Looking out for the silent killer | The Daily Star
12:00 AM, December 06, 2016 / LAST MODIFIED: 12:00 AM, December 06, 2016


Looking out for the silent killer

Dear Maya Apa,

I am a 37 year old female, and a mother of two children. I have a mass in my right breast for the last six months and it is painless. I have noticed an increase in its size in the last one month. 

My mother and aunt died from breast cancer when I was in my teens. I am scared. Can you kindly provide the necessary information regarding this illness and how it should be addressed. 


Dear Troubled, 

Thank you for sharing your problem with us. We really appreciate that you felt confident in sharing your family history with us and we are sorry for your loss.

Breast cancer remains the most common cancer among women in Bangladesh. An increase in incidence rate has been reported due to lack of disease awareness, lack of confidence about medical treatment and improper screening tests and maltreatments, and of early spread to other area.

You have mentioned about having a painless lump for the last six months in your right breast. Did you find this lump by doing a self breast-exam?

Breast self-examination helps you understand the normal look and feel of your breast. You use your eyes and hands to observe the look and feel of your breast to be alert. Medically, it is believed there is a value in women being familiar with their own breast, so they understand what is normal and can promptly report any change. 


If you menstruate, choose a time in your cycle when your breast is less tender. Hormone levels fluctuate during menstrual cycles. Swelling and pain decreases as period starts. So, the best time to do self-examination is usually a few days after your period ends.


Take off your clothes and sit or stand topless in front of a mirror with your arms at your sides.


Face forward and look for any dimpling, skin redness, rash, change in size, shape and symmetry of both breasts.

See if your nipples are inverted.

Inspect your breasts with your hands pressed down on your hips.

Inspect breasts with arms raised overhead and the palms of your hands pressed together.

Lift your breasts to see if the ridges along the bottom are symmetrical. Next, use your hands to examine your breast.

Common ways to perform the manual part of the breast exam includes lying down.

Choose a bed or another flat surface to lie down on your back. When lying down, the breast tissue spreads out, making it thinner and easier to feel. Now, by using the pad of fingers, move them in a circular motion to feel any difference in tissues throughout the whole breast.


Lather your fingers and breasts with soap to help your fingers glide more smoothly over your skin. Do this self-examination once every month. Many women find lumps or changes in their breasts, since some of these are normal changes that occur at various points in the menstrual cycles. Finding a change or lump in your breast is not a reason to panic.


Make an appointment with your doctor if you notice the following -

A hard lump or knot near your underarm.

Changes in the way your breasts look or feel, including thickening or prominent fullness that is different from the surrounding tissue.

Dimples, puckers, bulges or ridges on the skin of your breast.

A recent change in a nipple to become pushed in (inverted) instead of sticking out.

Redness, warmth, swelling or pain.

Itching, scales, sores or rashes.

Bloody nipple discharge.

Your doctor may recommend additional tests and procedures to investigate breast changes, including clinical breast exam, mammogram and ultrasound.


Risk factors are discussed below to understand the group of people who can be at a higher threat of developing breast cancer. However, having any of these does not mean you will definitely develop the disease. Risk factors include -

Age - increases as you age, extremely rare before 20 years.

Race - Caucasians have a higher risk of developing than other racial groups. 

Early menstruation - early onset of menstruation before the age of 12 years of age.

Late menopause - not having menopause until after age 55.

Genetic - common in women with positive family history - mother, sister, aunt, grandmother. Women who have BRCA 1 and BRCA 2 gene mutation are more likely to develop it.

Delay in having first child - those who do not have their first child under the age of 30.

Pregnancy - never being pregnant.

Personal history - if you have had breast cancer in one breast, you have a 3-4 fold increased risk of developing breast cancer in your other breast or in a different area

Hormone replacement therapy - taking HRT after menopause.

Diet - low fibre diet may increase your risk.

Habits - excessive alcohol consumption and smoking.


Radiation exposure - if you receive radiation treatments to your chest as a child or a young adult risk increases.

Having any one or more of these risk factors do not necessarily mean you will develop breast cancer. To determine if your symptoms are caused by breast cancer or noncancerous physiological condition, the doctor will conduct a thorough physical examination and one or more diagnostic tests to diagnose properly.



Breast ultrasound.

Biopsy - removing breast cells for testing.

Breast MRI.

Usually the diagnosis is made from clinical history, clinical breast examination and mammography.

In this twenty-first century, variety of treatment options are available that helps to go back into normal life again. They are- 





Hormone therapy 


Breast cancer does not have an identifiable cause. For this reason even though it is not entirely preventable but several measures can be taken.

Lifestyle modification - do regular exercise, have healthy diet with fibre rich fruits and food that includes green leafy vegetables such as squash, cucurbit, aurum spinach.

Avoid smoking, drinking alcohol, and excessive caffeine. If you have a lump and genetic history then after age 40 go for regular 6 monthly screening. Do self-breast examination every month. 

I would advise you to take the time to do all breast self-examination and then to see your doctor for further screening and stay in a regular follow-up to lead a healthy, happy life with your family.

I hope the information provided was helpful for all our readers.

Always by your side, 

Maya Apa

PS: Males can also develop breast cancer but such instances are rare. 

If you have any questions regarding gynaecology and reproductive health please mail to: lifestyleds@yahoo.com. All mail will be forwarded to the expert panel of Maya.com

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