SamanthaNY
▄▀▄▀▄▀▄&
Okay, so I resorted to a bit of thread-title trickery to get you to open the post. It's an important topic, and I want people to read this. If trickery gets that done, I'm okay with it. This post is long and involved. I don't expect everyone to read it through, but I hope you try to take it in bits and pieces. Print it out. Show it to friends and family.
A number of years ago, I was sitting on the bed getting ready to go to sleep. I don't remember what caused me to find the lump in my right breast since I never did monthly self-exams. Always meant to... just never got around to it. But there it was. A lump. In my breast. Frantically, I felt around to see if it was possibly just... god, what could it be?? Is there one in the other breast too? (like that would make it *not* a lump). No, it's just there. And it's BIG. About the size of a quarter. SHIT. That's huge. Wait, this is craziness. It must just be the position I'm sitting in. I'll lie down and check. Damn. Still there. What the hell do I do now? It's... so big. That's bad!! That must be bad, right? It's nighttime... I can't call my doctor. Should I go to a hospital.. that seems silly. It doesn't hurt, maybe that means it's okay? My doctor said I have cysts - but never there. Can they move? Maybe they can. But... that doesn't feel like the others do. Oh, christ. I'm in big trouble. I never thought this would happen to me. It's cancer. That's it, I have cancer. Wait, my friend Lora has lumps, and none of hers were cancer, right? CANCER. God, that word. Fuck! I can't have cancer!
BSE = Breast Self Exam. Why are they important?
What are your risks for breast cancer?
Primary risk factors:
Factors placing you at greater risk:
What are the most common symptoms of breast cancer?
Okay. So the risks are daunting. If you're like me, you try to ignore most of the health horror stories we hear about being fat women. I listen, hear the multitude of things I'm going to die from, then I put it away. La, la la. Me? I'm fine!
But, sometimes we're not fine. I wasn't fine when I found the quarter sized lump in my breast. Had I done BSEs regularly, I would have found it earlier.
How to do BSE?
There are two basic steps to conducting a BSE:
Visual Examination
During the first part of the BSE, the visual examination, you look for changes in each breast. What is important in visual BSE is not the normal difference between your two breasts, but any change in one breast without a similar change in the other. The changes you have to look for include:
Stand in front of a mirror and look for the above changes in your breasts (from both a frontal and profile view) in 5 different positions:
This is the part of the examination when you need to feel your breasts for any changes. It is important to check the surrounding areas because breast cancer may be found in the lymph node tissue around the breast and underarm. Begin by lying in bed. Place a small pillow or folded towel under your left shoulder and your left hand behind your head. Your shoulder should be raised high enough for your left breast to be center on top of your chest, falling neither to the center nor toward the armpit; this arrangement distributes the breast tissue as evenly as possible across the chest wall. If a breast is not properly flattened against the chest, it is difficult to feel a lump particularly in the outer upper quadrant, where tissue is thickest (and where most cancers occur).Feel your breasts and surrounding areas, which include:
Patterns of breast examination
Spiral: Begin with a large circle around the perimeter of your breast and make smaller and smaller circles as you work your way toward the nipple.
Wedges: Pretend your breast is divided into sections like triangular pieces of a cake, begin in the nipple area and feel your breast in a small circular motion within one section, then move on to the next wedge starting in the nipple area again.
Vertical or linear: Pretend your breast is divided into vertical stripes. Begin on the underarm area on one side and feel your breast in a small circular motion up and down in a zig zag pattern till the whole breast is covered. Then repeat the process for the right breast with your left hand.
What to feel for?
Carefully notice the "feel" of your normal breast structure, so that you can note at once any changes from what is usual for you. Many women have a normal thickening or ridge of firm tissue under the lower curve of the breast, at its attachment to the chest wall; also the large milk ducts can be felt as a ring of bumps at the outer edge of the areola. In very slender women, the bony prominences of the chest wall may be mistaken for chest tumours, as may enlarged milk glands, fat tumours, lymph nodes, or benign cysts. All such thickenings should be felt carefully during each monthly BSE, in order to distinguish normal conditions from potentially dangerous changes. Any lump or other change found in one breast only (especially in the upper outer quadrant) is more likely to be serious. If in doubt about ANY development, consult your doctor.
