Breast cancer

01 October 2013

Breast Cancer: A life-saving 10 minutes

The latest news about Angelina Jolie’s double mastectomy has drawn attention to the importance of breast awareness. Here's why you should get tested.

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BRAC 1 and 2 gene tests can be performed locally by various pathology laboratories. The tests vary in cost depending on the patient’s individual requirements.

The cost of these tests are covered by most medical schemes, including Fedhealth, from the member’s out-of-hospital pathology benefits where member’s still have available funds in their OHEB/day-to-day pool. A co-payment may be levied where a member has reached safety net level.

However, Peter Jordan, Principal Officer of Fedhealth, says that screening for BRCA1 and 2 should only be done in high risk individuals following a full assessment and pre-test counselling.  

“Preventative Health is always important and we do strongly advocate that women follow a regular routine of self examination and carry out regular annual checks and mammograms.” He says.

The evidence is overwhelmingly positive showing that where women have access to education about their own health, and where there are more effective detection and treatment programmes, breast cancer can, and is, becoming a survivable disease.

Jordan says lack of education and fear causes many women to delay seeking medical evaluation of a possible breast problem.

A thorough breast examination takes only 10 minutes, however, a surprisingly large number of women still avoid undergoing breast examinations. Breast cancer can also occur in men which means examinations for men are also important and this is often largely neglected.

Clinical breast examinations

Part 1

The examination begins with visual inspection where the breasts are inspected for size and symmetry – a slight variation in the size of each breast is common and generally normal.

The skin is then inspected for colour, vain pattern, and any visible swelling or fluid retention. “You may be asked to relax your arms at your side, raise your arms over your head, or put your hands on your hips. These movements allow the practitioner to evaluate any changes in the breast,” explains Jordan.

Most slight swelling, redness, rashes or other skin presentations are normal, but if they continue or worsen, they should be evaluated to rule out a serious breast abnormality. Any change in the nipple, such as retraction (your nipple becoming inverted, when it was not previously) or nipple discharge, requires further evaluation.

Part 2

The second part of the examination involves palpation (feeling) of the breast and underlying tissue, which is performed with the patient either seated or lying down.

This is best performed a few days after menstruation, when less fluid is retained. Light, systematic palpation includes the entire surface of the breast tissue, which stretches from collarbone to the bra line and from the breastbone to the middle of the underarm. Finally, the areola is gently compressed to detect any discharge or secretion.

“It is important to note that the vast majority of suspicious lumps turn out to be benign (not cancer),” says Jordan. “Your health care provider may request that you return to have the suspicious area rechecked in a month, or you may be advised to have a diagnostic mammogram or a breast ultrasound (sonogram) to re-evaluate the physical findings.”

Breast Self Examination

In addition to a clinical check women must also take responsibility for their own health and check their breasts at home at least once a month. Breast Self Examinations are easy and painless and can avert a serious problem later.

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Ask the Expert

Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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