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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Wednesday, November 4, 2009
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Wednesday, November 4, 2009
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- How often should a 38 year old do self breast exams? Is there a particular time of the month that is best?
- When doing self-exams it seems difficult to judge whether there is a lump under the arm or just a swollen lymph node. Any suggestions?
- What information can you provide on diet during 16 weeks of chemotherapy?
- What are suggested exercises for the post-mastectomy patient?
- My implants are behind my pectorals and it makes certain movements feel strange. Can I still lift weights?
- I'm looking for the latest research about preventive effects of exercise and nutrition on breast cancer. Can you help?
Breast self examination (BSE) originated in the 1950's, before mammography, by Dr. Haagensen for women to find lumps in their breasts that could be cancer. Now, mammograms can detect changes that indicate cancer 2 years before a lump can be felt with BSE. However, we still recommend that BSE begin in adolescence (as early as puberty, but no later than 20) and continue for the rest of a woman's life. The reason is for every woman to become familiar with her own breasts and to be able to detect any changes that occur. Dr. Susan Love suggests that women explore their breast at different times of the month, as breast tissue changes throughout the menstrual cycle. Your breasts may feel different at different times of the month because of hormones. You need to know what is normal for your breasts and be aware of any changes. Some women experience lumpiness and tenderness, usually before their period starts, and this disappears after the menses (their period). With BSE, you are looking for persistent lumps that do not change in size after your menstrual period. The American Cancer Society recommends that a woman do BSE once a month, 5-7 days after her period starts. If a woman is post-menopausal, she should pick a date to examine her breasts each month, such as the first day of the month or on her birthday date. Suspected lumps should be reported to your doctor as soon as possible.
The tissue that extends toward and into the armpit may feel lumpy just before you menstruate and seems to disappear after your period. Usually, the lymph nodes in the armpit cannot be felt unless there is an infection. When a lymph node is swollen and can be felt, it is important to find out the reason. The hormone changes in your body can cause lumpiness in various areas of the breast tissue. Examine your breasts at different times in your menstrual cycle to determine if the lumpiness changes or disappears. If a lump persists and doesn't change in any way through a complete cycle, have it checked out by your doctor.
Many diets have been published for cancer. Specifically for breast cancer, a diet low in fat is recommended. To reduce fat intake, avoid fried foods and butter or margarine and decrease dairy foods and red meats. Dr. Susan Love writes that about the benefits of eliminating meat or chicken that has been fed hormones from the diet. This is because breast cancer can be estrogen dependent. She also recommends they cut out caffeine, alcohol, soft drinks and foods with additives. If a person with breast cancer is overweight, it is very important to reduce body fat because chemical toxins are stored in the fat of the body, which in turn, causes the body extra work to detoxify them. Your diet should include 5 vegetables and 5 fruits per day, whole grains and fish within a balanced diet of 3-5 meals per day. This healthy diet should be continued even after your 16 week period of therapy. If you are interested in exploring your diet further, please read Carlton Frederick's book: Winning the Fight Against Breast Cancer: The Nutritional Approach, published by Grosset and Dunlap. You can find additional diet and exercise recommendations by following this link: Medical College of Wisconsin HealthLink
Which week you are post-operatively determines which exercises can be done. The surgeon usually does not educate you about exercises until your first visit to the physician's office after the surgery. If that has already occurred, then call the doctor's office and request written materials on exercises. These printed instructions should be clear, easy to follow, and sometimes have pictures. Look in your telephone book for the address or call for materials that would be helpful to you. I do want to emphasize though, that you must speak to your surgeon first, so you are not doing certain exercises too early for the surgery you had.
The implants behind the pectoralis muscle have been very successful to maintain a good contour appearance. It is true that heavy exercises associated with body building are difficult and not recommended by the surgeons who do the implants. How long ago you had reconstructive surgery is important. Usually, no exercises are recommended for at least 6 weeks post-operatively. Ask your physician for exercise instructions specific to your situation.
There are many studies of nutrition and exercise and the relationship of breast cancer. In a pooled analysis of studies with more that 200 cases of breast cancer, no overall association was seen for total fat intakes ranging from 15% to greater than 45% of energy from fat. There is some evidence (case controlled studies in Spain and Greece) that suggest using olive oil as fat intake has reduced risks of breast cancer. This may be related to its high content of monounsaturated fat and antioxidants.
Many studies have been done testing fat consumption and the incidence of breast cancer. Many find no relationship between the ingestion of fat and breast cancer risk, whereas, others have. The studies seem inconsistent at this time. The theory is that fat changes the metabolism of estrogen. It has been found that with a high fat diet there is more estrogen in the blood. There is less estrogen in the blood with a low fat diet. Also, fat cells can make estrogen so it is possible that an overweight person with extra fat cells could produce more estrogen which would increase the risk of cancer. Knowing this rationale, I recommend women reduce fat in their diet.
I will give you some research references:
This article is a NetWellness exclusive. 
Last Reviewed: Jun 12, 2002
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Janet Trigg, RN, MSN, EdD Formerly: College of Nursing University of Cincinnati |
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