How to Perform a Breast Self Examination (and why)

How to Perform a Breast Self Examination (And Why)

The statistics on breast cancer are troubling. Even with all the research and new treatments available, there are still 55 new breast cancer diagnoses daily. The most important detection for early breast cancer is regular breast self examination. This post will inform you of how to perform a breast self examination correctly, and other important facts to be aware of.

Early Detection of Breast Cancer Leads to Higher Survival Rates

If breast (and other cancers) are detected early, they have a much higher survival rate. Options for treatment are numerous. At present the five year survival rate for breast cancer is 91% in Australia, and 96% if the cancer is caught early. That is an excellent outcome, but there are still over 5000 deaths yearly. A free breast screening program is available in Australia, but performing breast self examination is still the best way to detect early cancer. It is important to note that males can get breast cancer too, albeit at a much lower percentage than women.

Breast Cancer Statistics in Australia.  Breast cancer is the most commonly diagnosed cancer, affecting 1 in 7 women and 1 in 675 men.  Source:  National Breast Cancer Foundation
Australian Breast Cancer Statistics. Credit: National Breast Cancer Foundation

How to Perform a Breast Self Examination

If breast cancer is caught early there is a very high chance of survival. A monthly breast self examination is the best way to detect early breast cancer because every woman’s breasts are different. If you know how your breasts usually look and feel, you will be in the best position to identify early changes and seek medical attention. Some breast changes are very subtle so it is important to know what to look for. The most important thing is to check your breasts monthly. Some guides say to do it on the first of every month, and some say after your monthly period ends. Post menopausal women should do theirs on the first of the month.

I have seen a number of ways to perform breast self examination. I have always done mine in the shower with soapy, slippery skin. Some women prefer to do theirs lying down. What matters the most is that you check all parts of your breast including up to your collar bone and under the armpit. Here is an excellent video which shows very clearly the correct procedure:

Breast Self Examination. Credit Madras Institute of Orthopaedics and Traumatology, India

Signs and Symptoms to Watch For During Your

Breast Self Examination

The signs and symptoms to watch for are:

  • Changes in the size or shape of your breast
  • Dimpling or a ‘pulling’ of skin on your breast
  • Any new lumps in the breast or under your arm
  • Breast pain or swelling (pain is rare)
  • Discharge of fluid (except breast milk) from the nipple, including blood
  • Dry, flaky red skin around the nipple area

If any of these symptoms are found, make an appointment to see your General Practitioner as soon as possible. Some women have no symptoms and the cancer is found during a routine mammogram or physical examination by a doctor. Mammograms should be done two yearly between the ages of 50 to 74. Breast Screen Australia provides a free screening service for women aged 50 to 74. Free screening is also available for women aged 40 to 49 and over 74, if requested. It is recommended that women with a strong history of breast or ovarian cancer are screened from an earlier age.

If symptoms are found, further testing may be required including ultrasound, biopsy and other scans such as a CT Scan or MRI. Treatments depend on the size and type of tumour, whether it has spread, and your general health.

Signs and Symptoms of Breast Cancer:  changes in the size or shape of your breast, dimpling or pulling of skin on your breast, any new lumps in the breast or under your arm, breast pain or swelling, discharge of fluid (except breast milk) from the nipple, including blood and dry, flaky red skin around the nipple area.  Source: ICON Cancer Centre
Signs and Symptoms of Breast Cancer. Credit: ICON Cancer Centre

Preventing Breast Cancer

Some factors that increase your risk of breast cancer include:

  • increasing age,
  • family history,
  • inheritance of mutations in the genes BRCA1, BRCA2 and CHEK2
  • Exposure to female hormones (natural and administered)
  • a previous breast cancer diagnosis
  • a past history of certain non-cancerous breast conditions

While you can’t do much about your genetic history, there are lifestyle factors that can impact your chances of getting breast cancer. These include:

  • being overweight
  • not enough physical activity
  • drinking alcohol
  • exposure to radiation

Know Your Breast Cancer Risk

I have written about my own diagnosis of BRCA2 gene mutation, which lead to my bilateral prophylactic mastectomies. It is important to know your risk because the presence of a gene mutation or family history of breast and ovarian cancers, could dramatically increase your risk. My risk before surgery was 60-80% as opposed to the general female population of around 13%. The only effective way I could guarantee that I would not get breast cancer was to have my breast tissue removed. It was a “no brainer” for me – the type of cancer that people with BRCA2 get is often the worst type with a very low survival rate. I did not even want to take that risk.

