Breast cancer is the most common cancer among women, accounting for more than 30% of all of their cancers. While spinal cord injury itself does not place women at higher risk of breast cancer, some of the results of SCI–reduced sensation, less likelihood of bearing children– can place SCI women in higher risk categories.
What is Breast Cancer?
Cancer is really a number of diseases caused by the abnormal growth of cells. Often the cells grow out of control, divide more than they should, and form masses known as tumors. Malignant or cancerous tumors not only invade normal tissue, but their cells can travel to other parts of the body to form additional tumors. This spreading is called metastasis. Breast cancer most often begins as a painless lump or thickening in the upper, outer portion of the breast; it can, however, occur anywhere in the breast, including the nipple. Breast cancers may spread to the lymph nodes in the arm pit and then, throughout the body.
What are the Risks?
Because the cause of breast cancer is unknown, there is no way to truly prevent it. However, several things put women at higher risk of developing breast cancer:
- A personal or close family history of breast cancer–mother, sister, aunt, grandmother
- Never giving birth, having your first full-term pregnancy after the age of 30, or experiencing an abortion
- During your first pregnancy
- Early onset of menstruation–before age 12
- Late menopause
- Cigarette smoking
- High fat diet
- Alcohol consumption
And, risk increases dramatically with age: at age 25 the odds are one in 20,000; by age 50 the odds are 1 in 50; by 85 the odds are 1 in 8.
Does SCI Increase the Risk?
Several basic steps can keep your risk for breast cancer as low as possible.
- Avoid obesity–cut fat intake to 25- 30% of your total calories, less than 50 grams of fat per day.
- Eat high fiber foods like whole grain cereals, fruits and vegetables, foods rich in vitamins A and C, and deep green vegetables, like broccoli, cauliflower, or other foods from the cabbage family.
- Limit salt-cured, smoked and nitrate-cured foods–cold cuts, ham, hot dogs, sausage.
- If you have fluid-filled sacs or small cysts in the breasts (called fibrocystic breasts), cut down or eliminate caffeine.
- Reduce your alcohol use to two or less drinks a day.
- Quit smoking!
The most common sign of breast cancer is a lump or thickening, especially one that does not go away and does not change the way it feels. Other signs include:
- Puckering or dimpling
- Soreness of the skin
- A fixed inversion of the nipple which is different from before
- Skin ulcers or scaling
- Crusting or drainage from the nipple or areola
Early Detection is a must...
You may be at higher risk if you have a family history of breast cancer; talk with your doctor about a screening schedule that is right for you if you are in doubt about your risk. For the general population, The American Cancer Society (2011) recommends:
- “Women age 40 and older should have a mammogram every year and should continue to do so for as long as they are in good health” (para. 1).
- “Women in their 20s and 30s should have a clinical breast exam as part of a periodic (regular) health exam by a health professional preferably every 3 years. Starting at age 40, women should have a CBE by a health professional every year” (para. 5).
- “Breast self-examination (BSE) is an option for women starting in their 20s. Women should report any breast changes to their health professional right away (para 8).
Monthly breast self-exams are recommended because breast cancer can develop between clinical exams or mammographies. Actually, most breast lumps are found by women themselves or by their sexual partners.
For your monthly exam, first use a mirror to look for lumps, changes in breast shape, pain, or discharge from the nipple. Then, palpate, using your fingers to feel your breasts in overlapping areas about the size of a dime. Remember to also check the underarm and upper chest areas.
"...but I have quadriplegia, and decreased sensation.”
Changes in your risk factors make these self-exams even more important. You can still do your own visual inspections, but if your sensation is at all impaired, get help to do a proper and complete exam. Have your husband, lover or friend help. Ideally, you should do your self-exam four to seven days after your menstrual period. However, you may wish to combine these exams with a monthly catheter change and have your nurse or caregiver help you at that time.
Be sure to have whoever helps you write down any questions or changes they feel so that the changes can be rechecked by your doctor. Remember: do these exams faithfully every month. Your SCI has changed some of the risks, so exams are even more important.
“What If I find something?”
This is the dreaded question, often the one which prevents self-exams in the first place. Remember that 80% of lumps–4 out of 5–are benign, but they feel the same as cancerous lumps. If you find a lump or notice a change, see your health-care professional as soon as possible.
- American Cancer Society -- 1-800-ACS-2345
- Y-ME -- 1-800-221-2141
- Susan G. Komen Breast Cancer Foundation --1- 800-462-9273
- For accredited mammography centers -- 1-800-4-CANCER
American Cancer Society. (2011). American Cancer Society recommendations for early breast cancer detection in women without breast symptoms. Downloaded March 15, 2011 from http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs