast everyday becomes an obsession. Women might be mistaken and not pay attention to changes. This method should not be abandoned, but should be done once a week, for example, then once a month.
4-BSE WHILE LYING DOWN:
A woman lies down, puts a pillow under her right shoulder, places her arm under her head, and then starts examining the right breast with the palm of fingers of her left hand by either a circular method or a checkers method
4.1- Circular method:
The breast should be examined starting with the upper middle in a circular manner. The hand should be placed and moved half a centimeter in a clockwise manner, as is shown in the drawing. Every half-centimeter should be examined alone. The hand should palpate all over the breast and get closer to the middle. Then, the nipple should be examined and squeezed to make sure there are no abnormal secretions. After being done with the right breast, the left one is to be examined in the same way by using the right hand.
4.2- Checkers method:
The breast is examined from top to bottom, and from right to left, or from bottom to top and from left to right, as if drawing a square to check all parts of the breast.
4.3- Correct Exam method:
Using the palm of the fingers and the hand
4.4- Examining the nipple:
It is examined and squeezed to make sure there are no abnormal secretions in the breast.
5-Repeating BSE WHILE STANDING:
All the details of BSE should be repeated. While standing, the upper part of the breast and the axilla are easy to exam- ine. Therefore, in this case, the exam should focus on these two areas.