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Patient Educ.(13)Breast Care




Currently breast cancer strikes more than 135,000 American women annually. One out of nine women will be diagnosed with breast cancer during her lifetime. Every woman should take the time to examine her breasts for signs of possible cancer. All women, not only those with prior breast lumps, benign or malignant, should learn and practice monthly breast self-examination (BSE). Breast cancer cannot be prevented; therefore, early detection is your best protection against breast cancer.

The consistency of breast tissue varies from woman to woman. By examining your breasts carefully at the same time each month, you will be able to notice any unusual changes, signs, or symptoms of breast cancer.

The following list will help you become aware of what to look for:

  1. A lump or thickening of the breast
  2. A discharge from the nipple
  3. Dimpling or puckering of the skin
  4. Retraction of the nipple
  5. Scaly skin around the nipple
  6. Other changes in skin color or texture, such as "Orange Peel" skin
  7. Swelling, redness, or heat in the breast
  8. A lump under the arm

The best approach to breast health care is three fold:

1) Monthly BSE (Breast Self-Exam),

2) A routine yearly exam by a doctor. An exception is for women with previous breast problems. These women should be examined by their doctor every three months.

3) After age thirty-five a baseline mammogram should be performed. A woman should have a mammogram every two years until age forty (our recommendation). Thereafter, it should be done annually, unless otherwise indicated by your doctor. Mammography is the single most accurate screening tool available to detect cancer in its earliest and most curable stages.

Mammograms are 80 to 85 percent accurate and can even detect lumps that are too small to be felt. In some instances a lump can not be detected on the mammogram even though you or your surgeon can feel it. The reason for this is the lump is transparent and it will not appear on your mammogram. Mammograms are not 100 percent accurate; therefore, it is crucial to have a physical exam as well as a mammogram.

Mammograms can detect very small lumps- less than one quarter of an inch. Most lumps can not be felt until they are at least a half an inch. Precancers can also be found on mammograms. These are the earliest demonstrable forms of breast cancer.

It is best to have all your mammograms done at the same facility so that subtle changes can be detected more easily, and techniques, equipment and interpretation are less likely to vary. Once again, even if you get a clean bill of health from a mammogram, you should still do monthly BSE at home on a regular basis.

Remember the three "ams":

1) Mammogram,

2) Doctor’s exam, and

3) Breast Self-Exam.

Certain women are at a greater risk for developing breast cancer. These women need to be identified and followed more closely. The risk factors for women most likely to get breast cancer are as follows:


  1. Women 50 years or over
  2. Women whose mother or sister has had breast cancer, particularly if the disease occurred when the patient was premenopausal
  3. Women who have already had breast cancer


  1. Women with precancerous breast disease
  2. Women with breast cysts proven by aspiration or surgery
  3. Women who have never had children
  4. Women who had first child after age 30
  5. Women who started first menstrual period at the age of 12 or younger
  6. Women who have experienced menopause after 55
  7. Women who are obese
  8. Women who consumes large amount of alcohol

Each woman is a separate individual and her risk factors can be quite variable.

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