In the shower
Many lumps are more easily felt when the breast and fingers are wet and slippery with soap lather, which reduces the friction. If your breasts are small, place one hand on your head and examine the breast on the side with your opposite had in an up-and-down pattern, as you do lying in bed. If your breasts are large or pendulous, you will be better able to feel them if you immobilize a breast with one hand (first supporting from below, then pressing down from above) and examine it with the other hand (first from above, and then from below).
If you find that you exhibit any of the characteristics as described above, do not delay. Go see your physician immediately for a clinical breast examination and other tests for a definite diagnosis.
Examining the fat breast
We're lumpy and bumpy, and often blessed with extra-large breasts. Standing in the shower isn't always comfortable for a very large person... so how to do an adequate exam? Here's what I recommend:
Take a large Ziploc freezer bag (they're thicker and sturdier), and put 1 tablespoon of oil inside the bag. Any oil will do. Remove as much air as possible while keeping the oil inside the bag (if it leaks out, start over), and SEAL THE BAG WELL. This step cannot be more important, lol. Also: If not Ziploc, use a good quality freezer bag.
Place the bag on your breast, and perform the 'shower' exam as described. The oil-filled ziploc will give you the frictionless touch that you need to feel breast tissue.
If you've read this far, you are to be commended!
As for the rest of my story, I went to my gynecologist who immediately sent me for a mammogram. Several of them. There was a large lump. The technician asked me if I had been hit by a baseball, or was something hard thrown at my chest? Hmm. I was sent to a surgeon. The surgeon examined me and said that the lump would have to come out and be tested. He said there was a 20% chance it was cancer... I don't know how he figured the odds.
After more mammograms where a wire was inserted in my breast (gross, and funny looking - but not painful... turns out there aren't many pain receptors in breast tissue) I had the lumpectomy under local anesthetic. The only thing that bothered me was the blood running down my armpit, and the smell of burning flesh as they cauterized the wound.
A few days later, the pathology report was in on my breast tissue. It was necrotic. That means it was "dead" tissue that had no blood supply. How the hell does dead tissue get in my breast? I thought back to the technician asking if I was hit. I wasn't hit, but years earlier, I did have a huge and horrible bruise across my chest when an ill-fitting seatbelt protected me during a violent car crash. That injury to my breast was so deep, the tissue had died.
I now have a 3 inch scar, but it's faded almost completely away. Since my story ended relatively well, I'm kind of glad to have that scar.
Take care of yourselves.
P.S. - Undoubtedly, there's more information out there on this topic. I gathered what I felt was good information, but I welcome additions, corrections, stories, comments.... whatever any of you wish to share. I only ask that we consider the importance of this topic, and give it the proper respect.
Sources:
So You Wanna
McKinley Health Center
DrNDTV
A number of years ago, I was sitting on the bed getting ready to go to sleep. I don't remember what caused me to find the lump in my right breast since I never did monthly self-exams. Always meant to... just never got around to it. But there it was. A lump. In my breast. Frantically, I felt around to see if it was possibly just... god, what could it be?? Is there one in the other breast too? (like that would make it *not* a lump). No, it's just there. And it's BIG. About the size of a quarter. SHIT. That's huge. Wait, this is craziness. It must just be the position I'm sitting in. I'll lie down and check. Damn. Still there. What the hell do I do now? It's... so big. That's bad!! That must be bad, right? It's nighttime... I can't call my doctor. Should I go to a hospital.. that seems silly. It doesn't hurt, maybe that means it's okay? My doctor said I have cysts - but never there. Can they move? Maybe they can. But... that doesn't feel like the others do. Oh, christ. I'm in big trouble. I never thought this would happen to me. It's cancer. That's it, I have cancer. Wait, my friend Lora has lumps, and none of hers were cancer, right? CANCER. God, that word. Fuck! I can't have cancer!