It has been a life changing decision for me because I had complications – I haemorrhaged post operatively. I’m still recovering 5 months later and have not been able to return to work. It may seem strange to say that I still don’t regret that decision.

I found out this past weekend that my brother has Stage 4 Prostate Cancer, undoubtedly from BRCA2. My mother-in-law has terminal lung cancer and only has a few weeks to live. The high incidence of cancer in my family gives me a lot of anxiety around it. Mum passed away at my age from cancer, and dad died from pancreatic and prostate cancer (BRCA2). My son had a melanoma at 24, and two of my siblings also had melanomas. Some families seem to cop a large burden, and ours is one of them.

Don’t Ignore Symptoms

One of the messages I want to convey is never to ignore symptoms. I have written about this previously in Signs You Need to See a Doctor. Be an advocate for your own health because without it daily life is so much harder.

Please share this article – it may help someone you care for. If you enjoyed this you may like my previous post October is For Breast Cancer Awareness which lists my previous posts about my BRCA2 diagnosis and surgeries.

Note: This post is for general informational and education purposes only. Please refer to my disclaimer.

Shared on Denyse Whelan Blogs Life This Week Linkup

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October is Breast Cancer Awareness Month

October is for Breast Cancer Awareness

October is Breast Cancer Awareness month.  I will be featuring breast cancer awareness in my blogs, as well as hereditary cancer.  My focus on cancer awareness this month is due to a passion for health promotion.  I can speak from experience because I have been a Registered Nurse for 30 years as well as having diagnostic tests and multiple surgeries.  

If you have been following Midlifestylist.com you may be aware that I have BRCA2 gene mutation which increases my risk of breast and other cancers.  Both my parents died of cancer – mum was my age, 54.  My father had BRCA2 as well.  He had prostate cancer and pancreatic cancer, and passed away when he was 84.  His father also died of prostate cancer and his sister died of ovarian cancer.  My son and two siblings had melanoma.   Cancer has therefore impacted my life dramatically. 

This year I had prophylactic surgeries to remove my ovaries and breasts.  That is because my chance of getting cancer was so high.  Unfortunately I had complications from both operations and required 3 extra operations.   I’m still recovering and have not been able to return to work since May.

Raising awareness of breast cancer and BRCA2

I can use my blog as an avenue of passing on my knowledge and experience of the impact of cancer and hereditary cancer risk.  Raising awareness will hopefully spare other families from seeing one of their loved ones suffer from cancer.

My previous blog posts about BRCA2 and cancer are:

The first of every month is the day women should perform a breast self examination.  My next post in this series will show you the correct way to perform the breast self examination, and what symptoms to look for.  

Shared on Life This Week Linkup by Denyse Whelan

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We Went PINK for Breast Cancer Research

As an update to my last blog, I am raising money for breast cancer research by taking part in the GO PINK campaign for the National Breast Cancer Foundation of Australia. GO PINK encourages people to dye or shave their hair, wear pink or hold events in order to raise awareness and funds for breast cancer research.

The National Breast Cancer Foundation

“National Breast Cancer Foundation (NBCF) is Australia’s leading national body funding game-changing breast cancer research with money raised entirely by the Australian public. We receive no government funding. What we do, would not be possible without the support and generosity of people and organisations like YOU. Our mission is simple: stop deaths from breast cancer. How? By identifying, funding and championing world-class research – research that will help us detect tumours earlier, improve treatment outcomes, and ultimately – save lives. Since NBCF’s inception in 1994, the five-year survival rates for breast cancer has increased from 76% to 91%. It’s proof our strategy is working. More than ever, NBCF is focusing keenly on how we can do more with less in order to achieve great outcomes that will impact the longevity and quality of life for patients with breast cancer.  For us, this means identifying new and effective models of funding and ensuring that we don’t stand alone but work collaboratively and creatively to achieve our mission of zero deaths from breast cancer by 2030.” Source: https://fundraise.nbcf.org.au/event/go-pink/why-we-need-you

Our team, The Tough Titties

My niece Ally, her friend Coralee, and I are the Tough Titties! Our dye day was on Friday. We went live on Instagram, so that our followers could watch us dye our hair pink. During the live feed we explained why raising money for breast cancer research is so important to us. We have raised $754 so far – our aim is $1000. If you would like to donate, here is a link to our fundraising page:

https://fundraise.nbcf.org.au/fundraisers/thetoughtitties

As promised, I am posting photos of our big day!

