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Health Matters with Fresh Start: October is breast cancer awareness month

By: Vanessa Flannery, DNP, APRN, FNP-C
Fresh Start Health, Grayson

October is Breast Cancer Awareness Month 

Breast cancer occurs when cells within the breast mutate and start to grow uncontrollably. As these cells accumulate, they form a tumor, which can be felt as a lump when touching the breast or can be seen on diagnostic imaging tests, such as an X-ray or an ultrasound. A tumor is considered malignant if the cells it contains can invade the tissues that surround it or metastasize (spread) into other parts of the body. 

Cancer can begin in different areas of the breast, though many cancers start in the milk ducts, which transport milk to the nipple. Cancer can also start in the glands that produce milk, as well as other areas of the breast, though they are less common. If it is caught early enough, breast cancer is highly treatable, which is why it is important for women to be aware of the signs of this disease. 

1. Dimpling of the skin 

Though the most obvious sign of breast cancer is the appearance of a lump (a tumor), there are several other signs that can be an indication of this disease. Changes in the appearance of the skin are one of the signs of breast cancer; particularly dimpling of the skin. Inflammatory breast cancer is the most common form of breast cancer that causes dimpled skin. 

This type of cancer blocks the lymph vessels within the skin. The lymph vessels carry lymph – the fluid that transports particles and excess fluids – from various tissues in the body into the bloodstream. When the lymph vessels become blocked, they can create a dimpling effect in the skin, which creates an appearance that is like the skin of an orange. If the skin on your breast is dimpled, even if there aren’t any lumps present, it could be an indication of cancer. 

2. Changes shape and size of the breast 

Another sign of breast cancer is changing in the shape and size of the affected breast. In the beginning stages of cancer, the changes may be subtle and unnoticeable, so many women may not realize that they have breast cancer until the change in the shape and size become noticeable. Additionally, women’s breast naturally differ in shape and size; that is, they aren’t symmetrical. 

One breast – typically the breast on the same side of the dominant arm – tends to be larger than the other, which can also make it difficult for women to spot any abnormalities in the early stages of the disease. As mentioned, breast cancer is highly treatable if it is caught early and more serious in advanced stages, so it is important for women to pay attention to their breasts and be aware of any changes in their appearance. 

3. Sudden nipple discharge 

When a woman is pregnant or breastfeeding, nipple discharge is normal and expected. However, if a woman experiences sudden discharge when she is not pregnant or breastfeeding, it could be a cause for concern. There are many conditions that can cause nipple discharge, and not all are related to cancer. For example, fibrocystic changes can result in discharge, as can a papilloma, which is a benign (noncancerous) tumor. 

Abscesses, clogged milk ducts, endocrine disorders, and birth control are other factors that can lead to nipple discharge. Cancer is a cause for concern if the discharge appears suddenly, only affects one breast, and the fluid that is being secreted contains blood. If only one of your breasts is affected, there is a lump in your breast, the discharge contains blood is spontaneous and persistent, and a lump is present, it could be an indication of breast cancer. 

4. Retraction of the nipple 

Nipple retraction, also known as nipple inversion or an inverted nipple, refers to a nipple turns inward toward the breast. Normally in a breast the nipple will point outward; however, when a nipple points inward, it could be a sign of breast cancer. An inverted nipple is not always related to cancer. It could be caused by scarring or inflammation of the tissue that is located behind the nipple, which can be caused by several conditions. 

However, in breast cancer, a nipple can retract as a result of a tumor attacking the duct that is located behind the nipple, which draws the nipple inward. If you notice that your nipple is pulling inward, you should schedule a breast exam as soon as possible. A thorough physical examination, including diagnostic imaging, will reveal if the cause of the inversion is the result of breast cancer. 

5. Swelling under the arm 

Though a lump is one of the most obvious signs of breast cancer, in some cases, a lump may not be able to be felt in the breast, but rather underneath the arm. If you notice a lump in your armpit, it could be an indication that you have breast cancer. There are several lymph nodes located throughout the body, including the armpits. 

When cancer progresses, it is not uncommon for it to spread into the lymphatic system. If this happens, the lymph nodes will likely become inflamed. A lump under the armpit is not always a sign of breast cancer, however; there are several other things that can cause a lump in this area, including irritation from shaving (an ingrown hair), a cyst, a reaction to antiperspirant, or an infection. Nevertheless, if you do spot a lump in your armpit, having an exam is crucial. 

The American Medical Association, the American College of Obstetricians and Gynecologists, the American College of Radiology, the American Cancer Society, the National Cancer Institute, and the National Comprehensive Cancer Network all have issued guidelines saying that all women should be eligible for screening mammograms starting at age 40. 

If you’re 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. 

If your breast cancer risk is higher than average, talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your situation. Your plan may include breast MRI or ultrasound in addition to mammograms. 

There’s only one of you and you deserve the best care possible. Don’t let any obstacles get in the way of your regular screening mammograms. 

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