Dr. Ayooluwa Iidowu, a consulting radiologist with a bias for breast cancer images in the Department of Radiology of the University College Hospital (UCH), Ibadan, in this interview with Sade Oguntola, talks about how women can avoid being a prey to breast cancer.
Why is early detection of breast cancer and how can this be achieved?
Breast cancer is a threat; We all know that many women die from breast cancer. Around one in eight women will experience breast cancer in their life, so each woman needs to be examined to detect breast cancer. We have what is called triple evaluation. The first SEP is for a woman to come to a clinical breast exam, where a doctor will feel her breasts, that is, palpated. The second step is the image of the breasts. The woman's age will determine what type of image should suffer. A woman who is 40 years old or more will undergo a mammogram, but a woman who is under 40 will undergo sinus ultrasound.
However, a woman labeled with 'high risk' can still suffer a mammogram if she is under 40 years old, particularly if she has a family relationship that had breast cancer. Women with positive family history of breast cancer should begin early sinus detection at age 35. For example, if a woman had breast cancer at age 40, her daughter is expected to begin to be examined for cancer at age 30. That is the guide.
However, for the average population, a woman must begin to make her mammography at age 40, and has to be annual. That is Nigeria's policy, although in the United Kingdom, they do it every three years.
The third step is biopsy. If a doctor detects something during a clinical breast examination, which implies feeling the breast, that is, the palpation, the woman will be sent to obtain images to confirm that there is a dough in fact and then a biopsy will be carried out depending on the appearance of that mass in the images. If the dough looks “suspicious”, the dough must be biopsy. And this will be sent to the pathologist, which will then see if it is benign or malignant. So, if it is malignant, he only says that it is breast cancer. If she is benign, it only means that the woman does not need to worry about that; It is not likely to become breast cancer.
However, we have some injuries within the breast conditions of the breast. They are not cancer per se. But once they are in the chest, the woman must be careful. It is a risk factor for a woman who develops breast cancer. For example, we have atypical ductal hyperplasia, which is not cancer. But if he found, that woman has an increased risk of having breast cancer.
When do you need the breast self -examination? When do you need a clinic to take a look at your bosom?
Once a woman is 20 years old, she must do a breast exam once a month. During menstruation, many women go through what we call premenstrual symptoms. The breast can feel lump at that time. Then, between day three and five after menstruation, those are the best days to make a breast self -examination once a month. A woman who is pregnant can also do it, also a woman who is breastfeeding. All you need to do is empty your milk chest and then examine it. Similarly, a woman who has stopped menstruation can choose her date of birth to examine her breasts monthly. She can establish an alarm as a reminder since there are no menstruations. This breast exam can be done while standing or lying down. The flat part of the three fingers moves in a circular movement of mild to deep pressure around each bosom, reaching the nipple, the clavicle and then under the armpit. Put your hand next to the breast to be examined under the head and then use the other hand to verify that breast. The breast exam is easier, preferably when it is in the shower and there is soap on the woman's skin. Of course, different techniques can be used or adopted.
What are you looking for?
We are looking for lumps most of the time. The bulge usually feels like a hard seed or nut. And then, depending on the size, sometimes you can feel like a lime or a walnut. It is likely that soft are not evil, so not all packages are cancerous. Even when it is not difficult, there must still be a biopsy for each bulge that looks “suspicious.”
Then, before starting to feel, I first look at the breast in the mirror. Are they the same size? Usually, one breast is slightly larger than the other. However, there should not be an obvious difference. In addition, there should be no warmth, redness, thickening, an appearance similar to cod or an eruption “Peau d'Onnge”, such as the cortex of an orange in the skin of the breast. There should be no pain or darkening breast skin or a discharge such as the liquid that comes from the nipple. So those are the things we are looking for. Once everyone is discarded, it is when you start feeling and then verify how the breast is seen.