BSE = Breast Self Exam. Why are they important?
"There is a 1 in 10 chance that a woman will have breast cancer during her lifetime. Over 1,000,000 women find lumps in their breasts every year some of which are cancerous but most are benign. A simple Breast Self-Examination (BSE) can be the key to finding any abnormality early."
What are your risks for breast cancer?
Primary risk factors:
- Age: It is rare for women younger than 35 to have breast cancer. The risk increases with age. Most breast cancers occur in women older than 50 years.
- Family history: If your mother, sister, or daughter has developed breast cancer before menopause, you are three times more likely to develop the disease.
- Personal history: If you've had breast cancer, you have an increased risk of getting it again. Also, if you've had benign breast disease (e.g., fibrocystic breast disease), you are at an increased risk. Women with a family history of two first-degree relatives (mother or sisters) should seek consultation with a geneticist to see if they may possess an inherited gene that would significantly increase their risk of cancer. Family history of a second-degree relative (grandmother or aunt) increases risk by approximately 10%.
- Lifestyle: There is a lower incidence of breast cancer among women who exercise regularly and a higher proportion of breast cancer among obese women. There is also evidence that there is increased risk of breast cancer with increased alcohol use (i.e., 3 or more drinks per week).
Factors placing you at greater risk:
- If you began menstruating early (before age 12)
- If you take birth control pills (though evidence is not conclusive)
- If you never have children
- If you have children when you are 30 or older
- If you have menopause at 55 or older
- If you take Hormone Replacement Therapy (HRT)
- Obesity
- History of benign breast conditions
[*]Painless breast mass - 66%
[*] Painful breast mass - 11%
[*] Nipple discharge - 9%
Okay. So the risks are daunting. If you're like me, you try to ignore most of the health horror stories we hear about being fat women. I listen, hear the multitude of things I'm going to die from, then I put it away. La, la la. Me? I'm fine!
But, sometimes we're not fine. I wasn't fine when I found the quarter sized lump in my breast. Had I done BSEs regularly, I would have found it earlier.
How to do BSE?
There are two basic steps to conducting a BSE:
- Visual Examination
- Tactile Examination
Visual Examination
During the first part of the BSE, the visual examination, you look for changes in each breast. What is important in visual BSE is not the normal difference between your two breasts, but any change in one breast without a similar change in the other. The changes you have to look for include:
- Shape
- Size
- Contour or symmetry (is there a difference in the level between your nipples? Do both breasts look symmetrical?)
- Skin discoloration or dimpling
- Bumps/lumps NOTE: normal lumpiness, like in the week before and of your menstrual cycle, will appear as very small and separate lumps like the texture of an orange.
- Sores or scaly skin
- Discharge or puckering of the nipple
- Dimple
- Ulceration
Stand in front of a mirror and look for the above changes in your breasts (from both a frontal and profile view) in 5 different positions:
- With your arms raised
- With your arms down at your sides
(she looks happy, huh? Perhaps the Cruella deVille hairdo causes her sour expression)
- Bending forward
- with your hands on your hips and shoulders turned in
- with your arms relaxed hanging in front of you
This is the part of the examination when you need to feel your breasts for any changes. It is important to check the surrounding areas because breast cancer may be found in the lymph node tissue around the breast and underarm. Begin by lying in bed. Place a small pillow or folded towel under your left shoulder and your left hand behind your head. Your shoulder should be raised high enough for your left breast to be center on top of your chest, falling neither to the center nor toward the armpit; this arrangement distributes the breast tissue as evenly as possible across the chest wall. If a breast is not properly flattened against the chest, it is difficult to feel a lump particularly in the outer upper quadrant, where tissue is thickest (and where most cancers occur).Feel your breasts and surrounding areas, which include:
- the breast
- between the breast and underarm
- the underarm
- the area above the breast up to the collarbone and across to your shoulder
- light (move the skin without moving the tissue underneath)
- medium (midway into the tissue)
- hard (down to the ribs "on the verge of pain") When using any of the 3 patterns, you should always be using a circular rubbing motion without lifting your fingers.
