Breast Cancer Self Examination Part 2 : Infront of Mirror
Nabta Editorial Team • October 2, 2022 • 5 min read
The breast self-examination in front of a mirror is the “look at your breast” section. While you’re not feeling your breasts, it is important to perform a certain set of actions to properly “look” at your breasts. The order is below:
a. Look at your breasts with your arms hanging by your sides
b. Lift your arms above your head: do you see any dimpling, changes in nipples, or change in the shape of one or both breasts?
c. Lastly, place your palms as if you’re getting ready to scold someone (!) and tighten your chest muscles: again, check for dimpling, nipple changes, and contour of the breast.
Continue to Part 3.
Source:
Breastcancer.org
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Diagnosing and Treating Breast Cancer During Pregnancy
Despite being the second most common malignancy affecting pregnancy, breast cancer during pregnancy is rare. Known as Pregnancy-Associated Breast Cancer (PABC), it affects approximately one in 3000 pregnancies. PABC is, in fact, defined as breast cancer that is diagnosed during pregnancy or in the first year postpartum. The aim with diagnosis and treatment of breast cancer during pregnancy is to follow, as closely as possible, the normal standards of care for patients of the same age who are not pregnant. That being said, some modifications may be required in order to minimise risks to the developing baby. **Diagnosis** ------------- Most breast cancers are diagnosed following self-examination and [identification of a lump](https://nabtahealth.com/is-the-first-sign-of-breast-cancer-always-a-lump/) in the breast tissue. During pregnancy, the breasts change in shape and size as they prepare for breastfeeding. It is not uncommon for them to feel lumpy and inconsistent as the milk producing ducts and glands start to fill with milk. This can make it difficult for women to establish which changes are normal and which are a cause for concern. All abnormal masses should be investigated, although, fortunately, 80% will be [benign](https://nabtahealth.com/glossary/benign/) in nature. The first diagnostic test a doctor will use is ultrasound. This uses soundwaves and is entirely safe for the unborn baby. It will characterise any unusual masses and identify whether there are features of concern within the mass. At around the same time a needle aspiration and/or core [biopsy](https://nabtahealth.com/glossary/biopsy/) may be taken. This enables doctors to explore the cells of the breast in more detail. Particular care will need to be implemented for analysing the results as, during pregnancy, it is not unusual for cells to become more proliferative in nature. Rapidly proliferating cells under normal conditions can serve as a warning sign that something is amiss. Mammograms will be used, however, they are known to lack sensitivity in pregnant or lactating females. As a mammogram involves radiation, doctors will endeavor to shield the baby from exposure. Newer digital mammograms might improve the sensitivity of the technique in women under 40 years of age. CT scans and bone scans, which are a normal part of the diagnostic process in non-pregnant females, are avoided during pregnancy, due to the dangers of radiation to the developing foetus. These methods are normally employed to check for [metastasis](https://nabtahealth.com/glossary/metastasis/), and thus, metastatic disease can be harder to detect in pregnant women. **Treatment** ------------- Most women with PABC will undergo surgery as the first-line treatment option, usually in the form of a modified radical mastectomy. It is generally safe to undergo anaesthesia whilst pregnant, but in order to limit the time you are under general anaesthetic, your doctor will probably recommend postponing reconstructive surgery until after delivery. [Radiotherapy](https://nabtahealth.com/glossary/radiotherapy/) is not recommended during pregnancy and wherever possible your doctor will attempt to delay this type of treatment until after delivery. This is because it increases the risk of [foetal malformations](https://nabtahealth.com/glossary/foetal-malformations/) and can delay [neurocognitive](https://nabtahealth.com/glossary/neurocognitive/) development. If breast preservation is desired, the disease is not advanced and diagnosis has