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Written By: Editorial Team | Updated : February 23, 2015 6:31 PM IST
Regular SBE helps identify changes in the breast tissue, allowing for prompt evaluation and diagnosis. Self-breast examination encourages women to become familiar with their breasts' usual look and feel.
Breast cancer is not very uncommon these days. Any woman can be affected by it but females with disabilities are more prone to the disease. This makes it essential that these women understand the importance of a breast self-examination to note any changes in their breasts. But given their disability, it may at times be cumbersome to do so. Abha Khetrapal, Founder of Cross the Hurdles -- an NGO for the physically challenged, in her book 'Keeping You Abreast', lists how women with disabilities can do a breast self-examination at home. Here's an excerpt.
Due to the relationship between behavioural factors and cancer risk and the cancer-causing potential of certain environmental factors, we can see that women with functional limitations are at increased risk for breast cancer. Women with disabilities are more likely to be exposed to frequent x-rays and prolonged use of medications and to experience differences in exercise, nutrition, and childbearing practices than women without disabilities.
Abnormalities that show up on screening mammogram are usually the earliest sign of breast cancer. Therefore, regular screening is likely to result in detection of tumours at earlier stages when treatment is more successful. But unfortunately in India and in many underdeveloped countries this screening is not done due to inaccessible healthcare centres and wheelchair unfriendly mammogram machines. Many women who use wheelchairs cannot transfer themselves or transferred onto standard examining tables. And women who have tremors, who experience spasms, or who lack the stamina to stand at an imaging machine also need to be seated for accurate screening.
They are more likely to be unemployed, live in households with incomes at or below the poverty level, and reside in rural areas, and they are less likely to have postsecondary education. The overwhelming nature of living with a disability can also result in forgetting to take care of preventive health needs. Disability combined with old age is also a risk factor for not receiving mammograms. Educational materials in accessible formats like Braille or audiotape are not available to those with sensory impairments. Women with limited hand and arm function, with lack of sensation in their fingertips, and with low vision may have difficulty performing the procedure.
Read more about causes, symptoms, diagnosis and treatment of breast cancer.
Breast cancer thus becomes a major health concern particularly for women with disabilities. Their physical limitations can interfere with proper screening and even their proper treatment. The treatment of primary breast cancer involves various combinations of surgery, radiation therapy, systemic chemotherapy, and hormone therapy. The inability to lie flat or adequately abduct the arm, conditions that are common in women with certain disabilities, limitations of joint mobility or fear that the disability would increase the patient's risk for radiationinduced side effects may make it difficult or sometimes impossible to deliver radiation. A woman who cannot undergo radiation therapy may also not be an appropriate candidate for Breast Conservation Surgery. The presence of a physical disability may influence decision-making in women about the treatment of breast cancer.
Thus:
1) Women with disabilities are less likely to undergo Breast Conservation Surgery.
2) Women with disabilities are less likely to receive preoperative chemotherapy.
3) Women with disabilities are more likely to be diagnosed at an advanced stage of breast cancer.
Symptoms
**These changes also can be signs of less serious conditions that are not cancerous, such as an infection or a cyst. It's
important to get any breast changes checked out promptly by a doctor).
Breast Self Examination (BSE) for the females with disabilities
According to recent research, 70% of women do not practise Breast Examination regularly. And for the females with disabilities this percentage is much higher. Here are some reasons why:
Why is it important?
As a woman with disability, you need to discuss about it to become more comfortable with the concept of regular BSEs. Breast self-examinations (BSEs) are a simple, private, quick way of taking control over your own breast health. If you are more familiar you are with your breasts, you are more likely to notice when something has changed. You can learn yourself what is normal. In that you may need to rely less on medical procedures such as biopsies or ultrasound. Breast examinations are more critical for women with disabilities who may not be able to get a mammogram for a variety of reasons. If you have severe muscle spasms or chronic pain, you may be unable to benefit from a mammogram regardless of your age. So even if your mammogram is negative or even if you feel safe, this examination must be conducted on a regular basis.
Do it yourself
By examining your own breasts, you may notice changes that may indicate the presence of a lump. It only takes a minute or two every month. Once a month, examine your breasts before you go to sleep or just when you're waking up. If you are of menstruating age, how thick (or dense) the tissue of your breast is may change throughout your cycle, so we suggest doing BSE just after your period ends each month.
1. To see and feel your breasts, you must take all your clothes off above your waist.
2. Sit or stand in front of a mirror. Look for wrinkling changes in the colour shape or texture of your breasts and nipples. For women who are blind or have low vision, may rely more on changes to the shape or texture. A small lump feels like a pea.
3. Look for the lump or thickening, redness or rashes on the skin.
4. Look for the discharge from the nipple by pinching it or notice if there is constant pain under the armpit.
5. Look if the nipple is inverted.
6. Look if there is swelling your armpit or around your collarbone.
7. Now lie down with a pillow under your left shoulder and place your left hand under your head with your elbow lying flat. By lying flat, you are best able to feel the lower part of your breast, behind your nipple, and near your armpits. For some of us, this may be difficult to do because of limited upper arm mobility, pain or difficulty lying flat.
8. Try to select a comfortable position. It is possible to do the examination in a semi-sitting position, with pillows behind you.
9. Hold together the fingers of your right hand. Feel your left breast by moving your hand in small circles or with a slight back-and-forth motion over a small area. Do this all the way from the nipple to under the arm.
10. Switch over and repeat the examination for your right breast.
11. If you become familiar with certain lumps in your breasts each month, and you notice no changes, still do not think there that there is no risk. Lumps which are cancerous are often hard and fixed. If you find a hard lump that doesn't move around, see your doctor.
12. The most important thing is to get to know your breasts. Breast cancer DOES NOT always show up as lump. It may show up as a rash, discharge from the nipple, or as puckering.
13. Modular mass in the armpit or above collar bone must be shown to an expert.
*Remember that you are not only looking for lumps, you are looking for any unusual change. Lumpy breasts are healthy and normal. Lumpy breasts do not lead to cancer. For women who menstruate, these lumps may change shape or texture throughout your cycle.
'Keeping You Abreast' is authored by Abha Khetarpal and published by Cross the Hurdles. To buy an eBook, click here. To buy a printed copy or an audio book, write to crossthehurdles@gmail.com.
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