By Kevin Wang
Lesbian/Women’s Health – Part II
This column is a continuation of last month’s column pertaining to lesbian health. Last month, we discussed finding a physician you feel comfortable with (who is also LGBT friendly) and the importance of the pap smear. As a side note, I hope you noticed the “Women’s” inclusion in this month’s topic. As a gay physician and writer for BTL, my focus is on the LGBT community, but some of the preventions listed below also pertain to all women.
So let’s pick up where we left off!
Let’s talk about breasts. Breast cancer is the most common female cancer in the United States and the second most common cause of cancer death in women. Studies have shown that one in eight women will develop breast cancer in their lifetime. Factors that increase your risk of breast cancer include family history, obstetric/gynecologic history (age of first period, age of first pregnancy, etc.), as well as some gene mutations.
Just as a side note (another one), family history is a huge risk factor for developing breast cancer. Any first degree relative puts you at high risk. And please discuss these findings and changes in your family medical history with your physician.
Putting those aside, what can you do to prevent breast cancer or detect it earlier? Just read on!
First and foremost, no one knows your body better than you do. That said, it’s important for you to perform a monthly breast self-exam so you know how your body changes and what it feels like. Pick a day of the month (preferably a few days after your period ends) and perform the exam the same day every month. Stand in front of a mirror and place your hands on your hips. Look for any skin texture changes, dimpling in your skin, changes in the nipple or any nipple discharge. Lean forward and check for any changes as well.
Next, you want to manually examine the breasts with your hands. You can do this lying down or standing up. To examine the left breast, position your left hand behind your head and examine the breast with your right hand. The same applies with the right breast (right hand behind your head and examining with your left hand). The first thing to do is to check for nipple discharge by squeezing the breast behind the nipple and attempting to express anything from the nipple. Next, you need to take the pads of your first three fingers and palpate the breast starting over the nipple and working your way outward in a circular fashion. The best technique is the 3-point technique using the most pressure to feel for deep tissue, less pressure to feel for the intermediate tissue and the least pressure to feel for the surface. Do this until you complete the entire breast but don’t forget two important areas – the area just below the collar bone and under the arm. These areas, the “upper outer quadrant and axillary areas,” are where most breast lumps are found.
The most common question I get when I show a patient how to perform this exam is, “What am I feeling for?” For the first few months, you are performing these exams to get to know your breasts. During this time, you’ll feel some small seed-like bumps throughout the breast. These are normal, consisting of glandular tissues that produce milk. What you’re feeling for, however, are new bumps that you don’t remember being there before. And don’t forget! If you feel a lump that seems suspicious to you, go see your physician and ask them to take a look. Better to be safe than sorry.
To get a more detailed description with some photos, please visit http://www.komen.org/bse. Additional information can be found at http://www.cancer.org.
Now what should you do if you find a lump or have bloody nipple discharge? Go see your doctor! They might do a mammogram, biopsy or take a sample of the discharge and send it off to the lab. But in any case, see your doctor if you have any questions or concerns.
Speaking of mammograms, who should get one? Current recommendations from the United States Preventative Services Task Force state that women over the age of 50 should have a mammogram done every 12-33 months as studies have shown that it reduces the mortality from breast cancer. Some say that mammograms should be done at age 40, but the benefit of mammography is smaller at that age. I can’t recommend one or the other but it’s something that you can discuss with your physician.
I think I’ll end this section of lesbian/women’s health here. If you have any questions or have input or additional advice, please feel free to contact me at the e-mail address below. Remember, I’m here to answer your questions and to advise our community! Stay healthy!