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Breast Health

The breasts are part of the female reproductive system. As a common characteristic of all mammals, the breasts appear during a birth and then feed the babies. But this situation is a little bit different in human being. A human's breasts develop long before becoming fertile and getting pregnant. Therefore, the breast in human being is not only a reproductive organ but also a part of the sexual life.

The breast can be said to be tear-drop shaped. Its size and shape vary. Therefore, the adjective "normal" is difficult to describe. Difference is not only between individuals. The same person's breasts are also different from each other. Usually the left breast is slightly bigger and sagging. The shape and size of the breasts have been genetically determined in advance. The breasts may have various shapes, sizes and consistencies. The breast contains skin, nipple, and fatty tissue. Approximately one-third of the breast consists of fat, and the remaining part is the breast tissue. During weight gain and loss, the normal breast tissue remains normal, while the amount of fatty tissue changes. There is no correlation between the size of the breast tissue and breastfeeding capacity or the possibility of cancer development. The ratio of these tissues to each other does not change only from person to person but also change in the same person, at certain times throughout her life. Ideally, the breast has a conical shape. Its largest diameter is at its base, i.e., the chest wall. There are pectoral muscles under the breast tissue. In young girls, breasts are typically firm and relatively lifted, and contain primarily breast tissue. With increasing age, the fat rate increases and the breasts begin to sag. If the sagging occurs after pregnancy and breastfeeding, it is called involutional sagging. Breast sagging may occur at too early or too late ages, depending on individuals. Heredity is the strongest determinant factor in sagging.

The dark area around the nipple is called the areola. Its shape, size and color vary depending on the individual and her skin color. After the first pregnancy, the areola acquires a darker color; and then, that color remains unchanged. Inside the areola, there are small sebaceous glands called Montgomery glands. The nipple and around the areola may contain hair. There is no problem with depilating these areas.

Normal nipple and areola

Like other organs of the body, the breasts have arteries, veins, nerves, and lymphatics, as well. When the greater part of the blood serum that comes through the artery and leaked into the tissues returns back to the veins, especially the ones with large molecules are transported to the lymph nodes through the lymphatics, and they are processes there and then are poured into a vein for reuse. This system also transports foreign matters, germs and cancer cells from the tissues to the nearest lymph node chain, and enabled the immune system to fight them in the node.
 
The lymphatic drainage of the breast and breast tissue start growing in the 6th weeks of fetal life. They develop on the line called the "mamillary line" that extends from the armpit to the groin. This line recedes and the development occurs in the chest wall only. Sometimes extra breast tissue or nipple remnants may remain on the line. When born, a baby girl may secrete milk called "witch's milk", under the influence of the hormones that the baby takes from the mother; and then this secretion rapidly recedes. No development occurs until puberty. With puberty, the breast tissue starts developing under the influence of the hormones. Her menstruation begins 1-2 years later. The effect of breast development on psychological development of girls varies. 56% of them feel pleased and proud of this development, whereas 34% of them feel shame at this, and 10% of them even hate this. This is a problem completely related to the environment and education. Support of the mother and even support of doctors, if necessary, is essential for ensuring this period to be experienced smoothly. Breast is a sensitive organ in terms of sensuality. This sensitivity increases particularly during the ovulation and second part of menstrual period. The sensations in the nipple and areola are different; and as sexual organs, they are highly sensitive to erogenous stimulations.

Bra Usage

Bra became popular in the 1920s; so, it is a relatively new invention. Some people find wearing bra comfortable, while some others feel uncomfortable with it. The thought that bras prevent sagging of the breast is totally wrong. Some people wear it compulsorily due to their social position. In conclusion, wearing a bra is something to be decided by a woman, depending on her aesthetic, psychological and social statuses. Your bra size consists of two values: body size, and cup size. Body size indicates the largeness of the body, while cup size indicates the largeness of the breast. Since the largeness of the breast and the largeness of the body are usually proportional to each other, different cups are not produced for each model.

How to determine your body size?

To measure your breast girth (underbust girth), wrap the tape measure around your chest, under your breasts. Make sure that the tape measure is placed under your breasts, in such a way as to form a straight and horizontal line at your back. For example, if your underbust girth is 76, the size of the bra that you must use should be 80. As bra sizes increase in steps of 5 cm, you should choose a bra one size larger, for values exceeding the unit values. (The measurement is made a few days before menstruation, with intent to ensure it not affected by any swelling and tension) The bra sizes for underbust girths are as follows: Up to 70 cm=70; 71-75 cm=75; 76-80 cm=80; 81-85 cm=85; 86-90=90; 91-95 cm=95; and 96-100 cm=100.

How to determine bra cup size

Wrap the tape measure again from back to front, but this time over your nipples. The value to be obtained (bust girth) will be greater than the value obtained from the measurement of the underbust girth.     The difference between these values gives the cup size. If this difference is less than 6.5 cm, the size is A; if it is between 6.5 and 13 cm, the size is B; if it is between 4 and 19.5 cm, the size is C; if it is between 19.5 and 26 cm, the size is D; and if it is greater than 26 cm, the size is DD. For example, let’s say your underbust girth is 73 cm. and your bust girth is 86 cm. Since the difference between the two measures is 11 cm, your cup size should be B. Therefore, your bra size is 75B. If the cup size is not indicated on the bra, it can be considered to be B. The vast majority of women already use B, as a cup size.

Self-examination

One of the most important concepts of the women's movements of the 1970s was women knowing their own bodies. It is because touching any erogenous zones was a taboo before that movement. It had two objectives. 1- Knowing one's own body and being proud of it, 2- being acquainted with one's own tissues by touching them for medical purpose, and noticing anything wrong as soon as it occurs. Knowing the breast begins with standing in front of a mirror and looking in it. Then the hands press down on the buttocks. In the both case, the appearance of the breasts are analyzed. The next step is to feel the breast. There are people who recommend doing this when lying on back or with soapy hands when having shower in standing position. The breasts may be felt granular or nodular in consistency. They all are normal, and varies from person to person. The important thing is to notice the changes that occur in the course of time. Rather than her physician, she herself feels such changes. Breast self-exam can be done in the following ways: Ideally it is done once a month, 7-10 days after the beginning of menstrual period.

Breast examination methods

Breast Imaging Methods... 1-Mammography: It is the most important tool in the early diagnosis of breast cancer. It can be used in two ways: Screening mammography; is used to monitor the breasts of normal women, whose breasts show no symptoms. The American Cancer Society recommends having a mammograph only once before the age of 40, yearly or biennially between 40-50 years of age, and yearly after age 50. Diagnostic mammography; is intended for diagnosis. It is performed for those who has complaints, or when a potential problem is detected with other methods. 2- Ultrasonography: It is mostly used in young people, with intent to understand whether the masses are cystic. 3-magnetic Resonance Imaging (MRI): It is an expensive process. It enables the lesions, detected by other methods, to be analyzed in more detail. It is most convenient in reviewing cases that include breast implants. 4-Positron Emission Tomography (PET): It is quite new. It is important particularly in the follow-up of cancer recurrences.