Having a lump in the chest is something that especially worries women. And in a way, rightly so. According to the GLOBOCAN 2012 report, the prediction for 2015 is 227,076 cases of cancer in Spain, with breast cancer being the most frequent among women and the one that causes the greatest number of deaths in them. In us.
I know, I know, these are not ways to start on a Monday. And much less this post Christmas week in which we are supposed to go back to that blessed? routine that some inexplicably adore. For the part that touches me, I was much more relaxed in my holiday chaos and I gave him my routine of working and getting up early to remove legacies from my children to whoever loves her. Free.
It turns out that The Professor of Physics , a Naukas blogger , launched a challenge last week that consisted of writing posts on scientific dissemination today with the hashtag #lunesTetas. The theme is not figurative, it is about talking about boobs. Although in this blog I do not strictly disclose scientific but health, I think that apothecaries have a lot to say about disclosure in general, and about boobs in particular, and I have decided to join the cause. In fact, I already wrote a post that raised an ampoule a few months ago to dismantle a myth related to boobs , specifically the myth of silver teat cups. Yes, a kind of Madonna roll cases in Blond Ambition which are supposed to prevent mastitis, there is nothing.
The issue of the bulge in the chest is perhaps less fun than that of the bulletproof liners, but it is important so today we will talk about it.
If I have a lump in my chest … do I have cancer?
Not necessarily. In fact, most abnormalities seen in the chest do not imply that breast cancer will develop later. Most often it is fibrosis, cysts or benign tumors. As a curiosity, the main difference between a cyst and a tumor is that the cyst is filled with fluid and the tumor is solid.
Is self-examination helpful in detecting breast cancer?
To touch or not to touch, that is the question.
There is controversy over whether it really has any use for women to periodically self-examine for any possible breast lumps or breast irregularities. The own Ministry of Health of Spain in a document on the strategy in cancer of 2010 exposes the following:
Regarding breast self-examination, there is reasonable evidence of absence of benefit and good evidence of harm, so its practice should not be recommended.
That is, theoretically, in this country the official recommendation is not to touch . Why? Because there are studies that show that women who touch end up going to the doctor more times and have many more benign biopsies performed, but a greater number of malignant tumors are not detected in them than in those who do not touch themselves .
For its part, the WHO is somewhat less blunt in a document on the prevention and control of breast cancer:
Consequently, self-examination is recommended to promote awareness among women at risk, rather than as a screening method.
The WHO (and other thinking minds) recognize the scant evidence but define self-exploration as a way for women to become involved in their self-care through (this is now finely known as empowerment) .
And now what do I do? Do I or do I not scan my breasts?
Each teacher has his booklet and indeed there are many gynecologists who nowadays recommend self-examination. Without going any further, Don Fermín Pistolero, my gynecologist has always recommended the periodic self-examination with devotion. Do you touch yourself frequently? is one of his star phrases next to do you plan to get pregnant this year? (Although the question bothers me a bit now, I know that at some point I will miss asking it).
If the gynecologist recommends self-examination, it is convenient to ask that of how? when? and where? In other words, do not leave the consultation without clear instructions on how to do the palpation so that it can be of use. If for any reason we do not achieve our goal or later do not remember the instructions the gynecologist gave us, below is a way to do the self-exam.
A monthly frequency of breast self-examination is recommended:
– If the lady has menopause, set one day a month (putting an alert on the phone can be useful).
– If menopause has not been reached, the examination should be done 3-5 days after the end of menstruation, since during it there may be breast tension and inflammation and can lead to confusion.
There are different techniques, but basically the exploration has three steps:
- Observationof the breasts in front of the mirror with the arms dropped, in order to detect different sizes of the breasts or changes in the surface of the skin (wrinkles, deformations, lumps) and nipples.
- Same observation but with arms raised.
- Palpation: it is recommended to do it lying on the bed, with one hand behind the head. The left breast should be explored with the right hand and vice versa. The “explored terrain” should be wide (from armpit to abdomen), making, for example, small circles with your fingertips. You should also apply a little pressure to the nipples to check for fluid discharge.
If any significant change is observed on this examination, a physician should be consulted.
Are mammograms really helpful?
Although we have discussed the controversy regarding the efficacy of self-examination, there is evidence that mammograms reduce the risk of dying from breast cancer. As much as some politician tries to the contrary, mammograms as screening tests are not useful, they are essential.
According to Royal Decree 1030/2006, a mammogram will be carried out on September 15 for all women between 50 and 69 years every two years . Women, even in remote towns of the Spanish geography, are provided with a collective bus transport so they can be examined at their hospital or reference specialty center. All this if they want, of course. There are always cases like that of Mrs. Jerónima, which I will tell you next.
The Apothecary’s advice
A few years ago, Mrs. Jerónima, a visibly worried older woman asked for help in the pharmacy making an aside:
– Apothecary, I think I have cancer. I have a lump in my chest.
She was terrified of going to the doctor (the gynecologist was implacable) and had thought that perhaps the pharmacist could “keep an eye on her.” Mrs. Jerónima described having different sized breasts and a mysterious hard lump that had grown on one of them. She was on the verge of tears so the pharmacist passed it to the bathroom and “took a look at it.”
After the apothecary’s initial shock, it turned out it wasn’t cancer.
Mrs. Jerónima, who was panicking to go to the doctor, apparently also had panic to wash herself and, due to a misunderstanding of modesty, she had not washed her breasts since she bathed in the river in 1940. The accumulation of secretions in one of her nipples throughout life had formed a scab for whose removal the warm water and soap would not be enough: a radial seemed necessary.
Now, now, I will be a bit rough, but Mrs. Jerónima too. She and many other women who, without going to that extreme, deliberately choose to ignore her body out of fear or embarrassment . Unfortunately it is not a thing of the past, today it continues to happen. And not only in older people. Gynecologists and dentists should have their space at the Amusement Park Horror House alongside Freddy Krueger. Petaban.
Regardless of what the gynecologist’s advice about breast self-examination is, the truth is that each woman should have a minimum of knowledge about her body that alerts her to possible changes in it and, of course, go to a gynecological review annual. Scares like that of Mrs. Jerónima and her mysterious lump on her chest would be saved.