Breast cancer: find out how to do a self-examination – 09/30/2024 – Balance and Health

Despite being useful, self-examination is not recommended for diagnosing breast cancer. The procedure can detect larger nodules or other changes, such as bleeding, hardening or changes in color. Therefore, checking is recommended for women aged 20 and over.

The practice consists of inspecting the breasts themselves in search of changes and, upon noticing changes, a medical evaluation should be carried out as quickly as possible. Women can carry out the procedure in different ways, as all they need to do is observe and palpate the region, but there is a way recommended by experts.

Oncologist and technical director at Hospital Evangélico de Cachoeiro de Itapemirim, in Espírito Santo, Sabina Aleixo states that self-examination should be done in three stages: in front of the mirror, in the shower and while lying down.

“In front of the mirror, the woman should observe her breasts with her arms along her body, then raised, looking for asymmetries, swelling or changes in the skin. When palpating in the bath, she should use her fingertips and perform circular movements, covering the entire breast and armpits. Palpation while lying down allows a more effective perception of changes in the breast tissue”, he explains.

Nurse Chrystina Barros, 50, for example, discovered a breast tumor in 2020, while palpating her breast while taking a shower. At the time, she noticed a lump in her left breast.

“My mammogram was up to date, because I had the exam annually. But it was the fact that I recognized my body, took a shower, palpated and felt my breasts, that made me, that day, realize that something was wrong. That’s what happened. It opened up the possibility for me to make an early diagnosis”, he says.

Confirmation of the tumor was done with imaging tests, such as mammography and ultrasound, and biopsy, which is the removal of a fragment of tissue or organ from the body for laboratory analysis. Afterwards, the nurse performed surgery and x-rays. Today, he uses medication only to prevent a possible return of the disease.

According to Sabina Aleixo, for women who are still menstruating, the ideal is to perform a self-examination between the seventh and tenth day of the menstrual cycle, when the breasts are less sensitive and swollen. “For those who do not menstruate, it is recommended to choose a fixed day in the month to take the exam, making it easier to create a regular routine.”

In the case of obese women, self-examination may not work in the same way. This audience has more difficulty identifying a breast lump due to the greater volume of adipose tissue (fat). In these patients, it is even more important to perform imaging tests.

According to the Ministry of Health, women need to pay attention to the following signs:

• nodule (lump), fixed and generally painless: it is the main manifestation of the disease, being present in around 90% of cases;
• breast skin that is red, retracted or looks like an orange peel;
• changes in the nipple;
• small nodules in the armpits or neck;
• spontaneous release of abnormal fluid through the nipples.

Why doesn’t self-examination replace mammography?

The Ministry of Health and SBM (Brazilian Society of Mastology) highlight that self-examination helps to understand one’s own body, but does not replace a clinical breast examination.

“The procedure has the limitation of only detecting larger tumors, and often at advanced stages”, says Sabina Aleixo.

For early diagnosis, mammography is the gold standard method, capable of detecting very small lesions, even in their early stages, which significantly increases the chances of cure. Self-examination, therefore, serves more as a complement and should not be used in isolation.

According to Daniela Giannotti, radiologist at Hospital Sírio-Libanês, after imaging and palpation tests, a biopsy is necessary to confirm the suspicion.

“With the collection of material from the nodule or calcification, the region is sampled and sent for analysis, to obtain an answer as to whether or not the change that appeared on imaging tests or self-examination represents breast cancer,” he explains. Giannotti.

Who should have a mammogram?

The faster cancer is detected, the greater the chances of treatment and cure. In 2015, Inca (National Cancer Institute) established guidelines for the early detection of breast cancer. Among them is the indication of screening (examination in women who have no symptoms) carried out with mammography, which is an imaging procedure on breast tissue that can detect nodules that are not yet palpable.

Mammography screening is recommended by experts for women over 40 years of age. In the SUS (Unified Health System), however, exams are authorized for women between 50 and 69 years old, every two years. For patients who have a medical recommendation, mammography can be done in any age group.

Despite not being screened by the SUS, men can also have breast cancer, but these are rare cases. Men can have a mammogram if they have a medical recommendation.

For trans men who have not undergone mastectomy, there has been a screening option in the SUS since 2022. The recommendations are the same as those made to women.

This report was made in partnership with Hospital Sírio-Libanês