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Frequently Asked Questions (FAQ)
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Breast Self Exam
A breast self-exam (BSE) involves a woman examining her own breasts. Regular self-exam helps a woman become familiar with the normal look and feel of her breast tissue. A breast self-exam involves visually looking at the skin, breast tissue, nipples, and underarms as well as manually palpating all breast tissue to determine the normal geography of individual breast tissue. When a woman regularly examines her breasts and knows their normal look and feel, she can more easily detect small changes to notify her health care provider.
Most major cancer organizations agree that breast self-exam is an option for women beginning at age 20. Early practice of breast self-exam can establish a baseline for how a woman’s breasts normally look and feel, enabling her to more easily detect changes later on. Women in their 20s, for whom mammography is inappropriate, may find that manual examination (either self-exam or clinical exam) is the only screening method available to them. As an advocate for her own health, a woman may choose to learn and perform BSE to participate in the early detection of abnormal breast changes.
“Breast self-awareness” is a term that describes an overall understanding of breast health and familiarity with the normal look and feel of one’s own breasts. “Breast self-exam” is one component of – and leads directly to – breast self-awareness; during the course of self-examination a woman increases her awareness of the normal look and feel of her breasts. As an active participant in her health, a woman can learn and perform best-practice BSE to improve her breast self-awareness
No. While any self-exam is better than no self-exam, some methods are better at improving breast self-awareness. The MammaCare Method® of breast self-exam is the only scientifically-validated method that teaches fingers what to feel for. The ability to touch silicone breast models specifically engineered to feel like real breast structures helps women identify normal structures in their own breasts and detect any abnormal changes.
Any woman can learn to do MammaCare breast self-exam (BSE). Our “MY Breast Friend” Learning kits allow women to palpate the tactually-accurate breast models and learn exam techniques from the instructional training video in the privacy of their own homes. Find out more HERE
Breast cancer is a malignant tumor that has developed from cells in the breast. An invasive tumor is a group of cancer cells that may invade surrounding tissues or spread to other areas of the body. Breast cancer is the second most common cancer diagnosed in women in the United States with nearly 250,000 new cases each year. Advances in research to understand, detect, and treat breast cancer in recent years are associated with a decrease in the rate of deaths from the disease
Middle-aged and older women are the most likely to be diagnosed with breast cancer although the disease afflicts women of all ages. The median age at diagnosis in the United States is 61. Men are rarely diagnosed with breast cancer. The number of new breast cancer cases remained level from 2001-2010, while deaths from the disease decreased steadily over the same time period
Although there is no known cause of breast cancer, certain risk factors have been identified. The most significant risk factors for breast cancer are gender and age. Women are at greater risk for developing breast cancer than are men because women have many more breast cells than men. Additionally, a woman’s risk of developing breast cancer increases with age. Some risk factors cannot be changed, such as genetics and family history. Having a first-degree relative (e.g., mother, sister, daughter) with breast cancer can almost double a woman’s risk. Women who carry BRCA1 or BRCA2 genes have up to an 85 percent chance of developing breast cancer during their lifetimes, though genetic factors account for only 5 to 10 percent of breast cancer cases. Other risk factors that cannot be changed include dense breast tissue, race and ethnicity, personal history of breast cancer, and certain benign breast conditions.
Women can take steps to reduce their risk by modifying certain lifestyle behaviors such as limiting alcohol use and increasing physical activity. There are many factors with uncertain, controversial, or unproven effect on breast cancer risk including the use of antiperspirants, chemicals in the environment, bras, and tobacco smoke. Women should speak with their health care providers about assessing risk for developing breast cancer and taking steps toward a healthy lifestyle to reduce risk wherever possible.
Abnormal changes in the breast may be signs of breast cancer. Some changes are visible just by looking, while most occur below the surface of the skin. A lump within a breast that persists beyond the monthly cycle is considered suspicious and should be examined by a health professional. Skilled self exams can help women learn the normal look and feel of their breasts so that they can detect a suspicious tumor when it is small. A clinician may notice a suspicious lump during a clinical breast examination. Lumps and changes underneath the surface of the skin can be distinguished from normal breast structures by fingers that have been trained using the MammaCare Method®. Any unusual changes in the skin or within the breast should be brought to a health care provider, even if a recent mammogram was normal. Visual changes might include redness, swelling, changes in the shape or contour of the breast (e.g. puckering, dimpling), large or pronounced vein changes, and excessive or bloody nipple discharge.
What are the Risks?
Breast cancer is the second most common cancer in the world and is fatal for more than a half million woman annually. Early detection and treatment of breast cancer are positively associated with survival and a breast lump that can be felt is the most common first symptom. When the cancer is small, less than <1cm (pea sized) and has not spread, the patient’s 15 year survival exceeds 88% as indicated in the table below. It is not surprising that failures in diagnosing and treating breast cancer represent the most frequent cause of successful malpractice claims in the United States. In response the US National Cancer Institute and National Science Foundation (NSF) and National Cancer Institute supported development of a safe, low cost screening program that provides an effective means to detect small, early breast cancer without increasing false positive alarms. Known as MammaCare®, scientists at the University of Florida conducted an extensive series of studies confirming that the sense of touch, when properly trained, can reliably detect the difference between small breast cancers and normal breast structures. The MammaCare® Foundation’s mission is to make the training program and technology available to all women and their practitioners for early breast cancer detection.
