•    On your last day of treatment or during your last on treatment visit, your doctor and/or nurse will discuss what is normal to experience after radiation therapy. You will also receive a follow-up appointment with your doctor, which can vary depending on your doctor's guideline

•    Please feel free to contact us at (021) 5339-3269 (Monday to Friday, 9:00am-6:00pm; for other time you can call 400-868-3000; call center will contact the on-call doctor) before your first follow-up appointment with any questions or concerns

•    Following radiation therapy, you may continue to have side effects related to your treatments. Below are some guidelines that will tell you what to expect and how to care for yourself after you complete your radiation treatments. Most side effects that you experienced during your treatments will gradually improve. Some may get worse for a few days after treatment before they start to improve. However, some may persist for months or may even be permanent. Your doctor will ask you about your symptoms when you return for a follow up visit:

  ○  SKIN: If you experienced a skin reaction during your treatments, it may worsen for 7-10 days after your final treatment and then begin to heal. Continue to gently cleanse and moisturize with recommended skin products as instructed by your doctor or nurse. If you notice that areas of your skin become open or weepy, if you have a fever (38.3°C or above) or notice large amounts of thick drainage, contact your radiation doctor or nurse. Once the skin has healed, be sure to protect it from injury and avoid direct sun exposure. Use a sunscreen if you cannot avoid the sun

  ○  DIET: If you have been on a special diet to control the side effects of your treatment, follow this diet until the side effects have resolved. Then, slowly advance to your normal diet

  ○  ACTIVITY: As tolerated. Fatigue and weakness can continue for several weeks. You may need to have rest periods and/or pace your activities

•    The end of cancer treatment is often a time to rejoice. You are probably relieved to be finished with the demands of treatment and are ready to put the experience behind you. Yet at the same time, you may feel sad and worried. It's common to be concerned about whether the cancer will come back and what you should do after treatment

•    When treatment ends, you may expect life to return to the way it was before you were diagnosed with cancer. But it can take time to recover. You may have permanent scars on your body, or you may not be able to do some things you once did easily. You may also have emotional scars from going through so much or you may fear that others view you as different or you may view yourself in a different way. You might talk to a friend who you trust.If you need, please feel free to talk with our social worker or schedule with our counselor

•    One of the hardest things after treatment is when you do not know what to expect next. Many cancer survivors feel that they had a lot of information and support during their illness and once treatment ends; they enter a whole new world - one filled with new questions

•    There are many emotional demands on you during this time in your life. It is common to feel anxious, depressed, afraid or hopeless. It may help to talk about your feelings. Feel free to talk about these feelings with any member of your treatment team. You can also talk to our social worker and/or our nurse

“Huuu…snort!…..huummm…gasp!” Your snoring echoes and booms through the night—much to the agony of the person being kept awake beside you. Our ENT doctor would like to remind us that: Apart from affecting the sleep of our families and housemates, snoring could also have a big impact on our health, so we must be on guard when it comes to obstructive sleep apnea.

What is OSA?

Obstructive sleep apnea (OSA) is the most common form of sleep apnea. It occurs when the upper respiratory tract becomes blocked, making breathing more shallow or stop, repetitively interrupting sleep. In serious cases this could happen 30 or more times per hour and lead to high blood pressure, heart attacks, brain problems, or increased risk of accidents.

What are the symptoms?

•  Snoring (most common symptom)

•  Fatigue or feeling tired during the day

•  Headaches in the morning

•  Dry mouth or sore throat when you wake up due to breathing through the mouth

•  Restlessness, screaming, sleep talking, convulsing, hearing sounds, having hallucinations, or sleep walking while asleep

•  Sexual dysfunction

•  Night sweats

•  Trouble concentrating, forgetfulness, and depression

•  Waking up suffocating or gasping due to difficulty breathing

Who gets it?

