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As the second-most common cancer in Canada, you or someone you know has likely come face-to-face with a life-changing breast cancer diagnosis.
The Canadian Cancer Society estimates that one in eight women will develop breast cancer during their lifetimes and one in 33 will die from it. In 2020 alone, approximately 27,400 women were diagnosed with breast cancer across the country, which is roughly the population of Whitehorse, Yukon.
Breast cancer is scary. It's malicious, demanding and will undoubtedly change your life; however, there's hope.
In Canada, 82 per cent of female breast cancer cases are diagnosed early in their development, at stages one and two. Additionally, "the probability of surviving breast cancer at least five years after diagnosis is about 88 per cent in Canada," according to government data.
Like all cancers, early detection can be a make or break in the prognosis of the illness. If breast cancer is found early, the person affected has more treatment options available and a higher survival rate than late-stage diagnoses.
Breast self-examinations: Are they worth it?
In regards to early detection, breast self-examinations are a surprisingly controversial subject. The Canadian Task Force on Preventive Health Care does not recommend breast self-examinations for women ages 40 to 74 who do not have a high risk of breast cancer; however, your primary health care provider may have different advice.
According to Dr. Melinda Wu, a general practitioner in oncology at the Women's College Hospital Breast Centre in Toronto, it's important to "get to know the [breast] tissue in your own body."
"I really promote breast self-awareness at every age, probably starting at 18," she tells Yahoo Canada. "You don't have to [perform a breast exam] monthly or in any regimented fashion, but you should start to get to know your own breast tissue so that you can let someone know if it starts to feel different to you."
Breast exams: Pros and cons
The main argument against breast self-examinations is that you may find a change in your breast tissue or appearance that sparks unnecessary concern. Studies have shown that self-examinations don't save women's lives and can lead to unneeded and invasive tests, such as biopsies.
Despite that, Wu encourages women to perform self-exams to keep in touch with the normal look and feel of their bodies.
"A few times a year, try to be conscious and just get to know the tissue in your own body," she advises.
How to perform a breast self-examination
To give yourself a breast exam at home, Wu recommends doing so in the shower with soap and water or lying down on your bed.
"I encourage people to use the finger pads of their first three fingers and glide over the tissue so that you cover all of it in some overlapping manner," she says. "Some people use a 'lawnmowing' type of pattern when you go from the collarbone to the underside of the breast, come back up next to it and go down, [making] vertical strips."
Wu says there is no one right way to perform a breast exam, "as long as you cover the breast tissue in its entirety and you do so in a regular fashion so that you get to know what feels right or normal to you."
In addition to a physical examination, Wu advises studying your naked reflection "so that you know what your normal breast shape looks like, what the contours look like and what the skin looks like."
"I encourage people to raise their hands over their heads [to] accentuate anything that might be tethering the skin or the nipple," she says. "If you notice that any part of the skin is pulling in or dimpling, that would be something to bring to the attention of your healthcare provider."
When is the best time to perform a breast self-exam?
Wu says the best time to do a breast exam at home is the week after your period, as "that's when the hormone levels are the lowest in your monthly cycle, so you will feel the breast tissue is less engorged." She suggests that after the age of 40, performing a self-exam every other month is a "good balance."
Mammograms under 50
Breast cancer screening guidelines are geared towards average-risk patients, which in Canada translates to mammograms every two years starting at age 50.
However, as with anything to do with your body, each person is different. If you have a strong family history of breast cancer, meaning a first-degree relative such as a parent, sibling, or child who's been diagnosed, you could be considered a high-risk patient and "screening can start as early as age 30," says Wu.
In the United States, breast cancer screenings begin at age 40, although Wu says this is controversial.
"It's outside of the Ontario Breast Screening Program," however, if someone is "very cautious and wants to be proactive," most Canadian health care providers won't deny the request.
Signs of breast cancer
While lumps are the most recognizable sign of the disease, Wu says to be cautious about skin changes that don't go away, persistent redness, skin dimpling and changes to the nipple.
"If it's crusted, red, if the skin overlying the nipple and areola look different than before," she says that these are all things that should be brought to the attention of your healthcare provider. Additionally, "spontaneous nipple discharge that is clear or bloody" should be brought up as well.
The bottom line
More than anything, Wu recommends breast self-awareness at every age. Despite self-given breast exams not being recognized by some healthcare entities, Wu says being cautious is key.
"I would never assume something is nothing; that's not the safest approach," she says. "The most cautious approach is, even if you're not sure, if something is new or different, bring it to the attention of your healthcare provider."
For more information about breast cancer, check out the resources at the Canadian Cancer Society.