Adapted from “Tumour size predicts long-term survival among women with lymph node-positive breast cancer,” by S.A. Narod, 2012, Current Oncology, 19(5), 249-253.
Evidence confirms that early breast cancer detection, combined with advances in treatment, are the key to long-term survival and quality of life. While large-scale screening programs have decreased the number of late-stage cancers, conflicting screening recommendations have created confusion about when to start screening, what the best methods and frequency of screenings.
Mammograms (breast x-rays) remain the most frequently used screen although a substantial portion of breast cancer is not visible on mammograms and they are inadvisable for screening women younger than 40 years old and women of any age with dense breast tissue. Clinical breast exams, performed by trained hands, can detect small palpable breast cancers and cancers missed or invisible on mammograms. A recent national study of 89,000 Canadian women examined over 25 years examines by the hands of trained nurses as well as self-exams or by mammograms alone found there was no difference in the total number of cancers detected or the in the life span of women in either group.
Recent research studies also found that skilled clinical or self-exams detect breast cancer after and between screening mammograms. Referred to as interval cancers, they are detected after a screening mammogram has found no signs of cancer. These “interval” cancers are most often found through touch – by a woman herself, by her partner, or by a clinician. Understanding that early breast cancer detection is correlated with better treatment outcomes and long-term survival, researchers have focused on better interval cancer detection in recent years:
While breast cancer among women under 50 is less common, its occurrence is often marked by more aggressive and deadly forms of cancer. Mammograms are not recommended for screening women under 50 years of age, limiting their options and leading to cancers that present at later stages with poorer survival outcomes. Palpation-based screening options are the primary tool available to typical-risk women under 50, and many agencies recommend “breast self-awareness” to young women without concrete strategies for achieving this awareness. The MammaCare Method® of Breast Self-Exam is an option for women beginning in their 20's to establish an evidence-based exam technique to promote awareness of the normal look and feel of their breasts.
What Do Different types of lumps feel like?
Breast cancer often presents itself when a woman notices something out of the ordinary in her breast, a lump that feels different from the feeling of surrounding tissues and structures or a change, something new and different that was not felt before. That is why it is important to know what your breasts normally feel like so that you will notice a difference that persists.
Feeling a lump is the first symptom of breast cancer for many women but as explained below, breast tissue is naturally lumpy and most lumps are normal. The most common question asked is, “What does breast cancer feel like?” To answer that question, the National Cancer Institute (NCI) supported research and development of standards and creation of tactually accurate breast simulation models that teach fingers what to feel for.
There are many reasons why you may feel a lump in your breast. Most of the lumps you may feel are likely benign. Common causes of benign breast lumps include: - Normal swelling and tenderness - Fibroadenoma (normal fibrous tissue) - Fat necrosis (bruised, injured or dead fatty tissue) - Breast cysts (benign water filled lumps) Infection - Lipoma (encapsulated group of fat cells) benign changes in breast cells.
Yes, fingers are exquisitely well designed to detect the difference between normal breast tissue because suspicious lumps are tactually different. There have been many attempts to describe in words or on videos what our fingers feel during a breast exam. Words like hard, soft, irregular shape, defined borders, fixed, or movable can be useful, but to get it right we must teach our fingers, not just hear about it with our ears or viewing videos or by reading instructions. As one woman reported after practicing the correct technique, “you can't palpate a pamphlet.”
We humans share, with other primates, a highly evolved, multi-layer tactile sensory system in our fingers. Touch, the web of highly differentiated tactile cells that learn what things feel like, are unparalleled in nature or technology.
We use touch—our tactile sense—to feel our pulse, to feel for a contact lens that fell on a rug, to feel whether a tomato is too ripe or too firm, and even to feel and interpret the tiny paper dots called Braille. Our tactile sense is so highly advanced that scientists and engineers devote entire careers to trying to create robots that emulate a few of its brilliant sensory capabilities. When properly trained, the sense of touch can also be used to detect breast cancer at its early stages.
A substantial body of evidence confirms that a large proportion of breast cancers are found by fingers, frequently the woman’s own. This is because most breast cancers are solid tumors and can be palpated (felt) by hand. With training on standardized breast models, fingers learn to detect small suspicious changes that feel different than normal lumpy breast tissue.
A team of scientists and physicians at the University of North Carolina at Chapel Hill identified the most effective method for teaching women how to do breast self-exam, in a study called “How Best to Teach Women Breast Self-Examination: A Randomized Controlled Trial.” Women were randomly assigned into three groups to learn how to learn to do breast self-examination using three different techniques. The first group of women was taught tactile BSE skills using Mammacare’s standardized breast simulations (models). The second group of women was taught BSE using traditional printed material—a pamphlet. The third group of women was encouraged to perform BSE without any instruction.
The study reported:
“Mammacare instruction resulted in more long-term improved lump detection and examination technique use than did traditional instruction or physician encouragement. “
Barton, M. B., Harris, R., & Fletcher, S. W. (1999). Does this patient have breast cancer? The screening clinical breast examination: Should it be done? How? Journal of the American Medical Association, 282(13), 1270-1280.
Gui, G.P. et. al. (2001). The incidence of breast cancer from screening women according to predicted family history risk: Does annual clinical examination add to mammography? European Journal of Cancer, 37(13), 1668-1673. Abstract
Narod, S.A. (2012). Tumour size predicts long-term survival among women with lymph node-positive breast cancer. Current Oncology, 19(5), 249-253. Full-text and table
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