Breast Self-Examination

Breast self-examination is a screening method used to detect early signs of breast cancer. Studies show that forty percent of women diagnosed with breast cancer detected a lump while performing a self-examination. Self-exams are a convenient, no-cost tool that can be incorporated into daily activities, such as bathing or dressing. Adult women of all ages are encouraged to perform a breast self-exam at least once a month. Here are five steps on how to perform a breast self-exam:

  1. Breast Self-Examination - BBNLook at your breasts in the mirror and visually inspect your breasts with your shoulders straight and arms on your hips.
    • Look for:
      • Breasts that are their usual shape, size and color
      • Evenly shaped breasts without distortion or swelling
    • Alert your doctor if you notice:
      • Dimpling, puckering or changes, particularly on one side
      • Inversion or pulling of the nipple
      • Redness, soreness, rash, or swelling

 

  1. Breast Self-Examination - BBNRaise your arms above your head and look for the same signs.

 

 

 

 

  1. Look in the mirror for any signs of discharge coming out of one or both nipples (water, milky, or yellow fluid or blood).

 

  1. Breast Self-Examination - BBNFeel the breast tissue while lying down on your back. This allows the breast tissue to spread evenly along the chest wall. Place a folded towel or pillow under your shoulder. Use your right hand to feel your left breast and then your left hand to feel your right breast. Apply light, medium, and firm pressure with the first few fingers pads of your hand, keeping the fingers flat and together. Gently examine the entire breast area and armpit using circular motions, about the size of a quarter. Cover the entire breast from top to bottom: side to side –  from your collarbone to the top of your abdomen, and from your armpit to your cleavage.  Squeeze the nipple and check for discharge.
  1. Breast Self-Examination - BBNFeel your breasts while standing or sitting. Cover your entire breasts with the same hand movements described in step 4. Some women prefer to do this step in the shower, when their skin is wet and slippery.

 

 

 

Here are some other helpful tips to consider:

  • Pick the same day of the month. Monthly hormonal fluctuations can affect breast tissue, so it is important to select the same day of the month to distinguish between normal and irregular breast changes.
    • Premenopausal women: Perform self-exams toward the end of your menstrual period, when the breasts are least tender.
    • Postmenopausal women: Choose a memorable day of the month (1st or 15th) and consistently perform your exam on that day each month.
  • Follow a pattern during your exam. For example, imagine the face of a clock over your breast, or move your fingers vertically in rows as if you were mowing a lawn.
  • Start a journal where you record findings of your self-exams. This may help you remember what is “normal” in your breast, especially around times of menstruation, or distinguish when a lump is abnormal.
  • Here are links to some videos that help visualize the breast self-exam: https://www.youtube.com/watch?v=clOEgvgUxfk and https://www.youtube.com/watch?v=LrfE6JUwIms (see videos at the the bottom of the page)

Performing breast self-exams does not replace annual mammograms or clinical breast exams. However, self-exams in conjunction with other screening methods can increase the odds of early detection and improve chances of survival. Most breast changes detected during a self-exam have benign causes, however, there is a chance it may be linked to something more serious, so always be sure to alert your doctor right away. Share this information with your mother, sister, aunt, or friend. Early detection could save a life.

Resources

Breast Self-Exam. (n.d.). Retrieved May 27, 2020, from https://www.nationalbreastcancer.org/breast-self-exam

Breast self-exam for breast awareness. (2018, July 3). Retrieved from https://www.mayoclinic.org/tests-procedures/breast-exam/about/pac-20393237

Breast Self-Exam: How to Check for Lumps and Other Breast Changes. Breastcancer.org. (2019, October 24). https://www.breastcancer.org/symptoms/testing/types/self_exam

Brown, K. (2017, March 6). Breast Self-Exam Guidelines: Johns Hopkins Breast Center. Retrieved from https://www.hopkinsmedicine.org/breast_center/treatments_services/breast_cancer_screening/breast_self_exam.html

Early Warning Signs of Breast Cancer

It is important to be very familiar with how your breasts look and feel, and to be aware of any changes in your breasts. Annual screenings are critical to breast cancer detection, but studies show that 40% of women with breast cancer discovered their tumors themselves. Many women often notice early signs of breast cancer while performing daily activities, such as bathing or putting on deodorant. The most common sign of breast cancer is a lump in the breast or armpit, however, there are many warning signs of breast cancer that you should be aware of including:
Early Warning Signs - BBN

  • Mass in the breast or armpit is the most common sign, often described as a ball or a nodule. Lumps may feel soft and rubbery or hard. It is unlikely that the lump will be visible, unless you have small breasts.
  • Dimpling or puckering on the breast
  • Scaliness on nipple
  • Redness or flaking of the skin
  • Nipple discharge (not breast milk)
  • Nipple changes (inversion, retraction, or pulling)
  • Ulcer on the breast or nipple
  • Thickening of the skin (orange-peel texture)
  • Swelling of all or part of the breast
  • Persistent pain in an area of the breast
  • Enlarged lymph nodes in the armpit

It is important to note that you should not ignore symptoms just because you do not feel pain. Pain is rarely a major symptom of breast cancer. If you have any signs or symptoms that worry you, be sure to contact your doctor right away.

