It was Mother’s day two weeks ago on Sunday 10th May and I nearly missed it.
I am sure, I am not the only one that had not noticed until the day was half gone. Probably because they are so many special days, you have national days, internationals days, religious days and the list is just endless.
For Mothers day in particular, what makes things even worse is that it is not commemorated on the same day in all the countries of the world, nor  does it fall on the same date each year. In Zambia, it is usually the 2nd Sunday of May.
What actually made me remember this time was that I happened to catch a clip of the Vice President Hon Inonge  Wina MP on ZNBC Television. There was something that caught my attention about her posture and demeanor, it held me long enough, not to change the channel, as many people do when politicians appear on the TV screen.
I did not really listen to what she said, what was more striking to me, was how she said it. It sounded personal, like something someone says not because it’s their job to say it, but something that really matters to them. Now having practised medicine, quite a while, I have learnt that the greatest partner a Doctor has in trying to provide health care in the community is the mother.
When I have to see a child in the hospital the first question I ask is, “Where is the baby’s mother?” Fathers, I have found are rather the opposite. They are really quite nervous about hospitals and Doctors, they tend to agree to everything and to have their eyes on the watch and the exit half the time.
So it struck me listening to the Vice President that the best present for Zambian mothers, who are always looking out for the welfare of all of us, is to turn the attention on them. How about if we were to talk about the good health of Zambian mothers on Mother’s day.
Well I wasn’t quick enough on the rebound, however, I thought even though belatedly we should write something this week on the health of women. The organ in the body which best represents the nurturing work of motherhood, and is in fact named for this work is “the Breast” or medically the “Mammary Gland”(or the mother’s gland). So I thought to write this week on the health of the Breast.
1. What are the common health problems of  the Breast?
2. How can these problems be addressed?
3.What can I do to keep my breasts healthy?
1.What are the common health problems of the Breast?
There are two things that make dealing with Breast disease difficult for women. These are compounding issues of beauty and fertility.
The breast has always been regarded as an organ of beauty as well as fertility.
This is so not only so in modern day life but also in traditional culture.
However, this has been exploited even more by popular advertising, beauty magazines and movies.
This means that often the health of the Breast competes and is overshadowed by the matters of the beauty of the Breast.
The effect on health has been that women are naturally reluctant about admitting to any disease of the breast. Since they may be perceived as either less beautiful or less fertile than others of their peers.
In brief there are 3 main problems of the Breast which are;
1.Breast lumps.
2.Breast discharge.
3.Breast pain.
When a woman has pain in her Breast, she will often worry and think she has Breast cancer.
In fact, the truth is that Breast cancer rarely ever gives Breast pain initially. In addition, a women who has a nipple discharge (material coming out of the nipple) unless they are breast feeding also thinks she may have cancer. For most women, any Breast problem is assumed to be cancer. Therefore, by learning a little more about the common diseases of the Breast, many women are likely to respond better to any disease of the Breast that may come along.
By far the most common complaint women will have about the Breast is the presence of a lump in the Breast. It is important to know that women of any age can develop a breast lump.
Put very simply there are three categories of Breast Lumps that are common. Those that occur in the age below 18 years, those in the age groups between 19 yrs and 45 years and those after 45 years of age. When a lump is found in a girl below 18 years, they tend to be harmless lumps related to Breast development. These are called Fibroadenomas or breast mouse. The better terms is ANDI-Aberrations of Normal development and involution. This means that this type of lump is within the range of a normal breast development, except when it is very large.
A similar thing occurs from 45 years onwards when the Breast begins to shrink and lose its fat component, these lumps are called cysts or Fibrocystic disease.
They are dilated Breast ducts ,which may contain fluid. This can also be included in the category of ANDI.
In Zambian women between the ages  of 25 and 45 years, a solid painless lump is likely to suggest Cancer.
This is 10 years earlier than the common age at which Breast Cancers is seem in developed countries.