occurred towards the end of pregnancy, it may be possible to treat with immediate lumpectomy and [radiotherapy](https://nabtahealth.com/glossary/radiotherapy/) after delivery. It has been shown that a six week window between lumpectomy and commencement of [radiotherapy](https://nabtahealth.com/glossary/radiotherapy/) does not have a detrimental effect on outcome. [Chemotherapy](https://nabtahealth.com/glossary/chemotherapy/) should not be given during the first [14 weeks of pregnancy](https://nabtahealth.com/articles/week-by-week-pregnancy-weeks-14-26/). It can cause severe [teratogenicity](https://nabtahealth.com/glossary/teratogenicity/) during organ development, which primarily occurs in the first trimester. In the second and third trimester, [chemotherapy](https://nabtahealth.com/glossary/chemotherapy/) can be administered. There have been no reports of later ill effects in children born to mothers who had [chemotherapy](https://nabtahealth.com/glossary/chemotherapy/) at this stage of their pregnancy. Most doctors will recommend stopping [chemotherapy](https://nabtahealth.com/glossary/chemotherapy/) at about week 36 to reduce the risk of infection or bleeding during delivery. Hormone therapy is not recommended for women who are pregnant or breastfeeding. Whilst, there are treatment options for women with PABC, additional work is required to establish a more effective treatment approach for these women. Certainly, as women postpone having children, the rates of PABC are likely to increase over the next few years. **Prognosis** ------------- The prognosis for women with PABC is generally lower than for women with breast cancer who are not pregnant. This is likely due to: * Less aggressive therapy being used due to concerns over the effect of harsher regimens on the developing baby. * Later stage of diagnosis because of difficulty in distinguishing physiologically-relevant changes from normal pregnancy-related changes. * The pregnancy having a direct effect on outcome, although knowledge regarding the exact mechanisms relating to this is currently lacking. * An increased percentage of [oestrogen](https://nabtahealth.com/glossary/oestrogen/) receptor negative cases. This is known to be associated with an increased risk of metastatic disease, which has a poorer prognosis. In terms of the developing foetus, women with PABC should be reassured that there are no reports of breast cancer spreading from the mother to the baby during pregnancy. In rare cases cancer cells will be found in the [placenta](https://nabtahealth.com/glossary/placenta/), so the doctor will always check this immediately after delivery. During pregnancy, a woman should remain under observation by a multidisciplinary team of healthcare professionals, including gynaecologists and oncologists to ensure that the support she receives is optimal for both her and her baby. Growth scans will be performed regularly to ensure that the baby is developing as he or she should be. If possible, the medical team will try to ensure that the woman delivers her baby as close to her due delivery date as possible. After delivery, treatment options will be reassessed. Get yourself the [post-surgery pack](https://nabtahealth.com/product/post-surgery-selfcare-pack-copy/) Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#99e0f8f5f5f8d9f7f8fbedf8f1fcf8f5edf1b7faf6f4) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * “Breast Cancer.” Breast Cancer during Pregnancy | Cancer Research UK, 21 Nov. 2017, [https://www.cancerresearchuk.org/about-cancer/breast-cancer/living-with/breast-cancer-during-pregnancy](https://www.cancerresearchuk.org/about-cancer/breast-cancer/living-with/breast-cancer-during-pregnancy). * “Breast Cancer, Pregnancy and (Green-Top Guideline No. 12).” Royal College of Obstetricians & Gynaecologists, [https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg12/](https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg12/). * Johansson, A L V, et al. “Diagnostic Pathways and Management in Women with Pregnancy-Associated Breast Cancer (PABC): No Evidence of Treatment Delays Following a First Healthcare Contact.” Breast Cancer Research and Treatment, vol. 174, no. 2, Apr. 2019, pp. 489–503., doi:10.1007/s10549-018-05083-x. * Keyser, E A, et al. “Pregnancy-Associated Breast Cancer.” Reviews in Obstetrics & Gynecology, vol. 5, no. 2, 2012, pp. 94–99.
SPF Properties of Natural Oils
The sun produces ultraviolet (UV) rays, which are damaging to the skin, causing premature signs of aging and increasing the risk of skin cancer. The best way of protecting against sun-induced damage is to regularly apply natural oils sunscreen. All sunscreen has a sun protection factor (SPF); the higher the SPF the more effective the protection against UV damage. The oils found naturally in fruit and vegetable seeds have been found to provide some protection against UV rays. Whilst too unstable to be used on their own, when combined with other ingredients, these oils have many properties that make them ideal for use on the skin. They are light, low in viscosity and less occlusive, meaning that they can be easily absorbed by the skin. #### Natural-based sunscreen Many natural-based sunscreens already contain oil extracts, including almond, avocado, coconut, cottonseed, olive, peanut, sesame and soybean. Due to their hydrating properties, natural oils such as these, provide soothing and non-toxic relief to those with dry or hypersensitive skin. It can be caused by eczema, or following [chemotherapy](https://nabtahealth.com/glossary/chemotherapy/) and/or [radiotherapy](https://nabtahealth.com/glossary/radiotherapy/). Adding these oils to moisturisers not only enhances the nourishing properties, but also provides a small amount of daily sun protection. Almond oil, for example, has an SPF of almost 5. It is found in the [Ozalys Soothing Care Soft Scalp Milk](../). Developed to soothe and moisturise the delicate skin of the scalp after hair loss, this product is ideal for use before, during and after sun exposure. #### Remember…. Please note that whilst it is always advisable to use additional protective measures, such as a sunscreen with an SPF of at least 30. However, hats and scarves help, care should be taken when choosing a sunscreen. Those with hypersensitive skin should avoid sunscreens that contain chemical filters, such as oxybenzone and retinyl palmitate. As these compounds can penetrate the skin, producing free radicals and, ultimately, causing more damage to the underlying cells. Instead, select products designed for use on sensitive skin, which are free from harsh chemicals, yet still provide sufficient UV protection. #### **About Ozalys** Ozalys’ products have been designed with women who have been affected by cancer in mind. Ozalys allows women to continue to care for themselves every day using products. That innovate through their formulas, optimal absorption and packaging. It’s specially-formulated solutions are catered for physiological conditions that cause dermal sensitivity. It is also for the side effects of certain treatments that may result in olfactory and dermal ultra-sensitivity. It’s personal hygiene, face and body care products have all been developed with the utmost care. Minimising preservatives and excluding all substances suspected of being harmful to the body. Their highly soothing, moisturising and protective properties. As well as their delicate application and scent, turn daily beauty routines into moments of well-being and comfort. **Sources:** * Kaur, C D, and Saraf, S. “In Vitro Sun Protection Factor Determination of Herbal Oils Used in Cosmetics.” _Pharmacognosy Research_, vol. 2, no. 1, Jan. 2010, pp. 22–25., doi: 10.4103/0974-8490.60586. * Floris. “Let’s Talk: Sunscreen — What You Should Know about Sun Protection.” Amazingy, 28 June 2018, [amazingy.com/magazine/sunscreen-uv-filters-nano-particles/](http://amazingy.com/magazine/sunscreen-uv-filters-nano-particles/).
