By Marc Eid | Medical Student at USJ
Breast cancer is the most frequent cancer in women worldwide, affecting over 2 million women every year. It is also one of the leading causes of cancer deaths in women (1). It is estimated that 1 in 8 women will develop breast cancer in their lifetime (2). Awareness about breast cancer is incredibly important, as early detection, often through screening, can catch the disease when it is most treatable and thus is associated with an increased survival.
A common misconception is that breast cancer affects exclusively women. In fact, males can be diagnosed with breast cancer but one should keep in mind that it is very rare, accounting for 1% of all breast cancer cases (2).
People often think that women with no family history of breast cancer are not at risk. Having a relative with breast cancer is a major risk factor but it is important to keep in mind that most women diagnosed with breast cancer have no history of the disease in their family. In fact, breast cancer is more commonly associated with environmental, reproductive, and life-style factors such as age, early menarche (first menstrual period), late menopause, first pregnancy at a late age and excessive alcohol consumption (3,4). However, some factors can help reduce the risk of breast cancer such as breastfeeding and physical activity (5,6).
Breast cancer most commonly presents as a painless lump or thickening in the breast. Thus, it is important that women finding an abnormal lump in their breast consult their physician. However, breast cancer does not always cause a palpable lump. For instance, it can also present as skin changes in one or both breasts such as swelling or redness, an increase in size or change in shape of the breast, nipple discharge other than breast milk or pain in any area of the breasts (7).
Over the past years, breast cancer survival rates have increased due to both a diagnosis at an early stage and advances in treatment (2). The early diagnosis of breast cancer, even when it is still asymptomatic, has been possible thanks to the use of the mammography. Thus, throughout the world, breast cancer screening through mammograms, and awareness campaigns have been spreading. October, known as Pink October, has been proclaimed the national breast cancer awareness month and has been associated with the use of a pink ribbon logo, the universal symbol of breast cancer. In fact, during breast cancer awareness month in October, people wear pink ribbons to evoke solidarity with women who currently have breast cancer, honor survivors, remember those lost to the disease, and support the progress we are making together to defeat breast cancer (8). The long-standing awareness campaign definitely means different things to different people. For some, it’s about celebrating strength and survival. For others, it’s about raising awareness and removing the stigma. This is incredibly important because awareness is the first step towards an early detection and thus a better chance at fighting breast cancer.
Since 2002, the Lebanese Ministry of Public Health organizes a 3-month yearly campaign from October till December, where eligible women are invited to undergo a mammography in participating centers at a discounted price (9). It is recommended for women to conduct mammographies yearly starting the age of 40 in order to diagnose breast cancer while it is still asymptomatic and at an early stage (10). This being said, a normal mammogram should not delay the next one which should be repeated the next year.
Breast cancer screening based on the mammography is recommended starting the age of 40 but one should keep in mind that breast cancer can occur before that age. Thus, women should consider a breast self-exam every month starting the age of 20 to look and feel for changes. The best time to examine your breasts is 7 to 10 days after the start of your period, when your breasts are least tender and least swollen. If you no longer have periods, then choose a date that is easy to remember. There’s no special technique, it’s as easy as TLC: Touch your breasts, Look for changes, Check any changes with your physician (11).
In conclusion, do not hesitate to schedule your annual mammogram as soon as possible. Early Detection Saves Lives.
1. WHO Breast Cancer. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer
2. Stuckey A. Breast cancer: epidemiology and risk factors. Clin Obstet Gynecol. 2011 Mar;54(1):96-102.
3. Momenimovahed Z, Salehiniya H. Epidemiological characteristics of and risk factors for breast cancer in the world. BCTT. 2019 Apr;Volume 11:151–64.
4. Vieira R, Tobar JSS, Dardes R, Santos Thuler LC. Alcohol Consumption as a Risk Factor for Breast Cancer Development: A Case-Control Study in Brazil. Asian Pac J Cancer Prev. 2018. Available from: https://doi.org/10.22034/APJCP.2018.19.3.703
5. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002 Jul 20;360(9328):187–95.
6. McTiernan A, Kooperberg C, White E, Wilcox S, Coates R, Adams-Campbell LL, et al. Recreational Physical Activity and the Risk of Breast Cancer in Postmenopausal Women. JAMA. 2003.
7. CDCBreastCancer. What Are the Symptoms of Breast Cancer? Centers for Disease Control and Prevention. 2020. Available from: https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm
8. Harvey JA, Strahilevitz MA. The Power of Pink: Cause-Related Marketing and the Impact on Breast Cancer. Journal of the American College of Radiology. 2009 Jan 1;6(1):26–32.
9. Ministry of Public Health. National Breast Cancer Awareness Campaign 2019. Available: www.moph.gov.lb
10. Adib SM, El Saghir NS, Ammar W. Guidelines for breast cancer screening in Lebanon Public Health Communication. J Med Liban. 2009 Jun;57(2):72–4.
11. Breast Self-Exam: How to Perform, What to Look For. Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/diagnostics/3990-breast-self-exam