Early Detection Starts With Paying Attention to Changes
- ‘Masterchef’ star and restaurateur Thomasina Miers, 50, is urging women to take breast changes seriously after discovering lumps she thought were cysts were cancerous, leading to a mastectomy [the removal of the entire breast during surgery].
- Self-breast exams can help women better understand what is normal for their breasts, making it easier to notice any unusual changes. While experts recommend performing regular self-exams, they should not be used as a substitute for routine mammograms.
- The U.S. Preventive Services Task Force (USPSTF) recommends women get mammograms every other year at the age of 40. The American Cancer Society recommends getting a mammogram every other year for women 55 and older.
- Check out SurvivorNet’s “My Health Questions,” it allows patients and caregivers to get personalized, doctor-backed answers to their cancer care questions in real time by typing them in or using voice command technology.
Miers, a 50-year-old mom of three and co-founder of the restaurant chain Wahaca, took to social media to share the news, writing alongside post-op photos on Instagram, “So….I had a mastectomy last Friday. Originally I’d had a cyst there but the 2nd (& 3rd) lump turned out not to be one at all. Quite the reverse. They were bad asses.
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Miers also explained how she believes in the healing power of food and the importance of maintaining a positive mindset. She referenced the principles of Hippocratic and Ayurvedic medicine, two ancient healing traditions that originated in Greece and India thousands of years ago.
She went on to highlight that “emotional health is as key,” noting how she’s coped with Attention-Deficit/Hyperactivity Disorder (ADHD), a neurodevelopment disorder, throughout her life, which has contributed to her “worrying” a lot.
“Battling with low self-esteem (in teens; 20s; 30s; even 40s!) is part of it too. Don’t bury that stuff. Address it and deal with it,” she added.
Miers also reflected on how growing older can bring wisdom and confidence, noting that women often gain a deeper understanding of themselves and their abilities over time.
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Further commenting on her breast cancer diagnosis, she said, “This scare, and what it puts in my path, may help me be braver at taking leaps into the unknown and making some scary decisions. This is a very good thing!
“We only get one life. So today I am feeling enormously grateful.”
Expert Breast Cancer Resources
- Getting to Know Your Breasts with Self-Exams
- Is a Preventative Mastectomy Right for Me?
- Implant Reconstruction After a Mastectomy: The Options
- Should I Have a Lumpectomy or Mastectomy?
- 3D Mammography Detects 34% More Breast Cancers Than Traditional Mammography
- Bi-Annual Mammograms At Age 40 Now Recommended For Most Women, What The New Breast Cancer Screening Guidelines Mean For You
Miers also commended her care team, family, husband, mom, and her three daughters, who brought heartwarming gifts to the hospital, for making her “feel [like] the luckiest person in the world.”
She then showed gratitude for, “Breast cancer care that has moved on SO MUCH in the last 10 years” and “for life itself.”
Miers says she’s praying for “no chemo” being needed in her cancer journey, before concluding, “So, hugest love to all of you. You follow me, you hang with me and I don’t tell you often enough what that means to me. Love, Tommi. Ps I got dressed today!!!”
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Breast Cancer Symptoms & Self-Exams
Women are encouraged to do regular self-exams to become familiar with how their breasts feel normally, so when something unusual, like a lump, does form, it can be easily detected. A self-exam includes pressing your fingertips along your breast in a circular motion.
For some women, that means going to their doctor and walking through what a self-breast exam looks like, so they know what normal breast tissue feels like, so if they do feel something abnormal, whether it’s a lump or discharge from the nipple, they know what to ask and what to look for.
Below are common symptoms to look out for:
- New lump in the breast or underarm (armpit)
- Any change in the size or shape of the breast
- Swelling of all or part of the breast
- Skin dimpling or peeling
- Breast or nipple pain
- Nipple turning inward
- Redness or scaliness of the breast or nipple skin
- Nipple discharge (not associated with breastfeeding
How to Perform a Self-Breast Exam
If you notice any changes in your breasts, such as new lumps or nipple changes, ask your doctor about getting a mammogram or other screening tests. Remember that you’re the best expert on your own health and what’s normal, or not, for your body. In between regular mammogram screenings, SurvivorNet’s experts also recommend that you do regular breast self-exams.
