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Your breast tissue begins just below the collarbone and extends from the
armpit to the breastbone and down to below the bra line. Breasts are made
up of lobules [LOB-yuls], ducts, connective tissue, lymph nodes and fat.
Many breast changes will occur during
your life. The rst changes occur during
puberty as breast tissue develops and
your breasts grow larger. During and
after pregnancy, milk is produced in the
lobules and carried through the ducts to
the nipple openings. Your breasts increase
in size during this time.
Your ovaries produce less hormones, and
the number of lobules decreases as you
get older and enter menopause. As a
result, you lose some breast tissue and
the size and shape of your breasts change.
The breast tissue is replaced with fat.
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Your breasts will go through many
natural changes from puberty through
menopause. And, like most women,
you may have some common breast
changes at some time in your life.
These changes might include lumps,
pain and nipple discharge.
The good news is that most of these
changes are common and benign (not
cancer). For instance, do your breasts
feel swollen and tender before your
period? If so, you might be having
cyclical breast changes a breast
condition that affects about half of all women. Cyclical breast changes are
related to your period. Thats because your breast tissue is inuenced by
the same hormones that cause your period.
Your breasts may even feel tender and heavy. Lumps may form due to
hormonal changes during your menstrual cycle. These are normal
changes. Both lumps and swelling generally go away by the end of the
period. Its important to tell your doctor about any changes in your
breasts that do not go away.
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Cysts are uid-lled sacs in the breast tissue. They most often occur in
women in their thirties and older. Cysts are almost always harmless.
Fat necrosis [ne-KRO-sis] refers to rm lumps formed by damaged fatty
tissue. They can develop as a result of a bruise, a blow or breast surgery.
#
Fibroadenomas [FI-bro-ad-eh-NO-mas] are round, rubbery, benign
tumors. Fibroadenomas are the most common tumors found in women in
their late teens and early twenties. These tumors are not cancer, but they
may grow bigger with pregnancy or breastfeeding.
Fibrocystic [FI-bro-SIS-tic] breast change is lumpiness plus tenderness or
pain at certain times of the month. The lumpiness may become more
obvious as you approach middle age.
Nipple discharge is a uid coming from the nipple. Take note of the color
and texture of the discharge to let your doctor know. Nipple discharge
may be of concern if it appears spontaneously without squeezing the
nipple, if it comes from only one nipple or if there is blood in the
discharge. Your doctor may take a sample of the discharge and send
it to a laboratory to be tested.
Non-cyclical breast pain is often noted in one specic area of the breast.
It is not related to your hormones or monthly periods and does not vary
over the monthly cycle. If you have this type of pain, you should see your
health care provider.
Non-breast origin pain usually starts in the chest or ribs. If you have this
kind of pain, it may not be a breast condition at all. It may be another
medical problem that should be checked by your health care provider.
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Benign breast changes can be distressing. Talk to your doctor about how
these breast changes can be treated. Your doctor may suggest surgically
removing broadenomas or fat necrosis, or draining painful cysts that
dont go away.
There are also things you can do to relieve some types of breast pain. To
help decrease the discomfort that can occur with brocystic breast changes,
doctors may suggest wearing a well-tted support bra to hold the breasts
close to the chest. Some women also nd that reducing caffeine intake
decreases breast discomfort.
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If you notice any breast change such as a new lump or thickening, nipple
discharge or pain dont ignore it! Make an appointment to see your
doctor. It may be a harmless breast condition or it could be a warning
sign of breast cancer. In any case, let your health care provider make the
diagnosis. See your doctor if you notice any of these things in your breasts:
U Lump, hard knot or thickening
U Swelling, warmth, redness or darkening
U Change in the size or shape
U Dimpling or puckering of the skin
U Itchy, scaly sore or rash on your nipple
U Pulling in of your nipple or other parts
U Nipple discharge that starts suddenly
U New pain in one spot that does not go away
Why should you be aware of these warning signs? Because it could help
you nd breast cancer early when it is easier to treat.
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Breast cancer is the most common type of cancer found in women in the
United States. It is also the leading cause of cancer death among women
between the ages of 20-39 and 40-59. So, what is breast cancer? Breast
cancer is not just one disease but a group of diseases. It occurs when
breast cells that line the ducts become malignant (cancerous). Unlike
benign (not cancerous) tumors, malignant tumors are made up of
abnormal cells that grow without normal controls and invade normal
breast tissue. These tumors can spread outside the breasts to other parts
of the body through the lymph system or blood stream.
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Early detection and treatment offer the best chance of surviving breast
cancer. When breast cancer is conned to the breast, the 5-year survival
rate is 98 percent.
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1. Annual screening mammography for women starting at age 40.
Women under age 40 with either a family history of breast cancer or
other concerns about their personal risk should consult with a health
care provider about risk assessment (your chance of getting breast cancer),
when to start getting mammograms and how often to have them.
2. Clinical breast exams
(CBE) by a health care
provider at least every 3
years starting at age 20,
and annually after 40.
3. Monthly breast self-
examination (BSE)
starting by age 20 to
become familiar with the
normal look and feel of
your breasts so you will be
aware if a change occurs.
This plan will help you take an active role in the health of your breasts.
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Mammogram (breast X-ray) is the best screening tool widely available for
nding breast cancer early. It can nd breast cancers before they can be
felt. It uses a very small amount of X-ray radiation.
During the mammogram, your breasts
are pressed between two plastic plates
in at least two positions. This attens
the breast tissue so that the X-rays will
be clear. Be sure to tell the technologist
about any lumps or changes you have
noticed. It is a good idea to have your
mammogram at the same place every
year so that your X-rays can be
compared. Or, pick up your previous
mammogram lms and take them with
you so that they can be compared to this years mammogram. The test
takes a few minutes, and you will usually have your results within two
weeks. If you do not receive the results in two weeks, call your doctor
or the mammography center.
Starting at age 40, women should get a mammogram every year. If you
are under 40 and have a family history of breast cancer or other concerns
about your breasts, talk to your health care provider about your risk,
when to start getting mammograms and how often to have them. Most
insurance programs cover mammograms, including Medicare. There are
many free or low-cost programs. Call the Breast Care Helpline at
1-877 GO KOMEN (1-877-465-6636) for more information.
Remember that some breast cancers are not found by mammography but
can be felt during a clinical breast exam. So, its important to have both
a clinical breast exam and a mammogram done each year.

