How to do Breast Self Examination Explained by Dr. Sunaina Ahuja

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Center Head: Today, Dr. Sunaina will handle a very sensitive but very important topic that is self-examination of breast.
Dr. Sunaina: Yeah.
Center head: To start with the topic, like how common the breast problems are?
Dr. Sunaina: Frankly speaking, every 2nd or 3rd female has issue; I won’t say that a major issue but minor issue, maybe minor issue but something related to breast problem, every 3rd-4th female once in a lifetime visits a doctor for having sorted out such breast problem.
Center head: So this is so common?
Dr. Sunaina: Yeah.
Center head: As the topic says that is self-examination of breast or breast self-examination, so what exactly it means?
Dr. Sunaina: Breast self-examination short form BSE actually means looking and feeling your own breast at regular intervals, so that we can detect at the earliest most, any abnormality so that it can be treated as soon as we detect it. It’s basically the Center head or the person or the female, her self-examining her own breasts in very simple words.
Center head: So, actually you said it is a self examination…
Dr. Sunaina: Yeah.
Center head: But then what is the importance of self-examination? Like I would just like to quote, for a lay person who doesn’t know the anatomy, so what is the importance of that person doing the self-examination or she should go to doctor only?
Dr. Sunaina: See, a layman doing a self-examination, it’s like we have to teach to the person how to do it. Regular, frequent visit to a doctor, we can do it on yearly basis or a each 6-month basis, but for a layman, especially in India, they don’t frequently visit to the doctor. Doing examinations at their own private room makes them much more comfortable, first, and doing at
their home by themselves, they can very very easily detect things which are at an early stage. So, as we all know, for any treatment for any disease, the more early we detect it, it’s better, the treatment options are good and the outcome is better. So, doing it on their own at their own private homes makes them also at a comfort zone and the disease can be detected at a very early stage, as compared to when the Cancer comes later in life and you know the disease has already progressed to a very high stage.
Center head: So, basically for early detection, this is very useful?
Dr. Sunaina: Yeah.
Center head: So, my next question is approximately, at what age one should start this self-examination?
Dr. Sunaina: Actually, for breast self-examination, as early as 20, the females should start examining. I know it might sound too early for many people listening, but uhh for breast problems, there are different types of breast problems related to age. At 20 to 30 age, the diseases which are diagnosed are different. From 30 to middle age, the diseases are different. So, like say simple swellings are much more common at younger age like 20-30s. and same, 45-60, again the chances of cancerous swellings are more common, so depending upon… only the treatment option will change according to the type of the disease. But yes, it should be done as early as 20 because we have saying that it’s better the Cancer starts it early, the diseases detected are… quite in a lot of number, we have detected the diseases at an early stage.
Center head: So, as like early as 20 years of age, one should start the examination.
Dr. Sunaina: Yeah.
Center head: But how frequently one should do this examination?
Dr. Sunaina: It should be done every month means once in a month is quite good enough to do the examination.
Center head: Okay. Now, the most important part, I mean now we know that who should do it, when one should do it, and other things. How it should be done?
Dr. Sunaina: See, there are basically 5 steps, 5 basic steps for doing breast self-examination. To make it more easy, we will divide into kind of major 3 steps. First, you should examine your breast when you are standing straight in front of the mirror and what you should note while you are standing and seeing yourself in the mirror is the shape of the breast, any swelling which is coming up, any skin changes, any changes in the nipple which you can just, you know, you can look into the mirror and you can easily identify the thing. Next is you have to see for any redness or any skin changes which you can detect very easily just on seeing. In India, females are not even used to seeing their, you know, examining their breasts. I think 10-15% of problem is solved on just you know examining, just seeing/looking at yourself and examining it. Then comes, you have to do it in the lying down position, just lie down, relax it, if you are examining your right breast, you have to use your left hand. You have to start from the nipple, slightly you know trying to figure out that any swelling, any mass, any lump in a circular motion, you feel anything, and same is for the opposite breast, you have to examine both your breasts, regularly. And third is when you have to stand and you have to raise your shoulders to examine. These are 3 major basic steps for examining your breast.
Center head: So, apart from these 3 steps like any other precaution one should take during self-examination?