Step 1: Begin by looking at your breasts in the mirror.
Stand with shoulders straight and arms on hips, and look for the following:
- Breasts that are their usual size, shape, and color
- Breasts that are evenly shaped without visible distortion or swelling.
- If you notice dimpling, puckering, or bulging, bring this to your doctor’s attention.
Also, check with your doctor if a nipple has inverted or changed position; or if you see redness, soreness, a rash, or swelling.
Step 2: Now, raise your arms and look for the same changes.
While you’re facing the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid– or blood).
Step 3: Next, feel your breasts while lying down:
Use your right hand to feel your left breast; your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping fingers flat and together. Use a circular motion, about the size of a quarter.
Cover the entire breast from top to bottom, side to side from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women.
Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage.
Step 4: Finally, feel your breasts while you are standing or sitting.
Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 3.
When to Screen for Breast Cancer
The medical community has a broad consensus that women should have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered age for breast cancer screening could save 19% more lives.
The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.
WATCH: When you’re getting a mammogram, ask about dense breasts.
Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk of developing breast cancer, you should begin screening earlier.
What Goes into Deciding to Get a Mastectomy?
When a woman decides to have a mastectomy, several factors go into that decision. Among things to consider is whether to have breast-conserving surgery such as a lumpectomy. These decisions should be made alongside your doctor by openly and candidly discussing risks vs. benefits.
“A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet. “The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”
WATCH: What Happens During a Double Mastectomy
Other factors that weigh into the decision to get a mastectomy are the size and features of the tumor and your family history. However, the gravity of your decision comes into full view, especially if you choose to get a mastectomy and remove both of your breasts.
Some women decide to have their breasts reconstructed and have implants put in right after the mastectomy, while others don’t have reconstruction at all.
Dr. Port added that most women do opt to have some reconstruction. The length of these surgeries can vary a great deal. When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). There is also the option to take one’s own tissue (usually from the belly area) and transfer it into the breast area during reconstruction.
Getting Second Opinions
Once you’ve gone through all of the tests needed to diagnose your cancer and your doctor has recommended a course of action, you will likely, finally, feel a sense of resolution. But no matter how qualified and experienced the doctor who diagnosed you is, there may be a lingering feeling about getting a second opinion. It’s OK to consider your doctor’s treatment recommendations as just the first step in figuring out what to do next.
RELATED: Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
“If I had any advice for you following a cancer diagnosis, it would be, first to seek out multiple opinions as to the best care,” National Cancer Institute chief of surgery, Dr. Steven Rosenberg, previously told SurvivorNet.
“Finding a doctor who is up on the latest information is important, and it’s always important to get other opinions so that you can make the best decisions for yourself in consultation with your care providers.”
RELATED: National Cancer Institute chief of surgery, Dr. Steven Rosenberg, offers advice on seeking a second opinion
A second opinion gives you the chance to explore other therapeutic options. Another doctor may offer a new perspective on your cancer, and possibly recommend treatments that are different than what the first doctor you saw suggested.
Getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you, or isn’t giving you good advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
Questions to Ask Your Doctor
If you have been diagnosed with breast cancer, you may have questions about keeping your strength through treatment. Here are a few questions to help you begin the conversation with your doctor:
- What treatment will I be receiving?
- What side effects are associated with this treatment?
- Are there steps I can take daily to help minimize these side effects?
- What physical activity routine do you recommend for me during treatment?
- Do you have recommendations for someone who doesn’t particularly enjoy exercise?
- Can you recommend a dietician who can help me with healthy eating tips and weight maintenance?
- I’ve been having trouble sleeping. Do you have any treatment recommendations?
WATCH: How One Cancer Survivor and Her Sister Used “My Health Questions” to Navigate Care
Contributing: SurvivorNet Staff
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