Why are we afraid of breast examinations?

Proven content

Breast cancer is the most common cancer. No wonder it ranks first at the top of women’s health-related anxiety lists.

The facts are as follows: around 12 people are registered in Poland. new cases every year. Women alone detect 70% of breast cancer cases. 75% of the lumps are not cancer but appear to be a benign lesion in the breast – a cyst, fibroma, or lipoma. Detailed diagnostic tests are performed when preliminary tests indicate the possibility of cancer. Only after initial diagnosis is confirmed, the nodule is called a “malignant tumor”. There are 25-30 forms of cancer. Most of them respond to the female sex hormones estrogen or progesterone, and some are linked to an overabundance of HER2 (this type of cancer is treated with herceptin). Today, more women diagnosed with breast cancer live than die. So why are we afraid of breast cancer?

Because more and more women get sick, so I can too

It is true that the number of cases is increasing year by year (the latest data say about 12 patients diagnosed with breast cancer every year), and cancer can affect both mature (at high risk) and young women. But it is also true that the tumor grows slowly, so systematic examinations – self-examination, ultrasound and mammography – give a chance to detect the lesion at an early stage. And if the cancer is detected early, it has a good chance of being cured. Among women aged 50-69 who participated in screening tests, early detection of the lesion reduced mortality due to this disease by approximately 27%.

Besides: more important than the absolute number of patients are the so-called incidence rates, especially the standardized incidence rate, which shows the number of cases per 100 people taking into account age groups. It is on the basis of analyzes of this indicator that the incidence of breast cancer is increasing from the east to the west. It is relatively low in Japan or China, it is rising in Europe, and it is high in the USA. In Poland, the incidence is still relatively low (45 cases per 100 women), it is higher in Greece, Portugal and Spain, and high in other Western European countries. Some populations of women in the US have an incidence rate of over 100 per 100. So, prevention becomes important – proper diet, physical activity, paying attention to the way women live and eat.

Because what I touch, I feel a tumor

Systematic self-examination of the breast cannot turn into an obsessive search for cancer. Each lump or thickening detected during bathing or beauty treatments should not be a reason for panic. In breasts – due to their structure (connective tissue through which the milk ducts and lobules run, producing milk in nursing mothers) – there may be many benign changes, cysts, fibromas, lipomas that are not cancerous, can be easily identified and to treat. It must be said, however, that each of these changes must be seen, examined and evaluated by a physician, preferably an oncologist, who will determine the further tests necessary to confirm or (more often) exclude cancer. It should also be remembered that in menstruating women, the breast undergoes some changes in the menstrual cycle.

Because I’m afraid that mammography will activate the cancer

Some of us are afraid of mammography because we remember the warnings that frequent exposure to X-rays is harmful. Meanwhile, you really do not need to be afraid of mammography. The problem of its safety was resolved from the very beginning of introducing these studies into clinical practice. All analyzes of the risk of developing breast cancer as a result of repeated exposure of the glandular tissue to ionizing radiation showed that this risk does not exist! The quality of mammography devices is so high, and the radiation dose is so small that there is not even a hypothetical risk. Therefore, if, due to the presence in the group of a higher risk of disease, your doctor orders you to have a mammogram every six months or even more often – do not be nervous and report to the tests.

Just pay attention to whether the mammography laboratory you are visiting is under constant quality control. Such control covers, for example, laboratories that participate in the nationwide preventive program. Those that do not meet the required quality criteria are eliminated from the program.

Because I’m afraid the doctor will send me for a biopsy, and this is the beginning of the end

After the initial examinations, your doctor may say, “I think there is something disturbing going on in my breast. This change needs to be investigated in more detail. We’re doing a biopsy. Don’t panic then. A biopsy is a method of diagnosing cancer that is designed to help you make a quick and accurate treatment decision, and is not a signing of a judgment. Common opinions circulating among the patients – “cancer is afraid of a knife”, “cancer becomes malignant after surgery”, “air supply accelerates tumor growth” – are absolutely untrue. The identified change in the breast is there and it turns out to be either benign or malignant, but no intervention, fine needle biopsy or open biopsy can change the qualification of this change. What can harm us the most is the lack of a definitive diagnosis of the disease, without which proper treatment will not be possible.

