Fiona McMahon, DPT
Have you noticed an increase in the amount of pink on just about everything the last couple days? The increase of pink everything is because October is Breast Cancer Awareness Month. Breast Cancer is an extremely common cancer. According to the Nation Breast Cancer Foundation, 1 in 8 women will be diagnosed with breast cancer in their lifetime. Men can also get breast cancer, however it is much more rare for men to develop breast cancer. Luckily with early detection and treatment of early stage and localized cancer, the 5 year relative survival rate is 100%. That being said, early detection is crucial and it is important to catch breast cancer early to ensure the best possible outcome. Let’s take some time to review the signs of breast cancer and recommended screening protocols.
Signs and Symptoms of Breast Cancer
- Change of Sensation/ texture of the Breast or Nipples
- Lumps, change in texture in the breast, nipple, or underarm area
- Change in appearance of Breast or Nipple
- Change of nipple orientation
- Discharge from nipple
- Recommend for women of all ages
- Should be performed every 12 months
- Check in the shower: move the pads of your fingers over your breasts in a circular motion. If you find any lumps or skin abnormalities, visit your healthcare provider.
- Visual exam: examine your breasts in the mirror. if you note any changes in your breasts such as bumps, skin changes, nipple orientation, dimpling, shrinkage, or swelling, visit your healthcare provider
- Lying down: moving the pads of your fingers, check for breast abnormalities. Squeeze nipples to check for discharge. If you find any lumps or skin abnormalities, visit your healthcare provider.
- Recommended every 1-2 years for women who are 40 years old or older.
- May be recommended for women who are under 40, but have increased risk of breast cancer.
For some types of breast cancer, there is a very specific link to a person’s genes and her or his risk of developing breast cancer. BRCA1 and BRCA2 are genes that are responsible for the production of certain tumor suppressing proteins. In some populations there are mutations in these genes that disable their tumor fighting properties. These gene mutations are relatively rare and currently screening is recommended just for individuals with increased risk of harboring these mutations. According to the National Cancer Institute, individuals who are at higher risk and should consider genetic testing are:
- Individuals who have a male relative who has developed breast cancer
- History of BRCA related cancers within family history
- People of Ashkenazi (Eastern European) Jewish ancestry
- Breast Cancer diagnosed before age 50 in family
- Multiple cases of breast cancer in family
Individuals that test positive for BRCA mutations may consider increased screening, prophylactic surgery or chemoprevention.
Mastectomy and Physical Therapy
Mastectomy, removal of the breast is currently the most common treatment for breast cancer. Some women chose to have their breasts reconstructed after their mastectomy and others do not. It is obviously a very personal choice. Like any surgery, mastectomies require close postoperative care to ensure maximal function and recovery.
You may have read the last sentence, and thought, “What is the function of the breast, besides breast feeding and for sexual pleasure?” The breast lies in an important intersection in the body. The armpit (axilla) contains bundles of nerves, blood vessels, and lymph vessels that course through it, serving the arm down to the fingers. After mastectomy, their course can be interrupted by scar tissue, radiation damage (if your treatment included radiation), causing painful conditions such as nerve entrapments, frozen shoulder, and lymphedema, ( a backup of lymph fluid, if left unchecked can cause permanent damage and deformation of the arm).
Victoria LaManna, DPT, CLT, is our lymphedema expert. If you have had a mastectomy and are unsure about lymphedema care, she is an excellent resource. She will be able to instruct you in self- care and lymphedema prevention measures. Physical therapy can also help to release scar tissue in the breast and upper arm area, regain strength in the arm, and ultimately improve your function. Visit us, and read up on Victoria’s bio here, as well ask on our website at: www.beyondbasicspt.com/lymphedema
Breast cancer is extremely common, but luckily outcomes continue to improve, but early detection is key. This October, let’s stand together to commit to regular self exams and educate the women in our lives to screen themselves as well. Let’s reduce the impact of breast cancer, one step at a time.
http://www.nationalbreastcancer.org/. Accessed: September 24, 2016
National Cancer Institute. BRCA1 and BRCA2: Cancer Risk and Genetic Testing. https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q1. Accessed September 25,2016