Resources

CDC – What Are the Symptoms of Breast Cancer? (2018, September 11). Retrieved from https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm

Roth, M. Y., Elmore, J. G., Yi-Frazier, J. P., Reisch, L. M., Oster, N. V., & Miglioretti, D. L. (2011). Self-Detection Remains a Key Method of Breast Cancer Detection for U.S. Women. Journal of Womens Health, 20(8), 1135–1139. doi: 10.1089/jwh.2010.2493

Underferth, D., & MD Anderson Cancer Center. (2019, September 4). Breast cancer symptoms you shouldn’t ignore. Retrieved from https://www.mdanderson.org/publications/focused-on-health/breast-cancer-symptoms-you-shouldn-t-ignore.h10-1592991.html

What Are the Warning Signs of Breast Cancer? (n.d.). Retrieved May 26, 2020, from https://www.healthline.com/health/breast-cancer/warning-signs

Inflammatory Breast Cancer: the “Silent Killer”

Inflammatory Breast Cancer (IBC) is a rare and aggressive form of breast cancer in need of increased awareness. IBC accounts for only 1-5% of all breast cancers, and it differs from other types of breast cancer in symptoms, outlook, and treatment. It is termed the “silent killer” because it tends to grow and spread quickly, often without a lump. Inflammatory breast cancer symptoms are sometimes confused with breast infection, a more common cause of breast swelling and redness. Breast infection will respond to antibiotic treatment, however, if the redness does not improve, you should seek additional medical attention. Inflammatory breast cancer symptoms occur when cancer cells block lymph vessels in the skin and can worsen within days, or as quickly as within a few hours. Symptoms include:Inflammatory Breast Cancer - BBN

  • Breast swelling, heaviness, or visual enlargement of one breast
  • Tenderness, pain or aching
  • Purple, red, or pink color or bruised appearance of the skin
  • Dimpling or thickening of the skin (similar to an orange-peel)
  • Unusual warmth of the affected breast
  • Flattening or inversion of the nipple
  • Rapid change in the appearance of one breast, over a few weeks
  • Enlarged lymph nodes in the armpit, above the collarbone, or below the collarbone

Seek medical attention right away if you notice any these signs and symptoms on your breasts.

It is also important to note that IBC differs from other forms of breast cancer in risk factors and age of diagnosis, among other things including:

  • Often does not cause a breast lump and may not be detected on a mammogram
  • IBC is more common in African American women
  • People who are obese or overweight are at higher risk
  • Tends to occur in younger women (even women younger than 40 years of age)
  • In about 1 out of every 3 cases, IBC has already metastasized to distant parts of the body upon diagnosis

IBC, like other forms of breast cancer, can also affect men. Treatments for inflammatory breast cancer include chemotherapy, radiation, and surgery. Contact your doctor if you are concerned about any of the mentioned symptoms and share this information with family and friends to promote awareness of IBC. It could save a life.

Resources

Inflammatory Breast Cancer. (2020, January 21). Retrieved from https://www.breastcancer.org/symptoms/types/inflammatory?gclid=EAIaIQobChMIy6eju-3S6QIVBoTICh2S1Q9IEAAYASAAEgLNcPD_BwE

Inflammatory Breast Cancer: Details, Diagnosis, and Signs. (2019, September 19). Retrieved from https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/types-of-breast-cancer/inflammatory-breast-cancer.html

Jones, P., & MD Anderson Cancer Center. (2009, October 12). Identifying the silent killer: Inflammatory breast cancer. Retrieved from https://www.mdanderson.org/publications/cancerwise/identifying-the-silent-killer.h00-158517990.html

Applying for Disability Benefits with Breast Cancer in Texas

Breast cancer its treatments can prevent you from maintaining employment. It may put you out of work for a few weeks, or indefinitely. When your illness is likely to prevent you from working for a year or longer, you can potentially qualify for Social Security disability benefits. Disability benefits can be the financial support you need to get by without employment income.

Social Security Disability Benefit Programs Available

Disability benefits from the Social Security Administration come in two forms. Qualifying medically is the same for both, but each will have its own technical requirements.