Breast Cancer Research

I have written about why I am raising money for breast cancer research in this blog post. I am passionate about raising money for research into breast and other cancers, particularly cancers that have a genetic link. Unfortunately I have the BRCA2 gene mutation that increases my risk of breast cancer to 60-80% and ovarian cancer to 20-40%, as well as other cancers as I have outlined previously. Both my parents died of cancer and my son, brother and sister have all had a melanoma. Ally’s grandmother also passed away from cancer before she was born, and her other grandmother (my mother-in-law) is suffering from lung cancer. In our family alone, cancer has had a huge impact.

Update on my Bilateral Prophylactic Mastectomies

I am recovering at home after my bilateral prophylactic mastectomies that I had done on 13 May 2020. (Read about it in this post). Recovery hasn’t been as straightforward as I would have liked due to complications after my surgery. My wound is healing slowly and I still have a lot of swelling and bruising. I’m seeing a haematologist now, to try to uncover why I had a large post-operative bleed. Even with all the complications I have had and how much this has impacted my life, I do not regret having surgery to remove my ovaries and breasts. With my high risk of cancer, I could be going through these surgeries with cancer which would have been so much worse.

Doing something positive like raising money for breast cancer research has given me something to do other than feel sorry for myself. I’m not saying I haven’t had days where I’ve been very emotional. I’ve had some days where I’ve been very upset. But having something to focus on has been really positive and helped me to focus on something during this time. I’ve also had some really great support in the way of lovely messages and kind words. That’s the sort of impetus I need to get me through.

Having our dye day was so much fun, especially with Banjo as our mascot. Here is a collage of photos from our photo shoot with him, which was hilarious!

We went pink for the GO PINK campaign to raise money for breast cancer research
Banjo our mascot – photo shoot for the GO PINK campaign.
GO PINK raises funds for breast cancer research. It is organised by the National Breast Cancer Foundation
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I will GO PINK for Cancer Research

GO PINK for Cancer Research

I do some strange things while scrolling through my phone at night. My insomnia keeps me awake for hours sometimes with only my screen for company. I wake up the next day with buyer’s remorse, usually because I’ve bought shoes or clothes that never fit me, or an appliance that never gets used. But this time I woke up with a sinking feeling in my gut because I had signed up to GO PINK, and agreed to dye my hair pink for breast cancer research.

I’m pretty conservative and have never dyed my hair any shade that could be considered flamboyant or radical. As an introvert I hate to stand out in a crowd. The thought of it makes me blush so I’ll probably end up looking like a flamingo with cheeks to match my hair. I needed some courage and that came in the form of my beautiful niece Ally who LOVES to stand out in a crowd and possesses such a lively spirit that she’ll boost my confidence when I need it the most. Ally has been a wonderful support to me over the last few months. She was the person I turned to when I knew I was having my mastectomies because she’s been through breast surgeries herself. Having someone to talk to who has been through this has been a blessing.

My Niece Ally and I.  We will be fundraising together for the GO PINK for cancer research event.  Ally has been a wonderful support for me
My niece Ally and I. We will be fundraising together for the GO PINK for cancer research event. She’s been a wonderful support to me over the last few months

Why Breast Cancer Research is Important to Me

I’m doing this challenge because it’s to fundraise for a cause that is very special to me. I have written about my genetic disorder BRCA2 which increases my risk of breast, ovarian, pancreatic and prostate cancers and melanoma. I inherited it from dad who died from prostate and pancreatic cancer (both caused by BRCA2). I’m at home recovering from bilateral prophylactic mastectomies. It is a risk reducing surgery along with the removal of my ovaries which I had done in March.

The very fact that I could have risk reducing surgeries is entirely due to the discovery of BRCA2 in the mid 1990’s. Before that, entire families were devastated by breast and ovarian cancer striking again and again through multiple generations. It’s now commonplace for family members to be tested for genetic conditions when there appears to be a genetic link. Discovering this gene mutation in 1995 was a game-changer for breast cancer research.  It allowed people like me to discover their inherited risk for cancer and do something about it.  Increased screening, prophylactic surgery and medications to reduce the risk are all possible now thanks to breast cancer research.