CIinicaI Breast Exam (CBE)

Your health care provider should perform your CBE during regular
checkups. Ideally you should have your CBE just before your annual
mammogram. If your doctor does not examine your breasts, ask for it.
During the CBE, the doctor will look for breast changes such as size,
shape or color. Then, your doctor will feel the entire breast and underarm
areas for new lumps or changes. Ask any questions you have about doing
BSE, common breast changes or your personal risk.
Breast SeIf-Examination (BSE)
Get to know the normal look and feel of your breasts by doing BSE.
BSE should be done once a month just as your period ends. If you no
longer have monthly periods, do BSE on the same day each month.
Women should perform monthly BSE by age 20. For step-by-step BSE
instructions, go to www.komen.org/bse.
Make BSE a time for relaxation and self-care. It may feel awkward doing
BSE at rst, but the more you do it, the more comfortable you will feel.
Here are the basic steps to BSE:
U First, lie down on your back with a pillow
under your right shoulder and place your right
hand behind your head.
U Use the pads of the three middle ngers on
your left hand to check your entire right breast,
above and below your collarbone and in your
armpit area.

U Start under your arm, making small, dime-sized

circles in an up and down pattern.
U Continue this pattern using light, medium and rm
pressure without lifting your ngers off the skin.
Repeat these steps on your left breast using your
right hand. When lying down, remember to put
your left hand under your head and a pillow
under your left shoulder.
These steps may be repeated while bathing or
showering using soapy hands.
Then, standing in front of the mirror, check for
any changes in the shape or look of your breasts.
Look for any skin or nipple changes such as
dimpling, changes in skin color or nipple
discharge. Inspect your breasts in four steps:
U Hold your arms at your side
U Hold your arms over your head
U Press your hands on your hips and tighten
your chest muscles
U Bend forward with your hands on your hips
If you notice any change in the normal look or
feel of your breasts, make an appointment to see
your health care provider. Explain the breast
change you found while checking your breasts.
Remember, most lumps are benign.
Write BSE on your calendar to remind yourself
when to examine your breasts next month.
Remind your friends to do BSE as well.