Because if they find cancer in me, there will be no salvation

With four methods of cancer treatment to choose from – hormone therapy, chemotherapy, radiation therapy and surgical removal of the tumor – thousands of women have won the fight against breast cancer worldwide. If they succeeded, it may be for you. Provided that you undertake immediate treatment under the supervision of an oncologist, remembering that only he, and not any healer or miracle potion bought online, will give you a chance for life.

What do the statistics say? The cure rate, and more precisely 5-year survival (as this term is used to assess the effectiveness of oncological treatment), differs from country to country and depends largely on the percentage of women participating in preventive programs. In Poland, the cure rate is at the level of 60%, in Western Europe it reaches 80%, and in the USA it exceeds 80%.

Because after chemotherapy I’ll be bald

To put it simply: chemotherapy is most often administered in the form of drips, sometimes oral tablets, to destroy cancer cells. It is true that, by the way, chemicals poison the entire body, causing weight loss, general weakness, and hair loss. However, all these symptoms are reversible. The body returns to shape, hair grows back. The decision on the type of treatment – chemotherapy, hormone therapy, targeted treatment – depends on the prognostic factors identified by the oncologist (i.e. those that determine the stage of the cancer and the woman’s chances of survival) and predictive factors (i.e. the expected response to the planned treatment). It depends on this whether it will be possible to use oral or only intravenous treatment. It is possible to use medications that do not cause hair loss, but in many cases it can significantly reduce the effectiveness of the treatment.

Because I’m gonna lose my breast!

Yes, it is possible. Maybe one, and sometimes both. But when faced with the final choice, is it better to lose a breast or a life? The breast removal procedure (the so-called mastectomy) is a last resort. Conservative treatment gives good results for most women.

Besides, even a breast amputation is not the end of the world, after its removal it is possible to reconstruct the breast. Such operations are reimbursed by the National Health Fund. They can be performed simultaneously with amputation (which is less common) or delayed in time. The decision to undergo reconstructive surgery depends on prognostic factors, i.e. the risk of a possible recurrence of the neoplastic disease.

It should be emphasized, however, that there is an alternative (not applicable to all patients) in the form of the so-called breast sparing treatment (only part of the breast with the tumor is removed). However, this treatment is more long-term – it requires radiotherapy and many women do not decide to do so when deciding to have a mastectomy. However, women should know that such an alternative exists and that it is worth discussing this problem with a doctor in any case. (They’d rather remove their healthy breasts than risk cancer! – read more – editorial note)

Glossary

Terms you need to know:

• Breast tumor – an unspecified change in the breast, it may or may not be cancerous.

• Malignant tumor – A term that characterizes cancer (or sarcoma).

• Benign lesion – a non-cancerous lesion or a benign tumor; benign breast disease, which may or may not require treatment.

• Breast calcification – Calcium deposits may be an indicator of breast cancer, precancerous lesions, or the result of previous inflammation.

• Cyst – a closed cavity or epithelial lined space containing fluid or semi-fluid content.

• Fibroma – a benign tumor consisting of connective tissue.

• Lipoma – a benign growth consisting of fat cells.

• Screening – a routine regimen for early detection of breast cancer, usually for women who, because of their age or genetic makeup, are at increased risk.

• Imaging tests – visualize areas of the body using X-rays, ultrasonic waves or magnetic resonance. • Mammography – a method of imaging abnormalities in the breast using X-rays.

• Biopsy – obtaining tissue material for microscopic examination in order to establish the diagnosis and the presence or absence of hormone receptors and HER2 receptors.

• Pre-cancerous condition – A stage that measures the condition of tissue that has already changed but is not yet cancerous.

• Histopathologist – a doctor who specializes in diagnosing diseases by observing cells and tissues under a microscope, looking for changes in the structure and shape of cells in the taken tissue section.

• False positive result – test result indicating the presence of an abnormality when in fact it does not exist.

• False negative result – a test result in which no existing lesion has been detected.

• Targeted therapy – treatments that target specific elements of the tumor’s biological characteristics, such as HER2 overexpressing breast cancer cells.

• Mastectomy – surgical removal of the entire breast.

• Carcinoma – from Latin. “cancer”.

• In situ – from Latin. “in place of”; pre-invasive cancer, confined to a specific area.

Text: Inga Kazana, consultation: Kazimierz Drosik, MD, PhD, Provincial Consultant for Clinical Oncology.

Sources: Let’s live longer

Watch a video on how to examine your breasts!