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By Dr. J. U. Enumah (MBBS, MPH, Dip HSE Mgt) Supr. Occupational & Environmental Health NNPC Medical Services, Lagos
HOW IS BREAST CANCER DIAGNOSED?
1. Examination of the Breast
A complete breast examination includes visual inspection and careful palpation (feeling) of the breasts, the armpits, and the areas around your collarbone.
2. Mammography
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Miss 10-15% of breast cancers. |
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A false-positive mammogram |
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A false-negative mammogram Ultrasound |
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This is a BENIGN BREAST TUMOUR, not a breast cancer! |
3. MRI
4. Biopsy
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Fine-needle aspiration |
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Core-needle biopsy. |
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Surgical biopsy. |
5. Hormone receptor test
DIFFERENTIAL DIAGNOSIS: Can any other condition mimic breast cancer?
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Benign Breast Disease - commonest breast condition in adults and most girls |
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Inflammatory Breast Conditions ( e.g. Abscess) |
HOW IS BREAST CANCER TREATED?
1. Surgery.
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Breast conservation. |
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Excision +/- reconstruction. |
2. Chemotherapy.
3. Radiation therapy.
4. Hormonal therapy.
5. Immunotherapy
DO PEOPLE WITH BREAST CANCER SURVIVE?
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Stage 1 84% 5yrs survival (i.e. surgery after early detection) |
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Stage 2 71% 5yrs survival |
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Stage 3 45%-48% 5yrs survival |
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Stage 4 18%-26% 5yrs survival |
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Mammographically detected tumor >84% |
BREAST CANCER PREVENTION METHODS
1. Breast self examination: Cheap and easy.
2. Clinical Breast examination:
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Three monthly from 20 years. Yearly from 40 years |
3. Mammography:
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1-2 years from 40 years. |
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High risk women 10 years earlier than age at which the youngest relative developed breast cancer. |
4. Avoid Obesity after menopause and excessive alcohol.
5. Unnecessary hormone replacement should be limited in duration if it is medically required.
6. Prophylactic Tamoxifen in genetically prone women.
7. Prophylactic mastectomy to avoid developing breast cancer.
8. Prophylactic ooverectomy (ovarectomy) before 40 years in genetically prone women.
Breast Self Examination (BSE)
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Most important and most feasible method on a large scale |
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Who can do it? - Every woman |
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When? - Best 7 or 8 days after period |
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How should it be done? |
What are you looking for?
Change in symmetry of the breast (size shape, contour)
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Nipple inversion and/or deviation. |
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Skin changes (redness, puckering/dimpling, eczema). |
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Lump in the breast. |
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Nipple discharge. |
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BSE Step 1 |
BSE Step 2 - Hand Lifted |
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BSE Step 3 - Lying Supine |
BSE Step 4 - With Skin Slippery |
CONCLUSION
1. Know what is normal for you and see your health care provider right away if you notice any of these breast changes:
2. Know your risk
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Talk to your family to learn about your family health history |
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Talk to your health care provider about your personal risk of breast cancer |
3. Get screened
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Ask your health care provider which screening tests are right for you if you are at higher risk |
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Have a mammogram every year starting at age 40 if you are at average risk |
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Have a clinical breast exam at least every 3 years starting at 20, and every year starting at 40 |
4. Make healthy lifestyle choices
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Maintain a healthy weight. |
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Add exercise into your routine. |
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Limit alcohol intake. |
Please take this home: Breast Cancer when detected early and treatment promptly instituted offers patients good quality life.
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