OSA is more common in males above 30. People who may be more likely to have OSA are those who may:

•  Be obese or overweight with a BMI of >25

•  Have a thick neck

•  Have small airways in their nose, throat, or mouth

•  Have enlarged tonsils

•  Have a large tongue

•  Smoke

•  Have diabetes

•  Have high blood pressure

•  Be at risk of heart failure or stroke

•  Use long-term sleep medicine

•  Upper respiratory tract inflammation

How is it diagnosed?

You can have your sleep monitored by wearing a device known as a polysomnography (PSG) as you sleep. Once finished, it will generate a diagnostic report. Your doctor will interpret the results to see if you have OSA. Standard diagnosis includes oxygen saturation, thoracic motion, and nasal airflow. Complex diagnosis may include ECG, EEG, or EMG.

How is it treated?

•  Life intervention and avoiding working too strenuously

•  Using a ventilator applying continuous positive airway pressure (CPAP)

•  Surgery in some cases

Treatment can significantly improve sleep quality and reduce the possibility of complications associated with cardiovascular disease and diabetes.

How can it be prevented?

If you or someone you care about has recently been diagnosed with breast cancer, there will be questions. These may include: What should I eat?

During any cancer therapy, remember these four diet tips

•    Stay hydrated.Aim for at least 2 liters to 3 liters of fluid per day—about 66 ounces to 99 ounces—mostly from caffeine-free fluids

•    Get enough calories.Forget the calculator—the good way to know whether you are eating enough calories for energy is to weigh yourself once or twice a week. If your weight is trending down week after week, speak with a dietitian to make a plan. Remember to eat regularly throughout the day. Small meals five to six times a day typically work well

•    Focus on nutrients and get the most nutrients per calorie. Choose foods from the food groups—things like fruits, vegetables, grains, beans, nuts, seeds, meats/eggs and dairy products. A balanced diet helps ensure you are getting the nutrients you need to keep your body strong

•    Don't forget protein.Protein helps maintain lean body mass/muscle. Protein is found in meat, poultry, fish, seafood, eggs, beams, lentils, nuts, seeds, soy and dairy products. Smaller amounts of proteins are found in vegetables and whole grains

If you don't have nutrition-related side effects from your cancer treatment that limit your ability to eat and/or digest food, you can follow a generally healthy diet that includes:

Fruits and vegetables: Five or more servings a day

Fruits and vegetables contain antioxidant and anti-estrogen properties. Cruciferous vegetables such as broccoli, cauliflower, kale, cabbage and Brussels sprouts are especially good to include and are rich in phytochemicals.

Whole grains: 25 grams to 30 grams of fiber daily

Whole grains are unprocessed foods that are high in complex carbohydrates,fiber, phytochemicals as well as vitamins and minerals. A study by researchers at Soochow University in Suzhou, China, found that high fiber intakes may have a positive effect by altering hormonal actions of breast cancer and other hormone-dependent cancers.

Nutritious fats: Less than 30 percent of total daily calories

Some studies, including a study by researchers at the Karolinska Institute in Stockholm, Sweden, have suggested that the type of fat you consume may initiate the development of breast cancer. Limit your intake of saturated fat such as beef, lamb,organ meats, butter, cream, etc. and decrease your intake of foods containing trans fats, which also are called hydrogenated oils. Increase your intake of fatty fish like salmon, tuna, herring, and sardines to two to three times every week.

Lean protein—and soy, too

For good protein sources, increase your intake of poultry, fish, and legumes such as beans and lentils. Minimize your intake of cured, pickled and smoked foods. Soy in moderate amounts, which means one to two servings/day of whole soy foods, such as tofu, edamame and soy milk, also can be included. Studies, including research reported in the American Institute for Cancer Research, show that animals metabolize soy differently than humans. Not only is soy safe in moderate amounts, but research shows that soy contains isoflavones, a phytonutrient with anti-cancer properties. Up to three serving of whole soy foods per day does not increase a breast cancer survivor’s risk of recurrence or death.

