Black Women Breast Cancer And The Importance Of Mammograms And Breast Examinations

Breast Cancer Sizes Detected by Mammogram and Self-Exam:

MAMMOGRAM
0.2 – 0.3 cm Smallest size of a breast cancer visible on a mammogram
0.8 cm Mammograms can detect many other non-invasive cancers (such as DCIS) which are less than 1.0 cm
1.1 cm Average size of cancer found on a mammogram

SELF-EXAM
1 cm Average size of cancer found by women who practice regular breast self-exam.
2.62 cm Average size of cancer detected in a physician physical exam for women who do not practice regular self-exam.

Lumps and Masses

The other half of the breast cancers found by mammography appear as a mass or abnormal density on the mammogram. Some cancers may be felt as a lump on physical examination and be invisible on the mammogram. In these cases, ultrasound (sound wave examination) is useful. This is especially true in dense, glandular breasts. A palpable lump should never be ignored because it is not visible on a mammogram. Such lumps should instead be aspirated, or drained with a needle. If the lump cannot be aspirated, it should be removed or biopsied.

Mammography remains the state-of-the-art tool for diagnosing breast cancer.

Other techniques of visualizing the breast are useful, but do not replace the mammogram. Breast ultrasound is extremely important for examining lesions, such as a fibrosistic condition. The ultrasound can also locate abnormalities in the breast that will help to direct a required biopsy. Also, an MRI (magnetic resonance imaging) can evaluate breast tissue and identify areas of abnormality. The usefulness of the MRI in breast cancer diagnosis continues to improve.

Mammograms and Breast Implants:

Breast implants are used for augmentation (to make the breasts larger) or for reconstruction after mastectomy. The breast implant is usually filled with a fluid material such as saline, silicone or a combination of the two materials.

Because an X-ray beam is unable to penetrate the implant, special mammographic views are required to visualize the breast tissue that are obscured by the implant. One view requires that the technologist manipulate the implant by pulling the breast forward to compress the breast tissue without the implant in view. This may be uncomfortable, but does not harm the implant. Additionally, patients with breast implants will have standard mammogram films taken, which are also harmless to the implant.

Here are a few guidelines on Self-Examination:

1. Stand in front of a mirror with your arms at your sides. Look for any changes in the size, shape, or skin of your breasts, including dimples or scaly patches. Check for discharge. Any bloody discharge should be evaluated by a doctor right away.

2. Clasp your hands behind your head and again look for changes in the size, shape, and contours of your breasts. Then check again with your hands on your hips, bending slightly toward the mirror with your elbows and shoulders pressed forward.

3. Do this next part lying on your back in bed, where you have better access to the undersides of your breasts. Lying down also spreads the breast evenly and thinly, making any abnormalities in the tissue easier to feel.

With your left hand behind your head, use the fingertips of the three middle fingers of your right hand to feel for lumps under the skin of your left breast. Use small, overlapping, circular motions and start just below your left collarbone, pressing your fingers on a small area the size of a quarter. Using various amounts of pressure, feel both on the surface and deep in the breast tissue for lumps that differ from the overall consistency of the breast in any way. Continue to check the breast following one of the patterns shown in the diagram. Make sure you cover everything from the collarbone to the bottom of the breast, and out to and including the armpit. Move around the breast in an up and down pattern (experts say this is the most complete and effective way to examine the entire breast). Switch hands and examine the right breast in the same way.

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