The clinical examination of the breasts also follows this procedure, which is the same as a doctor will do in the hospital. Therefore, it is advised that if a woman is under 40, she should have a knowledgeable health professional about it, examine her breast once every two or three years. Once a woman is over 40 years old, the doctor must take the clinical breast exam once a year and that the doctor tells her that everything is fine. And at the same time, she should also have a mammogram. Magnetic resonance (MRI) is not the general detection tool; It is reserved for women who have a high risk of breast cancer who are women with positive family history of breast cancer. Mom Momsonance can also be done in women with breast to determine the scope of the disease.
Can you talk a little more about mammography? What does it imply? What are they looking for? Is it a painful procedure? Is it something that women can enter the hospital and have done easily?
Yes, a mammogram is an X -ray procedure, although these are low -dose x -rays to which breasts are exposed and for women over 40 can do so. In Nigeria, you enter the hospital to make a mammogram, except that you may need to book. It is a bit painful because the breasts will be compressed by the river pallets. Then, the X-ray machine is going to surround it, depending on the type of X-ray machine. If it is a digital sinus volume Detection of breast cancer, especially for women with a positive family history of breast cancer.
Mammography detects cancers even before the doctor can feel them. That is why a woman needs to make a mammogram regularly. Breast cancer could have a revealing sign in the images two or three years before it becomes a lump. There could be what is called suspicious microcalcifications. We are looking for four things in a mammogram. These are architectural distortion, asymmetry or asymmetric density, suspicious calcifications and mass. We do not want to see if there is a dough; We want to choose it at an early stage, what we call the zero stage. We want to see if the dough is still contained and treatable or if the whole place is full of many packages, and then if it has entered the armpits or the other breasts.
Then, a woman greater than 40 years can go for annual mammogram. A woman can begin to have an annual mammogram depending on her age and the age of her family member who had/has a history of breast cancer. It is also important that women are monitored; She also needs to have a magnetic resonance, advice and genetic detection for genes that cause cancer such as BRCA1 and BRCA2. Early detection is important, since it is more curable. The breast is composed of breast fabric, and then we have fat that supports it, ducts and blood vessels. Then, any structure within the bosom can develop breast cancer.
If mammograms can collect suspicious cases of breast cancer long before the breast self -examination and the clinical examination of the breasts, cannot be used to detect breast cancer?
Detection means that you want to make sure there is no cancer. Auto-Miel self-examination is not a detection tool for breast cancer. It is just what women can easily do at home. Even if a lump is detected, you will still need an image tool for diagnosis, which is also mammography. In addition, ultrasound scan is not used a detection tool because it will not collect any microcalcification, as well as the auto-rash test. That is why there is a need for a mammogram to take a look and see if there are microcalcifications. But not all microcalcifications are cancerous.
But experts advocate mammograms as a detection tool instead of a magnetic resonance. He cannot advocate that each woman will make a breast magnetic resonance. It is very expensive and reserved for high -risk women. Mamographies are affordable. However, detection with a mammogram is not covered by health insurance, except when there is already a disease in the bosom. Even then, women will still need to pay half their price. However, then, a biopsy is important to determine if the bulge is benign or malignant.
If there is a role for the clinical examination of the breasts in the early general detection of breast cancer, why is there any problem regarding this?
There is a problem because many women are not reviewing their breasts. Participation even for breast detection in many communities is poor; The mentality of many women is that there is nothing wrong with them. I feel nothing, so, why should I come to the hospital to spend hours with a health professional to review my breast or have a mammogram? But the early detection of breast cancer begins with all women knowing their breasts. They need to know how it feels and looks so that if something goes wrong, they will know. If you don't do it monthly, you won't know how those breasts feel. Maybe you felt by mistake while menstruating. So ask why my breasts are so lumpy?
But if he knew that when he is being menstruated, they can be thicker, then, after three to five days, they are established, and then that is how they should be. Therefore, women must know their breasts first before they can detect something different early. And then you have to do the mammogram annually. The first will be reference detection mammography. If you are doing it annually, we will now check it against you to see if something is changing in your breasts. The breasts are not staying the same either; They also change. As a woman ages, the breast fabric becomes less dense. The breast fabric is also being replaced by fat.
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