A month to protect: preserving the female breast

A friend of mine always says that God is marvelous when describing the anatomy of the human body. A lecturer affirmed this by saying that if you stand in front of a mirror naked in your room observing your body parts from head to toe you will appreciate how wonderful a designer God is. One part of the female’s body that was wonderfully designed by God to serve different purposes is the female breast. The Bible also affirms this in Songs of Solomon 4:5, “Thy two breasts are like two young roes that are twins, which feed among the lilies”.

Zelazniewicz and Pawlowsk, (2011) revealed that most males are attracted to females based on the shape and contour of the breast compared to the size of the buttocks. This implies that the female breast adds to the beauty of a woman. Consequently, some females have gotten their prospective partners based on the shape of their breast (Levin, 2006) even though love should not be based on physical looks. Despite this, it has been found that this part of female body has been ignored by most females (Levin, 2006) by exposing it anyhow and also subjecting it to several treatments in other to enlarge it.

The female breast as we know are two in number situated on each side of the chest. The development of the female breast is influenced by two female hormones known as estrogen and progesterone which results in changes of the breast with aging (Howard, 2017). This also explains why breast sags and become flabby during menopause due to the reduction in the levels of estrogen and progesterone. The breast play an active role during sexual intercourse for couples, and research shows that the most sensitive part of the female breast is the nipple (Garcia, 2015). This is because the nipple has erectile tissues making it possible to erect and numerous nerve supply making it sensitive. The main function of the breast is to produce milk after delivery which serves as food for the baby.

Figure 1

The National breast cancer foundation (2018), google pictures

Despite the various functions that the females breast has, sometimes the beauty and functions of these structures are marred by a deadly disease called cancer which has no cure yet making this beautiful structure look ugly sometimes with pains, lumps, dimpling, sores, inverted nipple, enlargement, bleeding and discharges from the nipple amongst others. Breast cancer ranks first among all cancers affecting women in Ghana (Wiredu & Armah, 2006). The worse of it all is that it may leads to removal of the breast and sometimes death of the victims.

According to WHO (2017) there were about 1.7 million breast cancer cases in 2012 with further estimation of about 49,500 new cases by 2018. In Ghana, the incidence of breast cancer is approximated at 30900 cases annually (Adai, 2016).

Several factors have been linked with breast cancer, some of which are;

• Aging (40 years and above)
• Obesity (BMI below 18-underweight, 18-24- normal weight, 25-30- overweight, 30 and above- obesity).
• Hereditary (Having a closed relative with breast cancer, parents, siblings etc).
• hormonal factors (early menarche before age 12, late menopause after age 55 years, no pregnancy or late pregnancies after age 30, oral contraceptives, lack of breastfeeding, hormone replacement therapy at menopause)
• Prolong exposure to radiation
• excessive alcohol consumption
• too much dietary fat intake
• Smoking
(Laamiri et al., 2016; Nde et al, 2015; Maas, 2016; Sun et al, 2017; Kamińska, 2015)
To help detect breast cancer early, it is recommended that women engage in Breast Self-Examination (BSE), once every month, between the 7th and 10th day of the individual menstrual cycle (Birhane et al, 2017). After menstruation, the breast is less painful and is easier to detect any lump. BSE can be done by the woman herself, the husband of the woman or health personnel. It can be done whilst standing or lying. The woman can also do BSE whilst under a shower. Note: every woman should know the normal shape and size of their breast so that they can easily detect any abnormality. There are several ways of doing BSE but only one is described in this article. The following are the steps one could follow