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Simply being a woman and getting older put you at risk. In addition,
there are a number of other risk factors. Having several risk factors for
breast cancer does not mean that you will get breast cancer. It means
that your chances of getting the disease are higher than women who
have fewer risk factors. Many women with breast cancer do not have
any known risk factors aside from being female.
So what causes breast cancer? The causes are not fully known.
However, there are known risk factors that you can control and
others that you cannot change.
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U Drinking more than one alcoholic drink per day
U Being overweight after menopause or gaining weight as an adult
U Current or recent use of birth control pills
U Having rst child after age 35
U Never having children
U Currently or recently using some form of hormone replacement
therapy (HRT) for menopause symptoms
U Being exposed to large amounts of radiation, such as frequent
X-rays in youth
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U Being female
U Getting older
U Having already had breast or ovarian cancer
U Having a family history of breast cancer
U Having certain mutated breast cancer genes (BRCA1 or BRCA2)
U Having had your rst period before age 12
U Having started menopause after age 55
U Having a breast biopsy that showed atypical hyperplasia or
carcinoma in situ
U High bone density
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The best way to protect yourself against breast cancer is to do the
following:
U Become familiar with your breasts.
U See your doctor to discuss risk assessment and your
breast health needs.
U Become aware of your risk for developing breast cancer.
U Change the risk factors that you can control.
U Follow the 3-step early detection plan (page 9).
"
#
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If you have breast cancer,
you can play an active
role in your treatment by
being informed. Find out
what your treatment
options are by asking
questions, doing some
research on your own and
getting a second opinion.
Today, many treatment
options are available to women who have been diagnosed with breast cancer.
The most common forms of treatment include surgery, chemotherapy,
radiation therapy and hormone therapy. Make a list of things that you
would like to know about your cancer and the treatments available.
This booklet is only an introduction to breast health. It will give you some
insight on the issue of breast cancer but will not answer all your questions
nor respond to all your concerns on the topic. For further inquiries on the
kinds and stages of cancer, treatment options and information on support
groups, you can contact any of the organizations listed on page 16.
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Areola: darkly shaded area that encircles the nipple
Benign: not cancerous
Biopsy: test used to remove breast tissue so that it can be examined under
a microscope to look for cancerous cells
Breast Self-Examination (BSE): screening that involves examining ones
breasts for lumps and changes
Cancer: diseases involving abnormal cell growth that can spread
throughout the body
Chemotherapy: the use of drugs to treat cancer
Clinical Breast Examination (CBE): screening performed by a health care
provider that includes visual examination (looking) and palpation (feeling)
of the entire breast in both sitting and lying-down positions
Cysts: uid-lled sac in the breast tissue
Diagnostic Testing: tests used to determine the nature of
breast changes
Ducts: channels that transport milk from the lobules to the nipple
Estrogen: a female reproductive hormone
Fat Necrosis: hard lumps that are formed by damaged fatty tissue
Fibroadenomas: round, rubbery, benign tumors
Fibrocystic Breast Changes: lumpiness in the breast or tenderness and
pain at certain times of the month
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Susan G. Komen for the Cure is the largest grassroots network of breast
cancer survivors and activists ghting to save lives, empower people,
ensure quality care for all and energize science to nd the cures.
1-877 GO KOMEN
www.komen.org
The National Cancer Institutes Cancer Information Service provides
cancer information and resources to patients, the public and health
care providers.
1-800-4-CANCER
www.cancer.gov
The American Cancer Society is dedicated to preventing cancer, saving
lives and reducing suffering through research, education, advocacy
and service.
1-800-ACS-2345
www.cancer.org
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The Arab-American and Chaldean Council (ACC) is committed to educating
the Arab-American and Chaldean communities about breast cancer
through promoting awareness and providing early detection services.
1-248-559-1990
www.arabacc.org
The Arab Community Center for Economic and Social Services (ACCESS)
is dedicated to increasing awareness and knowledge about breast cancer
in the Arab-American community through its outreach and screening services.
1-313-842-7010
www.accesscommunity.org
$
5Z]aaO`g
Hormones: chemicals produced by glands in the body
Hormone Therapy: treatment that blocks your bodys natural hormones
from stimulating the growth of any remaining cancer cells
Lobules: milk-producing glands in the breasts
Lymph Nodes: glands, found throughout the body, that lter the
lymph uid
Malignant: cancerous
Mammogram: X-ray picture of the breast
Menopause: when the menstrual cycles end
Nipple Discharge: secretions or uid coming from the nipple
Radiation Therapy: treatment using high-energy X-rays to destroy
cancer cells
Screening: a test or procedure used to detect cancer in a person who does
not have symptoms
&
5Z]aaO`g
Areola: darkly shaded area that encircles the nipple
Benign: not cancerous
Biopsy: test used to remove breast tissue so that it can be examined under
a microscope to look for cancerous cells
Breast Self-Examination (BSE): screening that involves examining ones
breasts for lumps and changes
Cancer: diseases involving abnormal cell growth that can spread
throughout the body
Chemotherapy: the use of drugs to treat cancer
Clinical Breast Examination (CBE): screening performed by a health care
provider that includes visual examination (looking) and palpation (feeling)
of the entire breast in both sitting and lying-down positions
Cysts: uid-lled sac in the breast tissue
Diagnostic Testing: tests used to determine the nature of
breast changes
Ducts: channels that transport milk from the lobules to the nipple
Estrogen: a female reproductive hormone
Fat Necrosis: hard lumps that are formed by damaged fatty tissue
Fibroadenomas: round, rubbery, benign tumors
Fibrocystic Breast Changes: lumpiness in the breast or tenderness and
pain at certain times of the month
%
Resources
5Z]aaO`g
Hormones: chemicals produced by glands in the body
Hormone Therapy: treatment that blocks your bodys natural hormones
from stimulating the growth of any remaining cancer cells
Lobules: milk-producing glands in the breasts
Lymph Nodes: glands, found throughout the body, that lter the
lymph uid
Malignant: cancerous
Mammogram: X-ray picture of the breast
Menopause: when the menstrual cycles end
Nipple Discharge: secretions or uid coming from the nipple
Radiation Therapy: treatment using high-energy X-rays to destroy
cancer cells
Screening: a test or procedure used to detect cancer in a person who does
not have symptoms
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