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Women Health Series: "Breast Health Basics: Understanding Your Body"

The breasts go through multiple phases of transformative changes throughout a woman’s life. Understanding your normal is key in detecting abnormalities.
October 27, 2023    |    266 Views
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The breast, a symbol of femininity and nurture, holds a profound significance in the lives of women. Beyond its aesthetic and cultural importance, the breast plays a vital role in a woman’s overall well-being. From the moment a girl reaches puberty to the transformative journey of pregnancy and motherhood, and the natural progression into menopause, the breast experiences a myriad of changes. Understanding these changes, both structural and functional, is a fundamental element of women’s health that spans generations.

The breasts, located in the pectoral region, are paired structures that present in both males and females, but are more prominent with females. They form a complex and dynamic system that evolves with the different phases of a woman’s life, from the moment it awakens during puberty, through the transformative phases of pregnancy, and ultimately, the profound changes experienced during menopause.

Breast Anatomy

Understanding the basic components of the female breast is essential for overall breast health and early detection of potential issues. Figure 1 below showing briefly on what construct a woman’s breast, following the basic description of the structure from top down:

figure 1 – breast anatomy

Rib : The ribs are part of the thoracic cage, which forms the framework of the chest. The breast tissue lies over and between the ribs in the anterior (front) chest wall. The ribs provide structural support and protection for the underlying organs, including the breasts.

Muscle: The base of the breast lies on the pectoral fascia – a flat sheet of connective tissue associated with the pectoralis major muscle which acts as an attachment point for the suspensory ligaments.

Fatty Tissue / Adipose Tissue: The breast also contains fatty tissue, which provides shape and protection.

Areola: This is the dark-coloured area surrounding the nipple. It contains sweat and oil which has sensitive nerve endings which lets the body know when to release milk. Stimulation to the entire areola is needed for milk release.

Nipple: Nipple contains several tiny pores (up to about 20) that secrete milk. Nerves on the nipple respond to suckling (either by a baby, hand massage or a breast pump). This stimulation tells the brain to release milk from the alveoli through the milk ducts and out through the nipple.

Milk ducts: Milk ducts are small tubes that transport milk stored in the lobules of the alveoli through a network of ducts to the nipple for secretion during breastfeeding.

Alveoli: These small, grape-like sacs produce and store milk. A group of alveoli is called a lobule, and each lobule connects to a lobe.

Epithelial tumours grow inside the lobes as well as in the ducts and then form masses, creating breast cancer. Breast cancer can arise from several places in the breast, including the mammary glands, milk ducts, and other tissues.

Breast Screenings

Breast health screenings are an integral part of preventive healthcare. They not only aid in detecting breast cancer but also identify other non-cancerous breast conditions that may require medical attention. While breast cancer is more common in women, it’s essential to remember that men can also develop breast cancer, although it’s relatively rare.

1.

Regular breast self-examinations (BSE) are an essential part of breast health awareness. A woman should perform BSE monthly to become familiar with the normal look and feel of their breasts, making it easier to detect any changes or abnormalities.

Self-examination can be done about one week after menstruation as many women experience changes in their breasts during a menstrual cycle. Some may experience swelling, tenderness, or even changes in texture due to hormonal fluctuations, particularly due to the changes in oestrogen and progesterone levels in the days leading up to their menstruation.  Performing a self-exam during this time can be uncomfortable or even painful for some.

Performing a BSE correctly involves several key steps:

  • Begin with a visual inspection, looking for any visible changes or irregularities in the breast’s size, shape, or skin texture. Pay attention to any dimpling, puckering, or redness. 
  • Breast checking during a shower is a convenient way to start including it into a regular routine.
  • Press firmly with the pads of your fingers, and move your hand in small, circular motions, covering the entire breast from top to bottom and side to side. Pay attention to any lumps, thickened areas, or changes in texture.
  • Next, raise your arms and inspect the breasts again, this time focusing on the underarm area. Many lymph nodes are located here, so be sure to check for any swelling or tenderness.


Types of Abnormalities
Breast abnormalities found during self-examination or clinical examination may take in various forms. Picture below showing some types or signs of abnormalities to be paid attention to during regular self-examinations.

types of appearances of the breast vector illustration design

If any unusual lumps, changes in size or shape, skin dimpling, or nipple discharge are noticed during a self-examination, it is crucial to consult a healthcare professional promptly. BSE is something that a woman should do at least once a month at home.

2.

Clinical breast examinations (CBE) are physical examinations performed by healthcare professionals. During a CBE, the doctor checks for any abnormalities in the breasts, lymph nodes, and surrounding areas. This is an important part of early detection, as an experienced and trained professional may notice abnormalities that a patient may dismiss as one, during her self-examination.

A clinical breast examination is recommended at least every three years starting in the early 20s and annually for women over 40s.

3.

Mammograms are a critical tool for breast cancer screening, particularly for women over 40. A mammogram is an X-ray of the breast, and it can detect tumours or changes in breast tissue that may not be noticeable during a physical examination. Regular mammograms can help in the early detection of breast cancer, often before any symptoms are apparent. For women with a family history of breast cancer or other risk factors, mammograms may be recommended earlier and more frequently.

