Monday, June 20, 2011


Even today, after a clinical breast examination, mammography or ultrasound of the breast, is frequently suggested that regular self-examination of the breast.

Many women, however, feel uncomfortable doing it, or not feeling up to the fear of discovering an anomaly. It is really useful in the present age, self-examination?
What are the odds of running into a very dangerous injury?

In the early seventies, the prospects for the treatment of patients with breast cancer were daunting.
On the one hand, in fact, the treatments which were available were the same for over seventy years and no new surgical technique, medication or progress had been made in recent decades.
All women were treated in the same way, with the total removal of the breast frequently followed by radiation therapy, regardless of age, nodule size and stage of disease.
On the other hand, was the high proportion of patients with large nodules and lymph nodes under the armpit, with a disease, in short, a fairly advanced.
Fear of being sick to find out, for fear mastectomy, misplaced sense of modesty, lack of attention to your body and disinformation, pushing many women who became aware of having a lump to underestimate the importance and hide themselves, their family and the doctor, until the situation became untenable.

In the meantime, however, the disease progressed and, in parallel, decreased the chances of recovery.

It was then that many groups, mostly made up of patients operated on, they began an intense piece of information to include women and make them an active part in the process of diagnosis, the technique of self-examination spreading of the breast.

Today women are very attentive to their body, aware of the importance of timely diagnosis and involved in prevention. Meanwhile, new surgical procedures have made possible curative care is not disfiguring, respecting the psycho-physical appearance and integrity, while new drugs and X-ray systems allow us to heal a growing number of people.
The view is, however, profoundly changed mainly through information campaigns and health education and radiological diagnosis of the mass screening, that have dramatically increased the percentage of patients who come to the surgeon with a disease in a very early stage and, therefore, with a good chance to heal.

In the current scenario is still justified to recommend breast self-examination?

Clinical studies conducted on this subject, have given a clear answer: self-examination does not affect healing rates in women who perform it, and you discover a lump.

The assumption, in fact, prevention is to find cancer when it has reached such dimensions that make it detectable with the hand.
The lump that can be "heard" by the woman or her doctor, has reached such dimensions so that it can not, except for exceptions, be described as "premature."
Prevention, or more correctly should be called, "the early diagnosis", is based rather on mammography can reveal nodules as small as to escape examination manual.
Is easy to understand, then, that the efforts of doctors must be concentrated in submitting the highest number of women over forty years with periodic mammography, then, the manual examination, especially one performed by the woman herself, becomes superfluous.

We must, then, consider that many women self-examination is a source of anxiety , without cause, feel the changes that actually are normal changes in the mammary gland during the fertile period or injury is not dangerous.
Ultimately, therefore, while recognizing self-examination to the merits mentioned above, one can safely say that this examination is not necessary, if the woman has regular mammograms or, if under forty years, specialist visits and ultrasound examinations according to the calendar your doctor recommends.
Of course, if the woman is able to perform self-exam properly, calmly, without fear or anxiety, and has a good knowledge of "how" it made her breasts, this test is not absolutely harmful and can help you feel quieter.

How to correctly perform the test?

The first thing to do is choose the most favorable time to take the test.
The breast, in the fertile period of life, shows, in fact, related to changes in monthly menstrual cycle.
The breast is composed of a glandular part, the one that produces the milk, and fat and fibrous tissue that supports the gland.
Everything is covered from the skin of the areola and nipple.
Each month, under the influence of hormones, the mammary gland is preparing for a possible pregnancy and subsequent lactation and, therefore, becomes more massive, compact, turgid, large to increase the number of cells and the water content, while the blood vessels swell to bring a greater amount of blood.
These changes, which hinder the palpation of the breast, reach their peak just before menstruation. At this stage it is better not to perform self-examination.
If pregnancy does not occur, after menstruation, the gland slowly resumes its regular feature: the swelling decreases, it becomes softer, the water content decreases and the contribution of blood, until in the tenth and the fourteenth day from 'beginning of the last menstruation, the breast begins again predispose for a possible pregnancy.
This is therefore the best time to perform self-examination, but also the medical examination and ultrasonography.
There is, however, some individual variability and therefore every woman should understand by experience what it is for her, the most favorable moment for self-examination.
For menopausal women, this rule does not apply because, with the loss of menstruation, the breast is no longer subject to cyclical changes.
After menopause, in addition, the mammary gland, no longer stimulated by hormones, is gradually undergo involution.
In other words, it shrinks until it disappears almost entirely and its place is taken by fatty tissue, making it much easier palpation, because fat is soft and smooth.
Again, however, there is wide variability. There are older women who still have abundant glandular and other debris, much younger, having a complete replacement of the glandular tissue with fat.
In women following hormonal therapy to combat menopause symptoms, palpation is preferably run around the fourteenth day.
It should be clear that those who follow replacement therapy should perform an annual mammography.

How to perform self-examination

The best position is standing in front of a mirror and observe, first, the appearance of their breasts, before abandoning arms along the body, after lifting them both up.
So you can highlight differences in shape between the two breasts, and changes the appearance, in particular, retractions, or depressions, or depressions in the skin of the nipple at any point of the breast.
The sinking of the nipple is a very common condition that often affects both breasts, and if present for a long time, is not dangerous.
If, however, the retraction appears suddenly to be reported to the doctor because it could be a sign of a lump placed immediately behind the nipple. Likewise, a retraction of the skin, not previously present, could be correlated with a lump in the substation and should encourage the woman to seek the advice of health.

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