Alcohol in moderation, if at all

Drinking alcohol is a known risk factor for breast cancer. A large, observational study of 105,986 women suggested that drinking three glasses of wine or more per week throughout life increases a woman’s risk of breast cancer by a small but significant percentage. The study saw a 15 percent increase risk of breast cancer when women drank an average of three to six drinks per week, compared to women who did not drink. Try to avoid intake of alcoholic beverages when possible.

After treatment, maintain a healthy weight

Obese women have higher levels of estrogen circulating in their bodies than women who are in their ideal body weight range. Many studies including a study conducted by researchers from the Iranian Institute for Health Sciences Research in Tehran, Iran, have demonstrated an association between body mass size and breast cancer in post-menopausal women.

Weight reduction should be accomplished through a healthy diet and regular exercise once treatment is completed. Weight loss during treatment is not typically encouraged, as this is often associated with undesired muscle loss, leading to fatigue, a suppressed immune system, and a slower healing process.

Allow your body the nutrients it needs to fight cancer; once treatment is done, consider meeting with a dietitian for individualized recommendations to decrease recurrence risk and support a healthy weight.

Potential cancer fighters in foods

Phytonutrients support human health and are found in plant-based foods, including fruits, vegetables, beans, and grains. Below, find common foods that contain important phytochemicals.

Phytochemical                 Food Source

Carotenoids                       Dark yellow/orange/green vegetables and fruits

Isothiocyanates                 Mustard, horseradish, cruciferous vegetables

Phenolic compounds        Garlic, green tea, soybeans, cereal grains, cruciferous, vegetables, flaxseed

Flavanoids                         Most fruits and vegetables

Orango-sulfides                Garlic, onion, leeks, shallots, cruciferous vegetables

Isoflavones                        Soybeans, legumes, flax seed

Indoles                              Cruciferous vegetables: broccoli, cauliflower, kale, cabbage, Brussels sprouts

If you have side effects

If you experience nausea, your nutritionist may recommend that you try to eat more foods are cool or at room temperature, because they don’t have a strong odor. Your nutritionist also may advise you to eat lower-fat food since fats take longer to digest.

Don't skip meals entirely if you have nausea, since an empty stomach can make nausea worse. Instead, focus on small bites of food throughout the day. Avoid strong flavors. Feel free to incorporate ginger root into your recipes, as this can help settle a nauseated stomach.

If constipation becomes an issue, your nutritionist may encourage you to eat fiber-rich foods and increase your fluid intake. Low-intensity walking and warm beverages also can help encourage regular bowel movements.

To combat fatigue, choose high-protein snacks and small frequent meals rather than large meals. People often experience more fatigue when they are not eating well, or when they are losing weight during treatment.If experiencing any side effect that affects your ability to eat regularly, ask your care team if you can meet with a dietitian to review individualized nutrition recommendations.

Skin Care－Avoid trauma/injury to reduce infection risk

•    Keep extremity clean and dry

•    Apply moisturizer daily to prevent chapping/chafing of skin

•    Attention to nail care; do not cut cuticles

•    Protect exposed skin with sunscreen and insect repellent

•    Use care with razors to avoid nicks and skin irritation

•    If possible, avoid punctures such as injections and blood draws

•    Wear gloves while doing activities that may cause skin injury (e.g. washing dishes, gardening, working with tools, using chemicals such as detergent)

•    If scratches/punctures to skin occur, wash with soap and water, apply antibiotics, and observe for signs of infection (i.e. redness)

•    If a rash, itching, redness, pain, increased skin temperature, increased swelling, fever or flu-like symptoms occur, contact your physician immediately for early treatment of possible infection

Activity/Lifestyle

•    Gradually build up the duration and intensity of any activity or exercise

•    Take frequent rest periods during activity to allow for limb recovery

•    Monitor the extremity during and after activity for any change in size, shape, tissue, texture, soreness, heaviness or firmness

•    Maintain optimal weight. Obesity is known to be a major lymphedema risk factor

Avoid Limb Constriction

•    If possible, avoid having blood pressure taken on the at-risk extremity, especially repetitive pumping