What To Expect During Mammogram
 
If you’re going in for your first mammogram, it’s completely normal to feel a bit apprehensive. However, gaining an understanding of the procedure and knowing what to expect can significantly ease any concerns. A mammogram is a critical tool for breast health and early cancer detection. Here’s a closer look at what the procedure entails:

During a mammogram, a specially trained radiologic technologist will guide you through the process. The exam itself involves gently compressing the breast between two flat surfaces to spread out the breast tissue evenly. While this might sound uncomfortable, it’s a crucial part of the process to obtain the clearest and most detailed images. To ensure accurate results, two images are typically taken of each breast – one from top to bottom and another from side to side.

The Low-Dose X-rays
The flat surfaces that compress the breast are part of the mammography unit. They contain X-ray detectors and a small, controlled amount of radiation is used to capture images of your breast tissue. The radiation dose is kept as low as possible to minimise any potential risks.


The Importance of Compression
Breast compression is vital for two key reasons. First, it helps in spreading out the breast tissue evenly, making it easier to detect any abnormalities. Second, it minimises motion, reducing the chances of blurred images. The technologist will gradually increase the compression until the optimal image is achieved.


A Brief Discomfort
For most women, the compression can be briefly uncomfortable, but it shouldn’t be painful. If you experience significant discomfort, do communicate this with the technologist. They can adjust the compression level to make the experience more manageable. Importantly, the compression lasts only for a few seconds, and the entire procedure is usually completed within 15 minutes.


Your Radiologist’s Interpretation
After the mammogram, a specialised radiologist will analyse the images. If any areas of concern are identified, further tests or evaluations may be recommended. It’s important to remember that mammograms are an invaluable tool in breast health, and the brief discomfort is a small price to pay for the potential early detection of any issues.

Lifestyle Changes For Breast Health

Screenings, along with other healthy lifestyle practices, can significantly reduce the risk of developing breast cancer and other breast-related issues. While factors like genetics play a role in your susceptibility to breast-related issues, making specific lifestyle changes can significantly reduce the risk of developing breast cancer and other breast-related problems. Maintaining a healthy weight, engaging in regular physical activity, limiting alcohol consumption, and avoiding smoking are some of the lifestyle choices that can contribute to better breast health


The Relationship Between Weight and Breast Health
Weight management is a crucial component of breast health. Research indicates that postmenopausal women who are overweight have a higher risk of developing breast cancer. The reason lies in the presence of adipose tissue, or fat cells, in the body. These cells can produce oestrogen, which in excess is linked to breast cancer. Hence, maintaining a healthy weight is not only essential for overall health but also for regulating hormone levels, which is key in breast cancer prevention.

Balanced Diet: Adopting a balanced, plant-rich diet with limited processed foods can aid in maintaining an ideal weight.

Portion Control: Paying attention to portion sizes helps control calorie intake.

Regular Exercise: Incorporating physical activity into your routine promotes weight management and overall well-being.

Engaging in Regular Physical Activity
Exercising isn’t just beneficial for cardiovascular fitness; it plays a vital role in breast health too. Physical activity helps regulate hormones, reduces inflammation, and improves overall health. Regular exercise can lower oestrogen levels, which in turn reduces the risk of hormone-responsive breast cancer. It also contributes to a healthier immune system, which can help prevent cancer development.

How to Include Exercise in Your Lifestyle

Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week.

Mix it Up: Combine cardio, strength training, and flexibility exercises for comprehensive health benefits.

Make it a Routine: Consistency is key, so find an activity you enjoy and make it a regular part of your schedule.

Limiting Alcohol Consumption
Evidence shows that alcohol consumption is linked to an increased risk of breast cancer. Alcohol can raise oestrogen levels in the body, potentially leading to hormone-responsive breast cancer. To promote breast health, it’s wise to limit alcohol intake.

Tips for Responsible Alcohol Consumption

If you choose to drink, do so in moderation. For example, one drink per day is considered safe. 

Consider Alcohol-Free Days: Give your body a break from alcohol to reduce overall intake.

Be Informed: Know what constitutes a standard drink and monitor your consumption accordingly.

Avoiding Smoking
While smoking is more commonly associated with lung and other types of cancer, it can indirectly affect breast health too. Smoking has been linked to an increased risk of breast cancer, especially among premenopausal women. It’s crucial to understand the harmful consequences of smoking on overall health, which includes its potential impact on breast health.

Quit Smoking Tips

Seek Support: Many resources are available to help you quit smoking, from counselling to medications.

Set a Quit Date: Choose a day to quit, and prepare yourself for the journey.

Lean on Your Support System: Inform friends and family about your decision to quit and ask for their support.

In conclusion, breast health is a complex interplay of genetics, lifestyle choices, and environmental factors. While genetics can’t be changed, lifestyle choices are within your control and can significantly reduce the risk of breast-related issues. By maintaining a healthy weight, engaging in regular physical activity, limiting alcohol consumption, and avoiding smoking, you can take proactive steps to nurture your breast health and lower the risk of breast cancer. Remember that regular screenings, like mammograms, should also be a part of your wellness routine to catch any potential issues early. Prioritise your health, and empower yourself with the knowledge and choices that support vibrant breast health.

References

https://www.medicalnewstoday.com/articles/320668#start-and-finish Access date 21/09/2023 Breastmilk & breastfeeding: benefits | Raising Children Network
Access date 21/09/2023

World Health Organization. “Cancer.” World Health Organization, World Health Organization , 3 Feb. 2022, www.who.int/news-room/fact-sheets/detail/cancer/.
Accessed date 4 Aug. 2023.

https://my.clevelandclinic.org/health/body/22201-lactation
Access date 21/09/2021