Getting Started with Nabta Health; Your 101 Guide to Perimenopause and Menopause
 **[Perimenopause](https://nabtahealth.com/glossary/perimenopause/)** is a natural process in a woman’s life caused by a normal biological decline in reproductive hormones. [Perimenopause](https://nabtahealth.com/glossary/perimenopause/) onset varies from woman to woman and can take place at any stage from a woman’s mid-30s (premature [menopause](https://nabtahealth.com/glossary/menopause/)) into her late 50s. Also known as the ‘[menopause](https://nabtahealth.com/glossary/menopause/) transition’, [perimenopause](https://nabtahealth.com/glossary/perimenopause/) lasts between three and 10 years. The average length of [perimenopause](https://nabtahealth.com/glossary/perimenopause/) is 4-5 years, and the average age of [menopause](https://nabtahealth.com/glossary/menopause/) is 51 years. **[Menopause](https://nabtahealth.com/glossary/menopause/)** marks the end of [perimenopause](https://nabtahealth.com/glossary/perimenopause/), when a woman has gone a full 12 months without menstruating. After a year of no menstrual periods a woman is considered to have gone through [menopause](https://nabtahealth.com/glossary/menopause/) to her post-menopausal phase. **Induced [menopause](https://nabtahealth.com/glossary/menopause/)** is when a woman’s menstrual periods stop due to medical treatments or intervention. [Chemotherapy](https://nabtahealth.com/glossary/chemotherapy/) or radiation damage to the [ovaries](https://nabtahealth.com/glossary/ovaries/), and surgical removal of the [ovaries](https://nabtahealth.com/glossary/ovaries/) result in medically induced [menopause](https://nabtahealth.com/glossary/menopause/). **[Postmenopause](https://nabtahealth.com/glossary/postmenopause/)** is the ongoing phase of a woman’s life after [menopause](https://nabtahealth.com/glossary/menopause/). It’s important to note that many women continue to experience the classic [menopause](https://nabtahealth.com/glossary/menopause/) symptoms for years after their ‘official’ [menopause](https://nabtahealth.com/glossary/menopause/). #### What happens to a woman’s body when she is perimenopausal? The hormones that flooded a woman’s body during [puberty](https://nabtahealth.com/glossary/puberty/) and her fertile years start to fluctuate due to the decline in the female reproductive hormones (estrogen and [progesterone](https://nabtahealth.com/glossary/progesterone/)) produced by her [ovaries](https://nabtahealth.com/glossary/ovaries/). These hormonal deficiencies [lead](https://nabtahealth.com/glossary/lead/) to many physical changes taking place in a woman’s body long before her ‘official’ [menopause](https://nabtahealth.com/glossary/menopause/). #### What are the symptoms of [perimenopause](https://nabtahealth.com/glossary/perimenopause/) and [menopause](https://nabtahealth.com/glossary/menopause/)? * Hot flashes / flushes * Night sweats * Vaginal dryness * Irregular periods * Hair loss * Weight gain and slowed [metabolism](https://nabtahealth.com/glossary/metabolism/) * Itchy or dry skin * Disturbed sleep * Urinary incontinence * Mood swings and anxiety * Brain fog or memory loss * Low libido The physical changes and symptoms women experience due to the reduction in hormones can be debilitating. #### What are the long-term health risks of [menopause](https://nabtahealth.com/glossary/menopause/)? Long-term hormone deficiency increases women’s risk of chronic health conditions including cardiovascular disease, [osteoporosis](https://nabtahealth.com/glossary/osteoporosis/), type 2 diabetes, dementia, and bowel cancer. #### How is [perimenopause](https://nabtahealth.com/glossary/perimenopause/) diagnosed? A doctor will assess symptoms and may recommend a blood test to check follicle-stimulating hormone ([FSH](https://nabtahealth.com/glossary/fsh/)) and estrogen levels. As hormones fluctuate during [perimenopause](https://nabtahealth.com/glossary/perimenopause/) the test may be repeated after a few months if the results are inconclusive. Women who want to confirm their symptoms can also take a [perimenopause](https://nabtahealth.com/glossary/perimenopause/) test measuring the levels of three hormones [from the comfort of their home](https://nabtahealth.com/product/perimenopause-test/). However, a hormone test isn’t always necessary, and some doctors will diagnose [perimenopause](https://nabtahealth.com/glossary/perimenopause/) based on physical symptoms. #### Can [perimenopause](https://nabtahealth.com/glossary/perimenopause/) be