Tips to do breast self-checks

October is Breast Cancer Awareness Month, and healthcare professionals are sounding the alarm on early detection.

It is estimated breast cancer affects one in 27 SA women.

Breast cancer, the most prevalent cancer among women, is increasingly detected in women under 40. This trend mirrors global patterns, where younger women are diagnosed with more aggressive forms of the disease, underscoring the need for early detection and awareness.

Dr Peter Schoub, the chairperson of the Breast Imaging Society of South Africa, a sub-speciality group of the Radiological Society of South Africa, warns that young women are more likely to develop breast cancers with aggressive biological characteristics.

“These cancers often present with larger tumours at more advanced stages of the disease, thus making early detection vital for improving outcomes,” he said.

“Early detection through regular self-examinations must start from age 20 and annual mammograms from age 40.”

Schoud says one of the biggest hurdles medical professionals face is the late-stage diagnosis of breast cancer, which severely limits treatment options and reduces survival rates.

“Late diagnoses are often attributed to a combination of factors, including a lack of awareness, socioeconomic disparities and limited access to healthcare facilities,” he said.

“Most major medical schemes offer complimentary mammogram screenings for women over 40, yet only about 20% take advantage of this service. Rapidly spreading aggressive forms of the disease is increasingly being detected in women in their 30s.”

He said the goal of breast cancer screening is to detect the disease before symptoms emerge.

“Cancers found through routine screening are often smaller and localised, increasing the chances of successful treatment and survival. The size of the tumour and whether the cancer has spread are key factors in determining the prognosis.”

Who is at risk of developing breast cancer?

Every woman is at potential risk, but certain factors increase the likelihood, such as:

Age
The risk of developing breast cancer increases as one gets older. However, one out of eight invasive breast cancers are found in women younger than 45.

Family history
Women with close blood relatives who have had breast cancer are at higher risk.

Personal history
A woman with cancer in one breast has a three to four times increased risk of developing a new cancer in the other breast or another part of the same breast.

Dense breast tissue
Women with dense breast tissue (as identified on a mammogram) have more glandular tissue and less fatty tissue and, thus, a higher risk of breast cancer.

Weight
Research has shown that being overweight or obese increases the risk of breast and other cancers.

Lifestyle
Excessive alcohol consumption, lack of physical activity, smoking and diets high in saturated fats contribute to risk.

Hormonal factors
Women who have not had a full-term pregnancy or have their first child after age 30 have a higher risk of breast cancer compared to women who gave birth before age 30.

Breastfeeding can lower the risk, especially if a woman breastfeeds for over a year.

Women who started menstruating before the age of 12 also have a higher risk. The same is true for women who go through menopause when they are older than 55.

Current or recent past users of hormone replacement therapy (HRT) have a higher risk of being diagnosed with breast cancer.

How to self-examine your breasts
The breast changes throughout the menstrual cycle, and it is crucial to always self-examine at the same time of the month, usually a week after your period when your breasts are less tender due to fluctuations in hormone levels.

Visual examination
Sit or stand naked in front of a mirror with your arms to your side and look for changes in size, shape, symmetry, puckering and dimpling.

Physical examination
Lie down so that your breast tissue spreads out, making it easier to feel, or in the shower, using soap to glide more easily over your breasts. Use the pads of your three middle fingers, not your fingertips, to examine.

Apply different pressure levels. Light to feel the breast tissue closest to the skin, medium to feel deeper and firm to feel the tissue closest to the chest and ribs.

Use a methodical technique like starting near the collarbone, then moving towards the nipples in a clockwork fashion.

Allow enough time, and don’t rush the examination.

Signs to look out for
It’s important to note that many lumps could be harmless, but having them checked is essential.

Visit your healthcare provider if you notice any of these changes:
• Swelling of all or part of the breast;

• Skin irritation, dimpling or ridges on the skin;

• Nipple pain or the nipple turning inward;

• Redness, scaliness or thickening of the nipple or breast skin;

• Nipple discharges other than breast milk;

• A lump or knot near the underarm area.

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