•    Wear non-constrictive jewelry and clothing

•    Avoid carrying a heavy bag or purse over the at risk or lymph edematous extremity

Compression Garments 

•    Should be well-fitting

•    Support the at-risk limb with a compression garment for strenuous activity (i.e. weight, lifting, prolonged standing, and running) except in patients with open wounds or with poor circulation in the at-risk limb

•    Patients with lymphedema should consider wearing a well-fitting compression garment for air travel. The NLN cannot specifically recommend compression garments for prophylaxis in at-risk patients

Extremes of Temperature 

•    Individuals should use common sense and proceed cautiously when using heat therapy. Observe if there is swelling in the at-risk limb or increased swelling in the lymph edematous limb and cease use of heat such as a hot tub or sauna

•    Avoid exposure to extreme cold, which can be associated with rebound swelling, or chapping of skin

•    Avoid prolonged (greater than 15 minutes) exposure to heat, particularly hot tubs and saunas

You may not need to stay in the hospital

•    Excisional biopsy 

•    A bandage should be placed on your breast to cover the incision 

•    Lumpectomy with either axillary lymph node dissection or sentinel lymph node biopsy usually does not require an overnight hospital stay. This procedure is often performed on an outpatient basis 

Note: Mastectomy with either axillary lymph node dissection or sentinel lymph node biopsy usually only requires an overnight stay in the hospital. 

After surgery is performed

•    The bandage over the incision should be kept dry until your follow-up appointment

•    You may have tubes, or “drains” from the breast or underarm to remove fluid; You will receive instructions on caring for them 

•    Drains, if you have them, may remain in place for 1 or 2 weeks. When fluid lessens to about 1 ounce a day, the drains are removed

•    See your doctor for follow-up in 1 or 2 weeks 

Wound care 

•    You can wear your bra for support 

•    Use an ice compress on the wound during first 24 hours after surgery to reduce swelling 

•    You may see drainage on the bandage and that is not unusual 

•    The wound should be covered at least for 3 days 

•    You can remove the bandage if it gets wet and replace it with a dry bandage (available from local pharmacies) 

Drain care

•    Wash your hands before handling the drain 

  °    Open the valve (bulb will expand). Gently squeeze the fluid from the bulb into the measuring container 

  °    Squeeze the bulb tightly to get all the air out, and use the other hand to close the valve with the stopper

  °    The vacuum in the bulb will reactivate the suction

•    Measure the amount of the drainage every time when you empty it 

•    Keep a daily record for each drain 

•    The time to empty the drain(s) are in the morning, midday, and before bedtime 

•    Empty the drain when it is one third to half full (when the bulb is compressed) or as needed 

•    Remember to keep a record of the drainage amount for each drain and every time you emptied the drain 

•    Bring the record with you when return for follow up 

Daily Activity

•    You can continue with daily activities as normal 

•    Avoid heavy lifting and sports until your follow-up visit

Pain control

•    You may take some painkiller as needed 

Please contact us 

•    If you have acute swelling 

•    If you have blood coming from the wound 

•    Fever, temperature>38.3℃

•    If you have any concerns please call 

Contact number: 86 21 5339- 3128   Monday to Friday,8am to 8pm.

Please contact 400-868-3000 (24/7 hotline) if not in business hours.

Many women with breast cancer have some kind of surgery, even though other kinds of treatment are done, too. You may have had a:

•    Breast biopsy

•    Lymph node biopsy or removal

•    Breast conservation surgery (lumpectomy)

•    Mastectomy

•    Breast reconstruction

Any of these can affect how well you can move your shoulder and arm, take a deep breath, or do your daily activities, like dressing, bathing, and combing your hair. Pain and stiffness can cause weakness and limit movement of your arm and shoulder. 

Exercises Can Help Restore Movement

No matter what type of surgery you have, it’s important to do exercises afterward to get the arm and shoulder moving again. Exercises help to decrease side effects of your surgery and help you get back to your usual activities.