Breast discharge is of 3 types, based on the colour of the discharge. These are white(milky), red(blood) or coloured (other colours such as green ,yellow etc). Milk discharge may occurs in breast feeding mothers.
This, when, associated with lumps is called a Galatocoele. It milk discharge may also be  due to certain drugs and occasionally following Breast injury. Coloured discharge occurs in lumps of the Breast  which contain fluid called Breast Cysts, the colour will vary according to the material within the cysts. If a women has a collection of pus they may have a yellow pus like nipple discharge.
When the discharge is red, this most often suggests Cancer in the lining of the Breast ducts.
Breast Cancer is the second most common cancer in women in Zambia after Cervical Cancer (Cancer of the neck of the womb).
Breast pain is of two types.
Pain from the Breast tissue, which is related to menstrual cycles called Cyclical Breast pain, or pain arising from tissues surrounding the Breast called Non Cyclical breast pain.
2. How can these problems be addressed?
The first hurdle is acceptance, it is difficulty for many women, to admit that they have problems with their breast.
This appears to be because of the excessive overemphasis on the Breast as an organ of feminity, beauty and fertility.
So for a woman to admit to herself  or worse still to anyone else that she has a problem, with her Breast is seen as an admission of  being less of a woman.
The first step would be to admit that there is a problem, in order to have it corrected early.
If a woman has Breast pain, she should try and keep a monthly record of the pain for at least three months.
The pattern of the pain will then become apparent. Most of the Breast pain, will be associated with menstrual cycles.
This is called cyclical Breast pain. Some tablets such as oil of primrose tables as well as pain killers maybe used to treat Breast pain.
A painless lump in a Zambian woman over 25years should be considered a sign of Cancer of the Breast until proved otherwise. The Breast lump can be assessed in 3 ways, which are physical examination by a doctor, evaluation by an  X ray(the breast X ray is called a Mammogram, in younger Breast Ultrasound can be used) and evaluation of the Breast cells in the lab ( cytology or histology).
Nipple discharge is evaluated by examining the material on a slide in the laboratory, this process is called cytological assessment.
If this shows the presence of cancers cells, further evaluation for cancer will be done. Small lumps in young women and cysts in elder women require regular monitoring for growth of size or change in other symptoms.
3. What can I do to keep my Breasts healthy?
The only way to keep the Breast healthy is develop an interest in the health of the breast beyond their beauty. Four approaches to Breast health can be suggested as listed below;
1.BreastSelf Examination (BSE)
2.Breast Care
3.Breast Support
4.Breast Feeding
Take an interest in inspecting your Breast daily, especially as you get older. Look regularly in the mirror at your breasts. Ask if they are the same size, shape and if the nipples point in the same direction on both sides. Hold your hips and look again at the Breast for these things.
Look at your bra for any staining, which may suggest nipple discharge. Touch your breast with the palm of your hand, feel for any lumps in the Breast and armpit. This technique  is called Breast Self Examination (BSE) and is easy to learn.
Take care of your Breasts, make sure your nipples do  not get cracked by apply Vaseline on the nipples,look at the Breast fold keep it dry and if it gets itchy apply an antifungal cream.
Keep your diet low in carbohydrates and eat good fats(polyunsaturated or plant fats, rather than animal fats).
This will keep you Breast from becoming too heavy, big and is protective from Cancer of the Breast.
May women wear Bras with metal lining, padding or with cups one size too small.
This is designed to lift the Breast or make them look more full. However this may squeeze the breasts making them uncomfortable or even painful. Wear a Bra one size bigger for comfort.
Many women, are reluctant to Breast feed, because they fear that this will shrivel the Beast and make it sag prematurely. However, Breast feeding is a good thing for the Breast, it tends to reduce the risk of Breast Cancer. Longer Breast feeding is associated with reduce risk of Cancer of the Breast and higher intelligence of children (according to recent studies on Breast feeding).