Time to Raise Awareness on Breast Cancer

Breast cancer is a malignant tumor of the lobules (milk-secreting glands) or ducts (milk-carrying ducts) in the breast. Breast cancer screenings are of great importance and can be diagnosed at an earlier stage with screening programs. Treatments of breast cancers detected in early stages are more successful and the patient's quality of life is significantly improved. Every year, October is known as Breast Cancer Awareness Month all over the world and activities are organized to raise awareness.

What are the risk factors?

These are factors that indicate that people who carry the defined factors are more likely to develop breast cancer than those who do not. It should not be forgotten that people who have these factors will not necessarily develop breast cancer.  

Gender: Being a woman is the main risk factor for breast cancer. Less than 1% of all breast cancer cases occur in men. Advanced age: Although we have recently observed an increase in the incidence in young women, the majority of breast cancer cases occur after the age of 50.   Past history of breast cancer: Women who have had breast cancer before are at higher risk of developing a second breast cancer.

Family history of breast cancer: A history of breast cancer in first-degree relatives, primarily mothers, sisters and daughters, increases the risk. Genetic mutations: Approximately 5-10% of breast cancers are related to genetic mutations, i.e. hereditary transmission. Early menstruation and/or late menopause: Menstruation before the age of 12 and menopause after the age of 55 increase the risk.
Never giving birth or giving birth late: Childbearing is one of the protective factors for breast cancer as it changes the body's menstrual cycle and hormone exposure. Therefore, never giving birth or giving birth after the age of 30 is known to increase the risk of breast cancer. Birth control pills: Studies have shown a slightly increased risk of breast cancer in those who use them for more than 10 years. Hormone replacement therapy: An increased risk of breast cancer has been observed in those who use it for more than 5-10 years. Smoking: Smoking has been associated with an increased risk of breast cancer. Alcohol intake: The risk of breast cancer increases in proportion to the amount of alcohol consumed. Obesity: Being overweight, especially after menopause, increases the risk of breast cancer Nutrition and lifestyle: : Being overweight is known to increase the risk of breast cancer. There are data suggesting that exercise reduces the risk of breast cancer. Receiving radiation treatment: Previous radiation to the breast/neck area increases the risk.

What are the examination findings?

Palpation of a mass in the breast: It is the most common finding. It is mostly a painless mass. The palpable mass may have 2 different structures. Cysts in the form of a fluid-filled sac are usually not among the symptoms of breast cancer. Solid masses filled with a different tissue should be investigated.
Changes in breast skin: Sometimes redness, swelling, thickening or orange peel appearance of the breast skin without a mass may be a sign of breast cancer.
Changes in the nipple: A new, inward recession of the nipple may be a sign of breast cancer. 
Discharge from the nipple: Not all discharge means cancer. You should consult your physician especially if there is a bloody or brown-black colored discharge that comes spontaneously without squeezing the breast.
Change in breast shape: There may be changes in breast shape and size,
A palpable lump in the armpit:  Enlarged axillary lymph nodes may indicate that cancer cells have reached the armpit. 
There are three methods that are recommended to be done together for early diagnosis:

Personal (Self) Breast Examination
Clinical (by a doctor) Breast Examination
Mammography
The screening imaging method currently used for breast cancer is mammography. After the age of 40, it is recommended to have a mammogram every year or every two years, depending on risk factors.

When is breast self-examination performed?

Every woman over 20 years of age within the first week after the end of menstruation,
A certain day of each month for women who do not menstruate,
Breastfeeding women are advised to examine themselves after breastfeeding or expressing milk.
What to look for in breast self-examination?

Abnormal growth, swelling or palpable lump in one of the breasts
Redness or thickening of the breast skin
Shape or color change in the nipple
Discharge from the nipple
Palpable mass under the buttocks
How is breast self-examination done?

First by observation and then by hand.

Visual examination:

Stand in front of a mirror, naked from the waist up.
Look with both arms hanging down.
Look with both arms raised up.
Look by pressing both hands on the waist.
Look by leaning forward while pressing both hands on the waist.

Manual examination:

Use the front sides of the 2.3.4 fingers of your hand.
Whichever side of the breast is to be examined, lift the hand on that side above your head and examine your breast area with your other hand in a circular motion.
After examining both breast areas standing up, lie down on a flat bed and repeat the same examination.
This year, the Turkish Society of Medical Oncology launched the "You are in control, the answer is in the gene" project. Prof. Dr. Gököz Doğu finally said that early diagnosis saves lives by saying that control is in our hands and advising all women to participate in free screening programs led by the Ministry of Health.