Breast health: Early detection is key

Most health experts advise women to have clinical breast exams every three years until the age of 40 and then once a year after that. Mammograms are also recommended annually after the age of 40 and every three years between the ages of 50 and 70.

From the age of 20 onwards, women should start checking their breasts regularly. After the age of 30, women should do a self-examination of their breasts every month. Here's how:

Self-exam tips

Your guide to maintaining healthy breasts

Homeopathic help

Dr Akshay Batra is the deputy managing director of Dr Batra's Positive Health Clinic in Dubai Healthcare City (04-4343981 or visit www.drbatras.com ). According to Dr Batra, homeopathic remedies can prove very useful for easing hard-to-treat breast issues. "Homeopathic remedies are safe and effective," he says. "You can self-medicate using low potencies, but if symptoms persist consult a homeopathic doctor who will be able to give you a prescription that is specifically tailored to your personal condition."

Homeopathic remedies can help with breast pain, cracked nipples, mastitis, milk engorgement, increasing or decreasing milk production for breastfeeding mothersand more.

In recent years, the issue of breast cancer has become very present in the general consciousness — and rightly so — but there are numerous other issues related to breast health, about which most women know very little. Here are some of the most common breast complaints.

If you are experiencing breast pain, chances are your breasts are reacting to hormonal changes. Dr Houriya Kazim is medical director and specialist breast surgeon at Well Woman Clinic, Jumeirah (04-3327117 or visit www.wellwomanclinic.ae ). She says, "As a woman, there are times in your life, and during your monthly cycle, when your breasts may feel sore or tender because of your hormones, for example, during puberty, right before your menstrual period, or as you get older." Dr Kazim explains that every month our breasts prepare for the possibility that we may fall pregnant. She says, "Your breasts don't know if you are in a relationship or single, or whether you are interested in falling pregnant or not. Every month they think you might get pregnant, so the ducts and glands get ready and your breasts swell, which can be painful. Breasts are dynamic organs — there is simply a lot going on in there."

While most women associate lumps with breast cancer, very often they are nothing to worry about. "The majority of cases I see on a daily basis are not cancerous," says Dr Kazim. "They are usually fibrous or fibrocystic. But the breasts are a very emotional area and people often come to me in a blind state of panic. I say to them, ‘Remember, you are eight times more likely to drop dead from a heart attack than to die from breast cancer."'

The two most common types of non-cancerous breast lumps are cysts, which are fluid-filled lumps, and fibroadenomas, which are fibrous lumps. Usually they form in response to hormonal changes in the body. However, as Dr Kazim points out, all women have the same hormones and the same hormonal cycle, and we do not all get cysts or fibrous lumps; it comes down to a combination of genetics and hormonal fluctuations. A woman who is genetically inclined may develop both at different points in her life.

Fibrous lumps: This type usually surface in the late teens and early 20s as hormonal levels are rising. Dr Kazim refers to fibrous lumps as ‘breast mice' as they are round, smooth and move easily under the fingers. To the trained eye, or fingertip, they are easily discernible from cancerous ones. However, your doctor may want to keep close tabs on fibrous lumps through scans and perhaps even a biopsy. Fibrous lumps are usually painless, and 98 per cent of them will stay the same size, grow smaller or even entirely disappear in their own time.

Cysts: Whereas fibrous lumps generally occur during the early stage of a woman's hormonal career, cysts tend to effect women aged 40 plus, at the age when hormone levels are decreasing. According to Dr Kazim, 70 per cent of women will experience breast cysts at some point in their lives. You may be alerted to a cyst by pain or by actually feeling a lump. Some cysts may disappear after a year or two, while others will stay right through to menopause. Generally, when a woman hits menopause and her hormonal levels drop off, the cysts will disappear, too. Dr Kazim says, "We usually don't do anything to cysts. We may scan them and keep an eye on them, but generally we will just leave them alone."

Interestingly, breasts are sterile, meaning if you have an operation on the breast, you won't need to take antibiotics. However, the milk ducts which feed milk out through the nipples are open to the outer world and, therefore, prone to dirt and bacteria build up. This is not a problem unless something happens to allow the bacteria and dirt into the breast itself causing infection and inflammation, known as mastitis. The result is a very sore, swollen area which will usually appear red and feel hot to touch. Mastitis patients usually need a course of antibiotics to clear the infection.

There are many types of mastitis, including TB in the breast, but the most common version occurs when a woman is lactating. If a woman has dry cracked nipples, microscopic tears in the nipple allow bacteria and dirt to seep through from the duct to the breast tissue. Dr Kazim advises breastfeeding women to protect their nipples from dryness and to keep the area clean.

Another type of mastitis is periductal mastitis, which refers to inflammation around the milk duct. According toDr Kazim, 90 per cent of patients suffering from periductal mastitis are smokers. She says, "Nicotine damages the lining of the milk ducts, which causes duct walls to break down allowing bugs and dirt to seep out and infect the area.

Unfortunately, once you have these leaks in your milk duct walls, they will never go away, leaving you at high risk of repeated infection." The only way to cure periductal mastitis is to cut the affected milk ducts out, which can mean losing a nipple.

Sometimes breasts will secrete fluid even when a woman is not breastfeeding. This could be because of unusual stimulation of the breast area, for example through clothing or sporting activities, but is most likely a result of either fibrocystic conditions or benign growths in the milk ducts, known as papillomas.

The discharge is usually a cloudy yellow or green colour. If the discharge is either red, brown or black, or if it only seems to be coming out of one breast, it could be because of something more serious. Either way, it is worth getting it checked.

Men have breast tissue, and consequently they are also susceptible to cysts and fibrous lumps. Another male breast issue is gynecomastia, which refers to swelling of the male breast tissue. This usually occurs during puberty, or as a result of certain medications or hormone therapy. The swelling should subside within two years. However, if it is painful he will need to see a doctor.