Self breast Testicular Self Examination

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Self-breast & Testicular Self Examination

Dr. Hanjabam Barun Sharma *

Self-Breast Examination (SBE) is a procedure in which a woman examines her breasts & their accessory structures for evidence of changes that could indicate a malignant process etc.

It is one of the basic techniques for early detection and treatment of breast cancer, which along with cancers of the cervix account for nearly 60% of all cancers among Indian women.

It becomes even more essential due to the fact that breast cancer is proportionately is on increase in a few metropolitan areas which may be related to late marriage, birth of the 1st child at a later age, fewer children & a shorter periods of breast feeding, which are increasing common practice among the educated urban women.

The method of SBE is simple & can be learnt easily.

Observe the breasts with you sitting, with your arms at sides, sitting with your arms over the head, back straight, then leaning forward; & finally, sitting upright as you contract your chest muscle (pectoral muscle) by placing your hands on your hips, in front of a full sized mirror in a bathroom, or in your private room.

Observe the breasts for symmetry of shape & size, & for surface characteristics, including moles or nevi, hyperpigmentation, retraction or dimpling, edema, abnormal distribution of hair, focal vascularity, or lesions etc.

With you lying on your back, each breast is shifted medially, & the glandular area in each is palpated with the flat of the fingers of the opposite hand in concentric circles or in a pattern like the spokes of a wheel, from the periphery inward. Palpate the areolar areas, the nipples, & the axillary tail of spence (normal breast extension into the axilla) in the upper outer quadrant & extending to axilla.

See for any abnormal consistency, masses, nodules etc. Squeez the nipple to check for any discharge. Any abnormality felt or detected should not be neglected, but rather should go to a nearby hospital, or inform your doctor.

Premenopausal women should do SBE 1 week to 10 days after her 1st day of the menstrual cycle, when the breasts are smallest & cyclic nodularity is least apparent.

Postmenopausal women should choose a specific time each month, and do SBE on monthly basis. It is helpful to check your breasts everytime you shower for the first few months after being taught the procedure to practise & become very familiar with your own breasts.

A woman who regularly & carefully performs SBE is better able to detect small abnormality than is a woman who is not familiar with her own breasts. Early diagnosis greatly improves the rate of cure in cancer of the breasts.

Similar procedure is Testicular-Self Examination (TSE), which is a procedure for detecting tumors or others abnormalities in the male testes.

TSE is conducted in 4 simple steps.

Starting by, standing in front of a mirror & looking for any swelling on the skin of the scrotum. Normally, one testicle may appear larger than the other, & one may hang lower.

Next, each testicle is examined with both hands, placing the fingers under the testicle while the thumbs are placed on the top. The testicle is than rolled gently between the thumbs & the fingers.

In the next step, the epididymis, a normal cord like structure on the top & back of each testicle, should be found. A small pea sized lump is felt for on the front or side of a testicle. The lump, if found, is usually painless.

TSE should be performed once a month, usually after a warm bath or shower, as the heat causes scrotal skin to relax, thereby increasing the chances of detecting any tissue abnormality.

Testicular cancer, though relatively not common, almost always occurs in only one testicle. It is highly curable when detected at an early stage. So, all men should do TSE regularly.

* Dr. Hanjabam Barun Sharma, Raipur Medical College, Chhattisgarh , contributes regularly to e-pao.net. He can be reached at wang_fei03(at)yahoo(dot)com . This is webcasted on 12th July 2007.

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