  • Social Security Disability Insurance (SSDI) – which is for disabled workers who have paid Social Security taxes over their employment history and who have accumulated between 20 and 40 work credits, depending on the age in which you apply. A work credit is a metric that represents how much you actually paid in taxes. Most workers earn the maximum of four work credits per year, so your employment history must typically range from five to ten years to qualify. SSDI recipients in Texas will receive Medicare 24 months after their cancer started.
  • Supplemental Security Income (SSI) – which is a support program available to low-income individuals of all ages, including disabled children and adults as well as the elderly. This program has strict income and financial asset limits, but there are no work history requirements to qualify. SSI recipients in Texas will automatically be enrolled in Medicaid.

Meeting the program requirements for SSI and/or SSDI additionally requires you either:

  • meet a Blue Book listed condition

OR

  • qualify through a residual functional capacity (RFC) analysis.

These options are the medical eligibility portion of qualifying for SSD benefits.

Medical Eligibility and Breast Cancer

Breast cancer is among the Social Security Administration (SSA’s) listed disabilities, though usually only those with advanced breast cancer meet the Blue Book specifications. The Blue Book is the SSA’s manual of impairments and is used by disability examiners when they review benefit applications.

The breast cancer listing appears in Section 13.10 of the Blue Book. This listing requires advanced cancer that has spread beyond regional lymph nodes. To meet the listing, your cancer must be:

  • An inflammatory carcinoma with adhesions to the skin, chest wall, or mammary gland internal nodes

OR

  • A carcinoma that has spread, with tumors present in axillary as well as regional lymph nodes, including infraclavicular (below your clavicle) or supraclavicular (above the clavicle) lymph nodes

OR

  • A carcinoma and has returned after initial treatment and is no longer responding to available therapies

Early Stage Breast Cancer and Disability Benefits

Breast cancer in its early stages does not meet the SSA’s Blue Book requirements, but you may still be able to qualify for benefits. The SSA must look at your “activities of daily living” or ADLs and decide if your illness and required treatments make it impossible for you to work for 12 months or longer. This process is known as a residual functional capacity (RFC) analysis. Activities of daily living include your ability to sit, stand, walk, or do other household activities like cooking or cleaning.

Severe reactions to chemotherapy and radiation may cause significant daily limitations and make it impossible for you to complete everyday tasks in your personal life. These same reactions can certainly prevent you from returning to work. If you are so impaired by your cancer and treatments that you cannot work, then you may be granted benefits through an RFC analysis.

Compassionate Allowance and Metastatic Breast Cancer

While the SSA’s Blue Book listing requires particular medical evidence for documenting breast cancer with metastases, it is also important to note that the SSA understands the debilitating nature of advanced breast cancer. As such, metastatic breast cancer is among the medical conditions that qualify for expedited review under the SSA’s Compassionate Allowance (CAL) program.

If you have advanced breast cancer and submit an application for benefits, your application is flagged and pushed through the review process quickly. The CAL program also minimized the medical evidence requirements in order to get your medical approval for benefits as fast as possible. You can be approved in as little as 10 days if your breast cancer has metastasized.

Applying for Benefits

The SSI and SSDI programs have separate applications. The SSDI application can be filled out online, but if you’re applying for SSI, you must participate in a personal interview with an SSA representative. SSI interviews are typically conducted at the local office. SSDI applications can be completed at the local office as well, if you choose.

Here are just a few of the SSA branch offices in Texas at which you can submit your SSI or SSDI application:

  • Abilene – 1202 E. South 11th St., Abilene, TX 79602
  • Austin – 1029 Camino La Costa, Austin, TX 78752
  • Dallas – 2530 S. Malcolm X Blvd., Dallas, TX 75226
  • Houston – 16200 Dillard Dr., Houston, TX 77040
  • Lubbock – 5826 16th St., Lubbock, TX 79416
  • Fort Worth – 819 Taylor St., Fort Worth, TX 76102
  • Odessa – 2015 E. 37th St., Odessa, TX 79762
  • San Antonio –  3438 E. Southcross, San Antonio, TX 78223

Deanna Power
Community Outreach Manager
Social Security Disability Help
857-366-7629

CPRIT Milestone

Today, the Cancer Prevention and Research Institute of Texas (CPRIT) announced that it reached a new milestone: more than 2 million cancer prevention services have been provided to Texans in all 254 counties of the state.

“This is a momentous occasion in CPRIT’s history and it demonstrates how Texas leads the nation in the fight against cancer,” said Wayne Roberts, CPRIT’s CEO. “Our innovative and proven cancer prevention strategies are saving or extending the lives of thousands of Texans who ordinarily might not have access to screenings and diagnostics. The greatest opportunity to reduce the burden of cancer is by reducing its incidence – preventing it altogether.”

The Bridge Breast Network is part of this new milestone in CPRIT’s History.  View patient videos for more information.