Breast health is currently a much talked about topic. As women, and to a lesser extent men, being able to understand the importance of breast health and the concerns, signs or symptoms that you may have that require further attention, is something that we all need to know. We can all agree that heart associations throughout the world have done an excellent job educating us on what are the signs of a heart attack. We can all now easily say when symptoms such as crushing chest pains, sweating or racing heart are definitely not to be ignored, so they have achieved something positive with public education initiatives when it comes to identifying heart disease.
We are not quite where we need to be with breast diseases and therefore, public education initiatives are not only desperately needed but definitely has a long way to go. Nonetheless, it is important for all of us to become aware of breast health and how important it is to get checked. In this article, I will explore some of the common signs and symptoms of breast cancer and debunk some of the myths that surround it as well. For many countries that possess a screening programme, breast cancer is often diagnosed without any signs or symptoms. By that, I mean that women accept screening invitations for mammography examination and or ultrasounds where cancers are often picked up from very early, and most patients are unable to feel any lumps or have any symptoms at all.
However, recent research (World Breast Cancer Report 2012) in T&T has shown that screen detected cancers only make up five per cent of all cancers that we have diagnosed in the last five years. This is a very worrying statistic, as in the US and the United Kingdom screen detected cancers make up about 75 per cent or more. It therefore means, cancers detected in these countries with screening programmes are smaller and less aggressive, and these patients have an even better chance of living a normal, fuller life. For the benefit of Trinbagonian women, let us discuss what are the common signs and symptoms that require urgent attention. The most common way for breast cancer to present itself is in the form of a lump. Very often, women would come to our practice with breast pain, and it is important to appreciate that breast pain by itself is not typical of breast cancer though many women may believe so.
Breast cancer presented as lumps are often painless and may lie in a woman’s breast for many, many months, if not a couple of years before becoming large enough to cause problems within the chest wall. Sometimes as the breast cancer becomes aggressive it can spread into the armpit. These are very large and swollen, and they can cause pain, but over 95 per cent of all breast cancer presented as lumps do not cause pain. On the flip side, breast pain is very rarely associated with breast cancer and therefore, most causes of breast pain in patients is either hormonal, due to badly fitting bras, muscular or chest wall injury. Very rarely patients may have blood stained nipple discharge from one spot or both nipples, this requires urgent investigation.
Often patients may be asked about itching in the nipples and this can be a very early sign of ductal carcinoma in situ, which is a very early form of breast cancer and is curable by surgery only.
It is unusual for breast cancer patients to have cancer spread to different parts of the body. At present, this makes up about 16 per cent of all cases presented for diagnosis in Trinidad, which unfortunately is twice the number in screen detected populations such as the US and the United Kingdom. It is important that patients become breast aware and are able to conduct a suitable self-examination to know what their normal breast feels like. Breast awareness is meant to teach you what your own breast feels like, so that if you feel something different, you are able to identify and monitor it and seek treatment.
