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Preparing for Breast Health Every Month

Strides made by the American Cancer Society and other groups have heightened breast health awareness so much that many women are comfortable with the ideas of self-breast examinations and mammograms.

Unfortunately, there are many women who are still timid when it comes to taking care of their breasts. If you are one of them, consider this: October marks the 15th anniversary of National Breast Cancer Awareness Month. For 15 years, the American Cancer Society has been enthusiastically encouraging women to have their breasts examined.

Consider these breast cancer facts provided by the Women's Information Network Against Breast Cancer:

Approximately 175,000 women and 1,300 men will be diagnosed with breast cancer this year.
43,000 women and 400 men will die this year from the disease
Every three minutes a woman is diagnosed with breast cancer
Every 12 minutes breast cancer claims another life
Approximately, 2.6 million women are currently living with breast cancer in the United States alone
Today, one in nine women in the United States will develop breast cancer in her lifetime
Breast cancer is the most commonly diagnosed cancer among women in every ethnic group in the United States
Breast cancer is the leading cause of cancer death for African-American women
70 percent of breast cancer cases occur in women who have no identifiable risk factors
Every woman is at risk for developing breast cancer. This risk increases with age, rising sharply after 40, if a woman has a family history of breast cancer and had her first child after the age of 30.
Because the causes for breast cancer are uncertain, it is impossible to predict with certainty who will and will not develop it
80 percent of all breast cancer cases occur in women over 50 years of age
Only 30 percent of all women over 50 get regular mammograms
Breast cancer can be detected at an early and treatable stage, but it cannot be prevented
By the time breast cancer is detected in a mammogram, a woman will have already had the disease for an average of six to eight years
By the time a breast lump is found through breast examination, a woman will have had the disease an average of 10 years
Breast cancer affects a small percentage of men and the risk increases with age
No one knows why men get breast cancer, but when it is detected, it is in its later stages

With all of this information, wouldn't it be a good idea to share it? One way is to print this article and pass it on to the people you know who might be at risk. Another way is to sign up with the American Cancer Society's "Tell A Friend" program. This program is conducted among friends, family and acquaintances. Trained volunteer callers contact five friends or other women they know to encourage them to get a mammogram. This strategy is called peer counseling because the volunteers contact other women much like themselves. It is a strategy that has been tested and shown to work.

Call your local chapter of the American Cancer Society and sign up for its "Tell A Friend" training for a rewarding and eye-opening experience. Why do you need training to make a telephone call and encourage your friends to get mammograms? According to Rachal Smith, the American Cancer Society program director for the Windward Hawaii chapter, "Anyone who calls to encourage others to get mammograms through the American Cancer Society needs to be trained."

Smith said that because of the delicacy of the subject, and because women who have chosen not to have breast examinations or mammograms are probably uncomfortable discussing it. The society felt it to be a good idea to conduct training classes for well-intentioned friends and family members who want to encourage their loved ones.

Consider the results of the Memphis, Tenn., program:

333 trained volunteer callers
3,003 women called
70 percent of those women had not been getting annual mammograms
40 percent of those women scheduled appointments
32 breast cancers were diagnosed

Once a woman finds out she has breast cancer and is facing the prospect of having a mastectomy, all hope is not lost. Thanks to the Women's Health and Cancer Rights Act (the Women's Health Act) passed Oct. 21, 1998, women now have the right to elect breast reconstruction.

House Resolution 4328 requires all health plans that cover mastectomies to provide breast cancer reconstruction for mastectomy patients, including coverage of prosthetic devices and reconstruction for restoring symmetry. To date, only 29 states have passed similar laws requiring health plans that cover mastectomies provide for coverage of reconstructive surgery. However, not all health plans are subject to state law. The federal law, known as the "Women's Health and Cancer Rights Act," covers those plans not currently covered by state law and sets a minimum standard securing this service for all women in all states -- including those with weaker state laws and those without any laws regarding mastectomy coverage.

In plain words:

Insurance companies and health maintenance organizations offering mastectomy coverage must also provide coverage for reconstructive surgery as determined by consultation between you and your physician. The coverage includes reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, and prostheses and treatment of physical complications at all stages of the mastectomy, including swollen lymph nodes.

If you have questions or concerns regarding the Women's Health Act, contact the U.S. Department of Labor's hotline at 202-219-8776. You can also telephone your health plan directly. Another option would be to telephone your state's insurance commissioner's office.

Breast Self-examination instructions from the American Cancer Society

By regularly examining her own breasts, a woman is likely to notice any changes that occur. The best time for breast self examination (BSE) is about a week after the period ends, when the breasts are not tender or swollen. Those who do not have regular periods should do BSE on the same day every month.

Lie down with a pillow under your right shoulder and place your right arm behind your head.
Use the finger pads of the three middle fingers on your left hand to feel for lumps in the right breast.
Press firmly enough to know how your breast feels. A firm ridge in the lower curve of each breast is normal. If you're not sure how hard to press, talk with your doctor or nurse.
Move around the breast in a circular, up and down line, or wedge pattern. Be sure to do it the same way every time, check the entire breast area, and remember how your breast feels from month to month.
Repeat the exam on your left breast, using the finger pads of the right hand. (Move the pillow to under your left shoulder.)
If you find any changes, see your doctor right away.
Repeat the examination of both breasts while standing, with your one arm behind your head. The upright position makes it easier to check the upper and outer part of the breasts (toward your armpit). This is where about half of breast cancers are found. You may want to do the standing part of the BSE while you are in the shower. Some breast changes can be felt more easily when your skin is wet and soapy.

For added safety, you can check your breasts for any dimpling of the skin, changes in the nipple, redness, or swelling while standing in front of a mirror right after your BSE each month.

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