Dr. Sunaina: Yeah, sure, I wouldn’t say precautions, actually but this is like the best way to do it, I should say rather. You should use your finger pads, what we say, you should not use your finger tips and should not use your palm of the hand. because finger tips if you will use it, they will hurt you and if you use the palm, you can miss a very small swelling. It’s easy to you know find a small swelling or thing with your finger pads. Other thing is you should examine your breast while you are taking shower, actually because that wet fingers makes the swelling more slippery while you are examining, so it is more easy to detect it. Third thing is once you start examining your breast, the person may find it you know a bit I am not able to understand what is to be examined, how it is to be examined, but it’s the regularity which makes you aware of how your breast feels to yourself, and within 2-3 examinations, you will be able to detect that yeah, this is my normal breasts and if anything abnormal appears then it would be much more easier for you to handle it. Question is it’s not a one-time job, you have to examine yourself at least 3-4 times, so that you become used to your normal thing then it will be very easy for you to detect some abnormality.
Center head: Right. First, like one should know one’s own normal and abnormal…
Dr. Sunaina: Yeah, yeah, which takes maybe 3-4 times.
Center head: Right. So, during the self-examination, if somebody finds some maybe mass or some kind of abnormality, so how they should approach or what approach they should take?
Dr. Sunaina: First of all, I should say, don’t panic, [chuckles] 90% of breast diseases or breast swellings, especially at a young age are non-cancerous. So the first is it’s very good, you should be happy, you have detected something, go to your doctor, the doctor will examine you but don’t panic. The only first step is show to a doctor who is, you know, who will guide you. If the doctor feels like doing further investigation or the swelling or non-cancerous or something, it would be you know doesn’t need surgery or even doesn’t need medicine at all, just reassurance. But the question is most people, when they detect any swelling, the first thing which comes to their mind is cancer, but to clear it, I’ll say that 90% of the swellings which we detect or the person detects are non-cancerous, so please please please, be you know kind of be calm, and consult your doctor. The next step is to consult your doctor and then the doctor will further advice what is to be done.
Center head: And I think the last question is once the treatment is done like suppose somebody has found something, the treatment has been done, so after treatment, does this self-examination plays any role or one should stop?
Dr. Sunaina: No, I think the breast self-examination has even much more important role after the treatment. Suppose for an example, patient underwent the cancer treatment and the breast has been removed, but then the other person will think Now what to the breast has already been removed, why should I examine it but the opposite breast needs examination every time and even the same breast, reoccurrence what we call, means Cancer can be returned, even if a mild swelling, a very small swelling is detected, it can be a reappearance of cancer, so even more you have to be more vigilant after the treatment is done, so that even the reoccurrence occurs, we can detect it very, very early and it can be treated. So, I think breast self-examination both before, even if surgery is done or not done for that matter, even if there are some cyst which we say that no, it doesn’t need any treatment, even then you need to regularly examine… do self-examination because if the size increases they may require treatment, so you have to be vigilant that even if the doctor has said that this doesn’t require any treatment but for follow-up or something like that, you have to be careful. If the size increases then you may require treatment, so you have to be careful and you have to do this, and it hardly takes not more than 5 minutes, so I think you can give 5 minutes to yourself [chuckles].
Center head: Sure, so… yeah.
Dr. Sunaina: One thing I would like to add…
Center head: Yeah, please.
Dr. Sunaina: I am sorry, we have missed it, breast self-examination should be done after your periods are over.
Center head:Okay.
Dr. Sunaina: Means 2-3 days after your periods because during periods, because of hormonal balances and you know ups and downs, the breast is very tender, it’s difficult for the person to examine. After your periods are over, 2-3 days, you can examine. And for the person who are menopausal, they can fix one day in a month, you know, it’s easy to remember. And even we advice breast self-examination for a lactating mother also. it should be done after feeding, so that you know breast is not heavy with the milk. so you won’t be able to feel anything, that’s the only thing. You can fix one day and you can do it monthly. Thank you.
Center head: Thank you, Dr. Sunaina.
Dr. Sunaina: Thank you so much.
Center head: So, I think she clearly covered the entire importance of breast self-examination and I hope this will really spread the awareness for early detection, and definitely, prevention is always better than cure.
Dr. Sunaina: Yeah, surely [chuckles], sure.
Center head: [Chuckles] So thank you.
Dr. Sunaina: Thank you so much.
Center head: Thank you.
Dr. Sunaina: Thank you.

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