1. Breast cancer Health education Department Qatar cancer Society

2. Outline  What is Breast Cancer?  How I know my breast cancer risk?  What do I look for?  How I can protect myself?  What is Breast cancer screening modalities?  Early Detection Clinic  Breast self exam

3. What is Breast Cancer? A proliferation of malignant cells that forms in tissues of the breast, which grow and divide more quickly than healthy cells. The most common type of breast cancer is ductal carcinoma, which begins in the lining of the milk ducts.

4. Some of the cells begin growing abnormally These cells divide more rapidly than healthy cells do and may spread through the breast, to the lymph or to other parts of the body (metastasize) The most common type of breast cancer begins in the milk-production ducts, but cancer may also occur in the lobules or in other breast tissue. 4

5. Ductal Carcinoma in situ (DCIS) 5 Illustration © Mary K. Bryson Ductal cancer cells Normal ductal cell Carcinoma refers to any cancer that begins in the skin or other tissues that cover internal organs

6. How I know my breast cancer risk?  Gender ( female are 100 fold more risky than men)  Age (over the age of 50)  Family history  Early age at menarche & Older age at menopause  Hormonal therapy  obesity  Therapeutic & environmental exposures to radiation  Smoking & Excess alcohol intake  Diet ( high calorie)  No history of pregnancy or lactation

7. What do I look for?  Swelling of all or part of the breast  Skin irritation or dimpling  Breast pain  Nipple pain or the nipple turning inward  Redness, scaliness, or thickening of the nipple or breast skin  A nipple discharge other than breast milk (blood, pus, or transparent discharge).  Upper back, shoulder and neck pain  Changes in breast shape, size or appearance

8. Signs and Symptoms 8 Most common: lump or thickening in breast. Often painless Change in color or appearance of areola Redness or pitting of skin over the breast, like the skin of an orange Discharge or bleeding Change in size or contours of breast

9. How I can protect myself?  Get regular physical activity.  Reduce your lifetime weight gain by eating fewer calories and getting regular  Exercise.  Avoid or limit your alcohol intake  Finding breast cancer early  Genetic testing  Preventive surgery for women with very high breast cancer risk

10. Breast cancer screening modalities Screening Modality Recommended age for screening Mammogram 40 years & older : every year Clinical breast exam 20-30 years : every 3 years 40 years & older : every year Breast self-exam 20 years & older : every month Magnetic resonance imaging ( MRI) Upon medical request Genetic council If there is a family history of cancer

11. Mammography  Use a low-dose x-ray system to examine breasts  Digital mammography replaces x-ray film by solid- state detectors that convert x-rays into electrical signals. These signals are used to produce images that can be displayed on a computer screen (similar to digital cameras)  Mammography can show changes in the breast up to two years before a physician can feel them 11

12. Early Detection Clinic If you have any symptoms that might be a sign of breast cancer, don’t hesitate to call early detection clinic: Outpatient clinic -women’s hospital Phone number: 0097466004051 (7:30 am-2:00pm) Clinic time: Sunday & Tuesday (5:00pm-8:30pm)

14. Breast Self-Examination Commit, Learn, & Love your body.  Breast self-examination (BSE), performed at the same time each month, takes little time, costs nothing and can help you be aware of how your breasts normally look and feel.  Contact your health care professional if you discover any changes

15. Touch & grid  Touch & grid. Use the pads of your three middle fingers. Begin in your armpit, using small circular motions with varying degrees of pressure, to examine your entire breast area. Then Move your fingers up and down over your entire breast area, from the collarbone to below the  breast and side-to-side, from your breast bone to your arm pit.

16. Patterns to Use When Performing BSE Women should use three different patterns when examining the breasts each month

17. 3 Steps Breast self-examination

18. 1.Stand in front of a mirror Examine your breasts with hands at sides, then clasped overhead. Look for changes in size or shape, or nipple changes. Squeeze both nipples between thumb and forefinger to check for discharge. Then press hands on hips and push elbows forward to tighten chest muscles. Look for dimpling, puckering, redness, scaliness or changes in shape, size, and texture or skin color.

19. 2. In the shower. BSE is easier when your skin is wet and soapy. In the shower, raise your right arm above your head. Think about the BSE grid as you cover your entire breast area, using the “touch technique” described above. Repeat for left side.

20. 3.Lying down.  Lying down helps to flatten the breast, making it easier to examine the breast tissue by pressing it  Firmly against the chest wall. Place a pillow under right shoulder. Begin at the armpit and make a series of three small circles. Use light, medium and deep pressure. Think about the BSE grid pattern and begin again. Cover your entire breast area. Repeat for left side.

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