Patterns of breast examination
Spiral: Begin with a large circle around the perimeter of your breast and make smaller and smaller circles as you work your way toward the nipple.
Wedges: Pretend your breast is divided into sections like triangular pieces of a cake, begin in the nipple area and feel your breast in a small circular motion within one section, then move on to the next wedge starting in the nipple area again.
Vertical or linear: Pretend your breast is divided into vertical stripes. Begin on the underarm area on one side and feel your breast in a small circular motion up and down in a zig zag pattern till the whole breast is covered. Then repeat the process for the right breast with your left hand.
What to feel for?
Carefully notice the "feel" of your normal breast structure, so that you can note at once any changes from what is usual for you. Many women have a normal thickening or ridge of firm tissue under the lower curve of the breast, at its attachment to the chest wall; also the large milk ducts can be felt as a ring of bumps at the outer edge of the areola. In very slender women, the bony prominences of the chest wall may be mistaken for chest tumours, as may enlarged milk glands, fat tumours, lymph nodes, or benign cysts. All such thickenings should be felt carefully during each monthly BSE, in order to distinguish normal conditions from potentially dangerous changes. Any lump or other change found in one breast only (especially in the upper outer quadrant) is more likely to be serious. If in doubt about ANY development, consult your doctor.
In the shower
Many lumps are more easily felt when the breast and fingers are wet and slippery with soap lather, which reduces the friction. If your breasts are small, place one hand on your head and examine the breast on the side with your opposite had in an up-and-down pattern, as you do lying in bed. If your breasts are large or pendulous, you will be better able to feel them if you immobilize a breast with one hand (first supporting from below, then pressing down from above) and examine it with the other hand (first from above, and then from below).
If you find that you exhibit any of the characteristics as described above, do not delay. Go see your physician immediately for a clinical breast examination and other tests for a definite diagnosis.
Examining the fat breast
We're lumpy and bumpy, and often blessed with extra-large breasts. Standing in the shower isn't always comfortable for a very large person... so how to do an adequate exam? Here's what I recommend:
Take a large Ziploc freezer bag (they're thicker and sturdier), and put 1 tablespoon of oil inside the bag. Any oil will do. Remove as much air as possible while keeping the oil inside the bag (if it leaks out, start over), and SEAL THE BAG WELL. This step cannot be more important, lol. Also: If not Ziploc, use a good quality freezer bag.
Place the bag on your breast, and perform the 'shower' exam as described. The oil-filled ziploc will give you the frictionless touch that you need to feel breast tissue.
If you've read this far, you are to be commended!
As for the rest of my story, I went to my gynecologist who immediately sent me for a mammogram. Several of them. There was a large lump. The technician asked me if I had been hit by a baseball, or was something hard thrown at my chest? Hmm. I was sent to a surgeon. The surgeon examined me and said that the lump would have to come out and be tested. He said there was a 20% chance it was cancer... I don't know how he figured the odds.
After more mammograms where a wire was inserted in my breast (gross, and funny looking - but not painful... turns out there aren't many pain receptors in breast tissue) I had the lumpectomy under local anesthetic. The only thing that bothered me was the blood running down my armpit, and the smell of burning flesh as they cauterized the wound.
A few days later, the pathology report was in on my breast tissue. It was necrotic. That means it was "dead" tissue that had no blood supply. How the hell does dead tissue get in my breast? I thought back to the technician asking if I was hit. I wasn't hit, but years earlier, I did have a huge and horrible bruise across my chest when an ill-fitting seatbelt protected me during a violent car crash. That injury to my breast was so deep, the tissue had died.
I now have a 3 inch scar, but it's faded almost completely away. Since my story ended relatively well, I'm kind of glad to have that scar.
Take care of yourselves.
P.S. - Undoubtedly, there's more information out there on this topic. I gathered what I felt was good information, but I welcome additions, corrections, stories, comments.... whatever any of you wish to share. I only ask that we consider the importance of this topic, and give it the proper respect.
Sources:
So You Wanna
McKinley Health Center
DrNDTV