If you’ve had radiation therapy after surgery, exercises are even more important to help keep your arm and shoulder flexible. Radiation may affect your arm and shoulder long after treatment is finished. Because of this, it’s important to develop a regular habit of doing exercises to maintain arm and shoulder mobility after radiation treatments for breast cancer. 

It’s very important to talk with your doctor before starting any exercises so that you can decide on a program that’s right for you. Your doctor might suggest you see a physical therapist or occupational therapist, or a cancer exercise specialist certified by the American College of Sports Medicine. These health professionals are specially trained to design an exercise program just for you. You might need this kind of help if you do not have full use of your arm within 3 to 4 weeks of surgery.

Some exercises should not be done until drains and sutures (stitches) are removed. But some exercises can be done soon after surgery. The exercises that increase your shoulder and arm motion can usually be started in a few days. Exercises to help make your arm stronger are added later. 

The Week after Surgery

The tips and exercises listed below should be done for the first 3 to 7 days after surgery. Do not do them until you get the OK from your doctor.

•    Use your affected arm (on the side where your surgery was) as you normally would when you comb your hair, bathe, get dressed, and eat

•    Lie down and raise your affected arm above the level of your heart for 45 minutes. Do this 2 or 3 times a day. Put your arm on pillows so that your hand is higher than your wrist and your elbow is a little higher than your shoulder. This will help decrease the swelling that may happen after surgery

•    Exercise your affected arm while it’s raised above the level of your heart by opening and closing your hand 15 to 25 times. Next, bend and straighten your elbow. Repeat this 3 to 4 times a day. This exercise helps reduce swelling by pumping lymph fluid out of your arm

•    Practice deep breathing exercises (using your diaphragm) at least 6 times a day. Lie down on your back and take a slow, deep breath. Breathe in as much air as you can while trying to expand your chest and abdomen (push your belly button away from your spine). Relax and breathe out. Repeat this 4 or 5 times. This exercise will help maintain normal movement of your chest, making it easier for your lungs to work. Do deep breathing exercises often

•    Do not sleep on your affected arm or lie on that side

General Guidelines for These Exercises 

The exercises described here can be done as soon as your doctor says it's OK. They’re usually started a week or more after surgery. Be sure to talk to your doctor before trying any of them. Here are some things to keep in mind after breast surgery:

•    You will feel some tightness in your chest and armpit after surgery. This is normal, and the tightness will decrease as you do your exercises

•    Many women have burning, tingling, numbness, or soreness on the back of the armand/or on the chest wall. This is because the surgery can irritate some of your nerves. These feelings might increase a few weeks after surgery. But keep doing your exercises unless you notice unusual swelling or tenderness. (If this happens, let your doctor know about it right away.) Sometimes rubbing or stroking the area with your hand or a soft cloth can help make the area less sensitive

•    It may be helpful to do the exercises after a warm shower when muscles are warm and relaxed

•    Wear comfortable, loose clothing when doing the exercises

•    Do the exercises slowly until you feel a gentle stretch. Hold each stretch at the end of the motion and slowly count to 5. It’s normal to feel some pulling as you stretch the skin and muscles that have been shortened because of the surgery. Do not bounce or make any jerky movements when doing any of the exercises. You should not feel pain as you do them, only gentle stretching

•    Do each exercise 5 to 7 times. Try to do each exercise correctly. If you have trouble with the exercises, talk to your doctor. You may need to be referred to a physical or occupational therapist

•    Do the exercises twice a day until you get back your normal flexibility

•    Be sure to take deep breaths, in and out, as you do each exercise

•    The exercises are set up so that you start them lying down, move to sitting, and finish them standing up

Here are some of the more common exercises that women do after breast surgery. Talk to your doctor or therapist about which of these are right for you and when you should start doing them. Do not start any of these exercises without talking to your doctor first.

Wand Exercise

This exercise helps increase your ability to move your shoulders forward. You will need a broom handle, yardstick, or other stick-like object to use as the wand in this exercise. Do these exercises on a bed or the floor. Lie on your back with your knees bent and your feet flat.