(Women’s Health, 2013)
1. Expose the breast
2. Stand in front of a mirror
3. Assess the size, shape, contour, and color of the breast for any changes. If it is your first time do not be alarmed if you find one breast to be slightly larger than the other. This is normal.
4. Raise your two arms up, hold your waist when examining the size, shape, contour etc of the breast.
5. Examine each breast independently.
6. In examining the left breast, raise the left arm above or over your head. This make the breast become more prominent
7. Examine the breast with the pads of the three middle finger applying firm pressure
8. Start breast examination close to the armpit region and move in circles making sure all parts of the breast are covered till you get to the nipple.
9. Upon getting to the nipple squeeze the nipple for any strange discharges being it bloody or any colorful discharge
10. Also during the examination note any pain, dimple, and lump. Cancer lumps are small, painless that vanishes when felt.
11. Feel the armpit to assess for lumps since the breast extends into the armpit and also assess the lymph nodes in the armpit.
12. Examine the right breast following the same steps.
13. Visit the hospital when any abnormality is detected.
In conclusion the breast is a vital organ, breast cancer is not curable and the outcome is not always positive. Women are therefore admonished to engage in practices that will help preserve their breast for themselves, their husband and the unborn baby.

Author: Mr. Osei Evans Appiah, An MPhil nursing student, University of Ghana.
Contributed by:
Mrs. Kappiah Jamilatu, An MPhil nursing student, University of Ghana
Mrs. Diana Bosomtwe Duker, An MPhil nursing student, University of Ghana

References
Birhane K, Alemayehu M, Anawte B, Gebremariyam G, Daniel R, Addis S, et al. (2017). Practices of breast self-examination and associated factors among female Debre Berhan University students. Int J Breast Cancer. 2017;2017:8026297.
Edgard S. Garcia, Daniela F. Veiga, Miguel Sabino-Neto, Flávia N.M. Beraldo Cardoso, Israel O. Batista, Renata M. Leme, Isaias V. Cabral, Neil F. Novo, Lydia M. Ferreira (2015). Sensitivity of the Nipple-Areola Complex and Sexual Function Following Reduction Mammaplasty, Aesthetic Surgery Journal, Volume 35, Issue 7, 1 September 2015, Pages NP193–NP202, https://doi.org/10.1093/asj/sjv034
Kamińska, M., Ciszewski, T., Łopacka-Szatan, K., Miotła, P., & Starosławska, E. (2015). Breast cancer risk factors. Przegla̜d Menopauzalny = Menopause Review, 14(3), 196–202. http://doi.org/10.5114/pm.2015.54346
Laamiri, F. Z., Hasswane, N., Kerbach, A., Aguenaou, H., Taboz, Y., Benkirane, H., … Amina, B. (2016). Risk factors associated with a breast cancer in a population of Moroccan women whose age is less than 40 years: a case control study. The Pan African Medical Journal, 24, 19. http://doi.org/10.11604/pamj.2016.24.19.8784
Levin R.J (2006). The breast/nipple/ areola complex and human sexuality, Sexual and Relationship Therapy. Reader in Psychology, (Retired) (2006), 21:02, 237-249, DOI: 10.1080/14681990600674674
Maas P, Barrdahl M, Joshi AD, et al. (2016). Breast Cancer Risk From Modifiable and Nonmodifiable Risk Factors Among White Women in the United States. JAMA Oncol. 2016;2(10):1295–1302. doi:10.1001/jamaoncol.2016.1025
Nde, F. P., Assob, J. C. N., Kwenti, T. E., Njunda, A. L., & Tainenbe, T. R. G. (2015). Knowledge, attitude and practice of breast self-examination among female undergraduate students in the University of Buea. BMC Research Notes, 8, 43. http://doi.org/10.1186/s13104-015-1004-4
Sun, Y.-S., Zhao, Z., Yang, Z.-N., Xu, F., Lu, H.-J., Zhu, Z.-Y., … Zhu, H.-P. (2017). Risk Factors and Preventions of Breast Cancer. International Journal of Biological Sciences, 13(11), 1387–1397. http://doi.org/10.7150/ijbs.21635
Zelazniewicz, A. M., & Pawlowski, B. (2011). Female Breast Size Attractiveness for Men as a Function of Sociosexual Orientation (Restricted vs. Unrestricted). Archives of Sexual Behavior, 40(6), 1129–1135. http://doi.org/10.1007/s10508-011-9850-1

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