My Family History of Cancer and BRCA2 Gene Mutation

In my case there were few cases of breast cancer in my family. That alone prevented me from being tested ten years ago. It’s not as well known that men can have the genetic mutation too. Prostate cancer and melanoma have cropped up in our family through multiple generations, including my 24 year old son who had a melanoma. My cousin was diagnosed with BRCA2 about 10 years ago. Because of that I could be tested for free. The cost used to be extremely high. Improved testing methods mean that more people can now be tested under Medicare. My sons and any other close relatives are also eligible for free testing.

I am passionate about research into genetic causes for cancer and other diseases. I signed up to the GO PINK campaign because it raises funds for breast cancer research by the National Breast Cancer Foundation. If dying my hair pink raises awareness and funds, then I’ll do it. Even though I’m feeling anxious about looking weird with pink hair! The big day is this Friday. If you would like to donate to this cause via our team The Tough Titties the link is below. (The name is Ally’s idea, because people who have cancer have to be tough).

https://fundraise.nbcf.org.au/fundraisers/thetoughtitties

https://fundraise.nbcf.org.au/fundraisers/thetoughtitties

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Beating BRCA2 – How it has Affected My Life

I have had my own challenges while the World’s focus has been on the Coronavirus. This is a personal account of how the BRCA2 gene mutation has affected my life.

While the World Has Been Focused on the Coronavirus, I’ve Been Beating Cancer

The World around us changed dramatically between my birthday and my best friend’s birthday three days later. We spent the weekend together with our husbands, the four of us celebrating by staying in a resort and drinking, eating and laughing together. After we went home the restrictions started suddenly so that it would no longer be possible to socialise in that way. Our last weekend together from 20-22 March is the last time we could eat out at a restaurant or cafe, drink in a hotel or even spend time together. It seems like the distant past now.

We still can’t eat out at restaurants together, although restrictions in our State have begun to be lifted. We are unable to cross the border to visit my family who live just an hour south. Social isolation has added another layer to my own health battles that began to unfold this year.

BRCA2 Gene Mutation and Cancer Risk

I was diagnosed with the BRCA2 gene mutation in March. You may have heard about Angelina Jolie having BRCA1 and undergoing bilateral prophylactic mastectomies and a total abdominal hysterectomy a number of years ago. BRCA2 is similar – it increases my risk for breast and ovarian cancer dramatically. It’s a case of not if I develop these cancers, but when.

I knew there was a chance of inheriting this gene about 10 years ago when I nursed my cousin who told me she has the gene. I had genetic counseling back then but it was not very obvious that the gene was on my side of the family as there wasn’t a high number of family members with cancer, especially breast and ovarian cancer. The genetic counselor thought my cousin probably inherited it from her father (no blood relation to me). Consequently, I didn’t get tested and opted for more stringent screening instead.

I’m a huge advocate for screening. I have been having early mammograms and ultrasounds for the last 10 years. Every six months I get my skin checked. My son’s melanoma was picked up during a routine skin test. This was possible because I starting taking my sons for skin checks from a very young age. My son’s melanoma was diagnosed when it was just a stage 1 cancer. Many people ignore things until they’re advanced but that’s not me. I get every little bump checked out because I’ve seen too many invasive cancers as a nurse.

My son's melanoma.  He was only 24 years old when it was diagnosed.  It was a stage 1 melanoma.  Surgery completely cured him
My Son’s Melanoma – He was Only 24 Years Old when it was diagnosed.
It was a stage 1 melanoma. Surgery completely cured him

The last few years have produced more cases of cancer in our family – my son, brother and sister have all had melanoma and my father had prostate and pancreatic cancer. It was always in the back of my mind that I should probably get tested for BRCA2. I went back to the genetic counselor to be tested. Results showed I did have the BRCA2 gene mutation. I inherited it from dad – I had a 50% chance of having it and my sons then had a 50% chance of inheriting it from me. My first reaction was not for myself, but rather for my sons – “I’ve given them a death sentence”.