•    Hold the wand across your belly in both hands with your palms facing up

•    Lift the wand up over your head as far as you can. Use your unaffected arm to help lift the wand until you feel a stretch in your affected arm

•    Hold for 5 seconds

•    Lower arms and repeat 5 to 7 times

Elbow Winging

This exercise helps increase the movement in the front of your chest and shoulder. It may take many weeks of regular exercise before your elbows will get close to the bed or floor. Do these exercises on a bed or the floor. Lie on your back with your knees bent and your feet flat.

•    Clasp your hands behind your neck with your elbows pointing toward the ceiling

•    Move your elbows apart and down toward the bed or floor

•    Repeat 5 to 7 times

Shoulder Blade Stretch

This exercise helps increase your shoulder blade movement.

•    Sit in a chair very close to a table with your back against the back of the chair

•    Place the unaffected arm on the table with your elbow bent and palm down. Do not move this arm during the exercise

•    Place the affected arm on the table, palm down, with your elbow straight

•    Without moving your trunk, slide the affected arm forward, toward the opposite side of the table. You should feel your shoulder blade move as you do this

•    Relax your arm and repeat 5 to 7 times

Shoulder Blade Squeeze

This exercise also helps increase shoulder blade movement.

•    Sit in a chair in front of a mirror. Face straight ahead. Do not rest against the back of the chair

•    Your arms should be at your sides with your elbows bent

•    Squeeze your shoulder blades together, bringing your elbows behind you. Keep your shoulders level as you do this. Do not lift your shoulders up toward your ears

•    Return to the starting position and repeat 5 to 7 times

Side Bends

This exercise helps increase movement of your trunk and body.

•    Sit in a chair and clasp your hands together in front of you. Lift your arms slowly over your head, straightening your arms

•    When your arms are over your head, bend your trunk to the right keeping your arms overhead

•    Return to the starting position and bend to the left

•    Repeat 5 to 7 times

Chest Wall Stretch

This exercise helps stretch your chest.

•    Stand facing a corner with your toes about 8 to 10 inches from the corner

•    Bend your elbows and put your forearms on the wall, one on each side of the corner. Your elbows should be as close to shoulder height as possible

•    Keep your arms and feet in place and move your chest toward the corner. You will feel a stretch across your chest and shoulders

•    Return to the starting position and repeat 5 to 7 times

•    The picture shows stretching both sides at the same time, but you may find it more comfortable to stretch one arm at a time

•    Be sure you keep your shoulders dropped far away from your ears as you do this stretch

Shoulder Stretch

This exercise helps increase your mobility in your shoulder.

•    Stand facing the wall with your toes about 8 to 10 inches from the wall

•    Put your hands on the wall. Use your fingers to "climb the wall," reaching as high as you can until you feel a stretch

•    Return to the starting position and repeat 5 to 7 times

•    The picture shows both arms going up at the same time, but you might find it easier to raise one arm at a time

•    Be sure you keep your shoulders dropped far away from your ears as you raise your arms

Things to Keep in Mind after Breast Surgery

Start exercising slowly and increase as you are able. Stop exercising and talk to your doctor right away if you:

•    Get weaker, start losing your balance, or start falling

•    Have pain that gets worse 

•    Have new heaviness, aching, tightness, or other strange sensations in your arm

•    Have unusual swelling or swelling gets worse

•    Have headaches, dizziness, blurred vision, new numbness, or tingling in your arms or chest

It’s important to exercise to keep your muscles working as well as possible, but it’s also important to be safe. Talk with your doctor about the right kind of exercises for your condition, and then set goals for increasing your level of physical activity.

Other Kinds of Exercise

Exercise to help improve aerobic (heart-lung) capacity is also important for women who have had breast cancer. There’s evidence that fitness and weight loss may even help lower the risk that some types of cancer will come back after treatment. Ask your doctor about fitness exercises during and after breast cancer treatment.

