Saturday, March 13, 2010

Breast Exams and different ways to help.

I've told you about Rachia and her ride to help out BC Cancer Foundation on Team Finn. There are tons of Cancer fundraising initiatives that are possible to join in but due to my Jello knees, most of them don't appeal to me. I always feel guilty, all year long, until I get the phone call from the Learning Resource Centre at Dalhousie University, Medical School. They need my breasts.

Every year around this time, sometimes coinciding with Breast Cancer month, the Year II Medical Students get a Family Practice Unit and simulated patients are needed to role play the usual sorts of concerns an average family practice would encounter. Breast exams is one of the issues and for this, they need women to volunteer their breasts for an actual physical exam, a workshop specific to breast exams.

This is the first time for most of the students that they are encountering real breasts on real women and having to do a breast exam. About 10 of us participate. With a resident doctor in the room, we see 5-6 students, get a quick break and see another 5-6 students. That means about 12 breast exams in an afternoon. The girls are busy that day.

When I first started doing this, it was a challenge to myself to confront how comfortable I was with my body, and only as I spoke with students did I realize how valuable it was to their education. Breast exams in the past have had a bit of a struggle getting recognition as a standard practice that should take place in doctor's offices and sadly, a larger struggle getting into the regular practice of women themselves. There are also 3-4 versions of how to do it. From an educational point of view, the students are introduced and standardized to a correct method and then in their own practice they discover which one works best for them.

Each province has different standards as to when Mammograms should begin, and each research project has different outcomes on how effective a regular breast exam or a Mammogram is in preventing cancer or detecting cancer.

I get confused on this one. A physical breast exam takes nothing more than time. Your time, if you're female and we can always do one breast during one shower and the other during another shower and then the doctor's during the annual Pap exam. I am assuming you all get your annual Pap! Most doctors take a fleeting minute per breast, but 5 minutes is recommended for both. Pretend a doctor took that 5 minutes for each patient, that adds up over the course of a month and perhaps that's why they do it so quickly. That is one of the reasons it is so important to take those girls in hand and do a good exam ourselves. Most doctor's won't and if you depend upon them, you are fooling yourself. They are not trying to be poor practitioners, they are skimming over something they expect us to be doing for ourselves.

Having said that, recent research results implies that breast exams shouldn't be encouraged because women rush in with false 'lumps”, it causes hysteria and wastes resources. Well really medical people, whose fault is that. A) give a better description of what is and isn't a lump, B) explain how to monitor a lump if one is found and when to call and C) thinking that young and elderly women don't get enough lumps to be statistically significant doesn't mean they don't happen and it is especially true that lumps in young women are very aggressive and if doctor's don't check, who will? Discouraging self-exams is wrong-headed I say, really loudly. Let's deal with expectations, communications and better response options.

This suggests that going to a “Women's Wellness” Clinic, if your community has one, is a good alternative. You can go to these for your Pap and Breast exam, the doctors there specialize in women's issues and if you have another issue that isn't connected to your reproductive organs, you can go to your regular doctor. Twice the care!

Two great sites are: Breast Cancer Society of Canada

Mammograms....well, they hurt. I have been to the old machines and the new imagining machines. The new imaging machines hurt more in my opinion, but it is shorter in duration. I have large-ish, lumpy-ish breasts which makes it easy to heave them on the table and get squished. It is the one day in my life I don't envy women with smaller breasts. So it hurts. Plan ahead. Take some Tylenol and chocolate with you and think about how much it would hurt if you had to deal with a mastectomy. Small problem compared to a large problem. Get those breasts squished now.

41 % of all lumps are found in the Tail of Spence. It runs from the upper front part of your armpit to the outer side of your nipple. Statistically, if a lump happens, here is where you'll likely find it.

There are tons of other statistics, but the most important one is that early detections means a better survival rate. The other statistic that had me fooled for a long time was that 1 in 8 women in your circle of friends will get breast cancer. I took this to mean that once that one poor soul was in my circle, that meant I would be safe. The statistic was met, the other seven of us could breath a guilty sigh of relief.

I just clued in to the fact that 1 in 8 is a floating statistic. That means at any time, at any stage of your life, with any group of eight women, one of them is statistically likely to be suffering from breast cancer. It can overlap. You could have two or three friends with breast cancer at the same time. And it could be you.

Take responsibility into your own hands literally.

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