By Patricia B. Mirasol
THE more Filipinas perform early breast cancer detection, the higher the survival rate of the disease in the country will be.
At age 20, females are advised to learn and perform a breast self-exam (BSE) monthly. At age 30, an annual clinical breast exam by a doctor or a trained healthcare worker is recommended in conjunction with the monthly BSEs. At age 40, a low-dose X-ray of the breast called a mammogram is ideally added to the early detection equation.
“I can’t stress enough the importance of having a mammogram,” said Dr. Leya Suzette Evangelista- Espino, a radiologist from The Medical City, in an Oct. 30 webinar organized by the hospital. “A mammogram has the advantage of detecting breast cancer at the earliest stages. Even lumps that can’t be palpated can be detected in a mammogram,” she added in the vernacular.
The general symptoms of breast cancer are a lump or thickening of the breast; an alteration in the appearance of the breast; a dimpling in the skin of the breast, including the area surrounding the nipple; and/or a discharge in the nipple.
A survey published this October by Milieu Insight, a Singapore-based consumer data and analytics company, found that while 81% of Filipinas say they are familiar with breast cancer symptoms, less than half (or 45%) aged 30 years and above know the recommended frequency of a BSE. Only one-fifth (or 22%) of the same age group also know the recommended age for regular mammogram screening.
The 10-year survival rate among Filipinas with breast cancer is 57%.
Inasmuch as screening tests are an important tool for finding breast changes that could be cancer before physical symptoms develop, no one test is infallible.
Menstruating women can have prominent fibroglandular breast tissue, and these dense areas of the breast make lesions harder to find in a mammogram, Dr. Espino told the webinar audience.
“[For these cases], it is usually advised to also have a breast ultrasound,” she said, noting that the ancillary procedure can tell whether a breast lump that was seen in a mammogram is fluid-filled or a solid tumor.
Dr. Espino added that a breast ultrasound is advisable for pregnant women as well, since it does not use radiation and is thus safe for the fetus.
DIAGNOSTIC WORKUP
Breast masses develop for many reasons, and around 90% of these are not cancerous, according to the World Health Organization.
Individuals with persistent abnormalities (or those that last more than a month) or patterns that suggest malignancy (such as calcium deposits called calcifications) may be advised to undergo further workups such as an ultrasound-guided needle biopsy of the breast.
This procedure entails administration of local anesthesia and an incision of around .2–.3 cm to insert the said needle, said Dr. Lea Angela Pineda, a breast surgeon from The Medical City.
“We see the needle target the specific lump, and this avoids false negative results,” she said in the vernacular. The guided visualization also protects those with lumps close to the chest wall from having the needle prick an area outside of the lump, Dr. Pineda added. “We need to have the biopsy done so we can figure out how to help you.”
How to perform a breast self-exam
ICanServe Foundation, Inc., an early breast cancer detection advocacy group, outlines the steps to performing a breast self-exam:
- Lie down with your back resting on a flat, comfortable surface. Raise your left arm and put a pillow or rolled towel below your left shoulder.
- Use the three middle fingers of your right hand to feel for lumps, making sure they are pressed together. Use the convex of these three fingers together (not the fingertips) to feel for lumps.
- Keep your fingers straight and press them together on your left breast.
- Using vertical movements, begin from armpits and move fingers downward until below the breast. Move toward the middle and back up. Repeat through the chest and entire breast.
- Feel under and around the nipple.
- Repeat on your right breast using your left hand.