treated? [Perimenopause](https://nabtahealth.com/glossary/perimenopause/) and [menopause](https://nabtahealth.com/glossary/menopause/) are natural biological processes in a woman’s body and cannot be delayed or halted with treatment. That said, a healthcare professional may discuss Hormone Replacement Therapy ([HRT](https://nabtahealth.com/glossary/hrt/)) and lifestyle adjustments to help manage the physical impacts of hormone deficiency. #### What is [HRT](https://nabtahealth.com/glossary/hrt/)? [HRT](https://nabtahealth.com/glossary/hrt/) replaces the hormones the body is no longer producing. The hormone treatment includes estrogen, and sometimes [progesterone](https://nabtahealth.com/glossary/progesterone/) and [testosterone](https://nabtahealth.com/glossary/testosterone/) if needed, and is given as a skin patch, gel, spray, or pill. Most women report their [perimenopause](https://nabtahealth.com/glossary/perimenopause/) symptoms improving within 3-6 months of starting [HRT](https://nabtahealth.com/glossary/hrt/). Taking [HRT](https://nabtahealth.com/glossary/hrt/) reduces the risk of developing [osteoporosis](https://nabtahealth.com/glossary/osteoporosis/), cardiovascular disease, type 2 diabetes, bowel cancer, osteoarthritis, and other health conditions due to hormone deficiency. There are risks associated with [HRT](https://nabtahealth.com/glossary/hrt/), including a small increased risk of breast cancer and blood clots in women with a family history. However, research has shown that for most women who take [HRT](https://nabtahealth.com/glossary/hrt/) the benefits outweigh the risks. A woman should always have a conversation with her healthcare team to decide the best approach for her individual circumstances. #### Are there natural ways to reduce the symptoms of [menopause](https://nabtahealth.com/glossary/menopause/)? Lifestyle adjustments can also be beneficial in managing perimenopausal symptoms. Women should try to eat a balanced diet with plenty of fresh fruit and vegetables, protein, whole foods, and foods rich in omega-3 fatty acids and calcium. Phytoestrogens can mimic the effects of estrogen in the body and occur naturally in foods including flaxseeds, sesame seeds, beans, soy, garlic, and cruciferous vegetables. Stop smoking and cut back on foods that might disturb sleep or trigger hot flashes, such as caffeine and alcohol. And exercise is essential. The decline in hormones affects bone and joint health, so it is more important than ever to maintain strength and flexibility with regular cardio and weight bearing exercise. As a woman’s [metabolism](https://nabtahealth.com/glossary/metabolism/) naturally changes with age, exercise will also help with weight control. #### Can I still become pregnant during [perimenopause](https://nabtahealth.com/glossary/perimenopause/)? While you are still having your period you can become pregnant. If you don’t want to be pregnant you should continue to use contraceptives until you are postmenopausal. #### Understanding [menopause](https://nabtahealth.com/glossary/menopause/) Health organisations and governments are increasingly recognising the gaps in knowledge and understanding of [perimenopause](https://nabtahealth.com/glossary/perimenopause/) and [menopause](https://nabtahealth.com/glossary/menopause/) and its enormous impact on women’s health and wellbeing. Efforts are now being made to address gender inequalities in broader healthcare provision and rebalance the lack of [menopause](https://nabtahealth.com/glossary/menopause/) research. The last few years have seen investment in improving education around [perimenopause](https://nabtahealth.com/glossary/perimenopause/) with the goal of empowering the more than 50% of the world’s population who will go through [menopause](https://nabtahealth.com/glossary/menopause/) with evidence-based therapeutic support. Sources: Internal > [What is](https://nabtahealth.com/articles/what-you-need-to-know-about-perimenopause/) [Perimenopause](https://nabtahealth.com/glossary/perimenopause/)? External: > [](https://www.balance-menopause.com/menopause-library/)[Menopause](https://nabtahealth.com/glossary/menopause/) Library https://www.mayoclinic.org/diseases-conditions/[menopause](https://nabtahealth.com/glossary/menopause/)/symptoms-causes/syc-20353397 https://flo.health/menstrual-cycle/[menopause](https://nabtahealth.com/glossary/menopause/)/changes/[menopause](https://nabtahealth.com/glossary/menopause/)\-symptoms-and-stages