BRCA2 Affects Males Too

Telling them was difficult. It would have implications for when they want to start a family, and it might even be a deal-breaker for some women who wouldn’t want to have the risk of having children with a genetic disorder. They surprised me with their reaction, however. Their response was that they’d rather know if they had the gene or not. They were now aware of screening and get any changes in their bodies checked out early. They underwent genetic counseling and were tested for the BRCA2 gene mutation. The results came back negative. We were surprised and ecstatic at the results. Even my son who had a melanoma was clear which is even more surprising).

Risk Reducing Surgery

My first response to finding out I have BRCA2 was to swiftly decide to have prophylactic risk-reducing surgeries. That involves removing the organs most at risk of developing cancer – ovaries (I have a 20-40% chance of getting ovarian cancer) and breasts (60-80% chance). Having nursed women with ovarian and breast cancer for most of my nursing career, I know how devastating those cancers are and I want to avoid them as much as possible.

I had the first surgery on March 30th – a laparoscopic bilateral oophrectomy (keyhole surgery to remove my ovaries). This surgery is low-risk and most people bounce back quickly, with very little complications. Then there’s me. I seem to have the worst luck when it comes to complications to procedures – I went into complete heart block after an angiogram and required CPR. One medication landed me in hospital from a severe allergy. So to have complications after this small operation, while not surprising for me, was a shock to the system all the same.

Complications

I bruised. My abdomen became extremely distended. A lot of pain and nausea. But the worst thing – I couldn’t pass urine. I ended up going home with an indwelling catheter and it unearthed a problem with my bladder that’s probably been there for a long time but wasn’t apparent until I had pelvic surgery. I had follow-up surgery to fix it last week. While there was an improvement, there will be ongoing issues for a long time because my kidney and bladder have been damaged. All my back pain was from my kidney, not my spine after all.

BRCA2 Gene Mutation.  While the world has been focused on the Coronovirus pandemic, I have been battling my own health dramas

My next challenge is Bilateral Prophylactic Mastectomies

This week I will undergo my biggest challenge yet – a bilateral prophylactic mastectomy. After my previous operations I’m scared of having this surgery. I’m more scared of breast cancer though. Someone said to me that I’m brave to do this – I don’t feel brave. In fact I feel just the opposite. The women who have breast cancer are brave. Imagine going through this operation as well as radiotherapy, chemotherapy and medications for life. That’s brave to me.

I feel like I’m cheating cancer by doing these surgeries, but there’s still the risk of getting a different type of cancer because of this gene mutation. BRCA2 causes pancreatic, prostate and renal cancer as well as melanoma so I’ll still have to remain vigilant. Of course I can’t get prostate cancer, but pancreatic cancer is hard to detect. My dad’s was too far advanced to have any treatment. Pancreatic cancer ravaged his body. He only lasted for 7 months after it was diagnosed. Poor bugger, it was a horrible way to die.

How the Coronavirus Has Impacted Me

Attention has been on my own health issues while the world has been focused on coronavirus. I have found it hard to cope at times because it has restricted my ability to interact with the people who are my confidantes and support system. Talking on the phone is not the same. Even when I was in hospital I could only nominate one visitor for the whole hospital stay. My husband was sent away from the hospital and could only visit for 2 hours once a day. Going through mastectomies will be daunting without him there for my support. The thought of it upsets me a great deal. I won’t be able to have my sons and best friend visit at all.

Elective surgeries were cancelled in March. I feel really lucky that I knew the surgeons personally and my first operation was pulled forward. Any later it would have been impossible. I feel a little guilty that I could get this preferential treatment but there has to be some perks for nursing alongside these doctors for the last 20-30 years.

Other Concerns

Having to tell my brothers and nephews over the phone and Messenger that they too have a 50% chance of inheriting this really sucks. Social distancing sucks when you have to have these very full-on conversations. Worrying that I may get the coronavirus affects my health too, because I have co-morbidities that would mean I’d be one of the cases most likely to end up really sick from it. It’s been a very stressful time, and I’ll be glad when this is all over and we’re out the other side. The world will be a changed place when this pandemic is over.

Beating BRCA2.  While the world has focused on the Coronavirus, I have been beating cancer.  BRCA2 gene mutation increases my risk of breast, ovarian and pancreatic cancer.

Note to my followers: I’ll be out of action for a while due to my surgery this week. I may be able to post short updates via my mobile phone but my usual blog posts will be on hold for a few weeks. Thank you all for your support, I really appreciate it.

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