Other exercises are designed to help reduce your risk of lymphedema, or swelling in the arm on the side where you had surgery. The exercises shown here are mainly designed to help regain range of motion (flexibility) of the arm and shoulder. Ask your doctor about your lymphedema risk and if you should use exercises to help reduce that risk. 

Strengthening exercises are now recommended as part of regular exercise programs to improve health. These are not started until 4 to 6 weeks after surgery, and must be tailored to your general health, medical condition, and fitness. Strength building starts by using small hand weights, and is increased slowly over time. Again, this is addressed with your doctor or physical therapist. It’s probably  to start a strengthening program in a supervised setting with a cancer exercise trainer or physical therapist to be sure you’re doing the exercises properly. 

This information was developed with assistance from the Oncology Section of the American Physical Therapy Association.

The goal of screening tests for breast cancer is to find it before it causes symptoms (like a lump that can be felt). Screening refers to tests and exams used to find a disease in people who don’t have any symptoms. Early detection means finding and diagnosing a disease earlier than if you’d waited for symptoms to start.

Breast cancers found during screening exams are more likely to be smaller and still confined to the breast. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis (outlook) of a woman with this disease.

Screening Guideline

An active breast care health plan includes:

•    Increasing self-awareness on breast health, i.e., if you notice any breast changes, please communicate with your doctor and follow medical suggestions for examinations and follow up visits

•    Mammograms; a mammogram has been proved to decrease mortality between the age from 40 to 74, especially among the age of 50 and older. Get mammograms every year starting from 40 years old to 75 years old in order to get early treatment and increase survivor

If you want to know about breast self-exam and whether you need early screening and prevention, you can consult with your doctor.

We have consolidated current international standards on screening guide for average risk and high risk.

Guidelines for Women at Average Risk for Breast Cancer

These guidelines are for women at average risk for breast cancer. For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase risk of breast cancer (such as in a BRCA gene), and has not had chest radiation therapy before the age of 30.

•    Women between 40 and 44 have the option to start screening with a mammogram every year

•    Women 45 to 54 should get mammograms every year

•    Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer

All women should understand what to expect when getting a mammogram for breast cancer screening – what the test can and cannot do.

Guideline for High Risk Women for Breast Cancer

Women who are at high risk for breast cancer based on certain factors, i.e., family history, or having had a biopsy and its result was high risk, or mammogram result showed should have mammogram earlier and also get breast color ultrasound, and even breast MRI. These women should get an MRI typically starting at age 30. This includes women who:

•    Have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools that are based mainly on family history 

•    Have a known BRCA1 or BRCA2 gene mutation (based on having had genetic testing)

•    Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves

•    Have radiation therapy to the chest when they were between the ages of 10 and 30 years

•    Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes

You have been diagnosed with blepharitis, which is an inflammatory condition of the eyelids. You may notice some or all of the following:

● Eyelids become crusty, irritated and red due to a build-up of oil and debris on the eyelids and eyelashes

● Burning, irritation, soreness and itching of the eyelids

● Foreign body sensation (you feel like there is something in your eye)

● Scales close to the root of the eyelash

Blepharitis is a chronic (long-term) recurring condition and so the most important part of treating and managing it is to keep your eyelids clean. Occasionally it is due to an infection, if so you may also have to take medication prescribed by your healthcare professional to be used throughout the prescribed treatment. 

Although blepharitis is not life threatening, if not treated it will not improve, and your symptoms will remain and possibly worsen. Blepharitis is one of the most common reasons for cancelling elective (planned) eye surgery.

Eyelid Hygiene

There are two easy methods for proper eyelid hygiene which will help manage your blepharitis.

1. Apply Heat & Massage

● Wash your hands before and after cleaning

● Apply a warm compress to your closed eyes at 35-40°C for 10 minutes, which will soften the debris and oils. Then massage your eyelids, which will help reduce your symptoms

● You can use a clean facecloth soaked in hot water or alternatively there are a number of heat masks specifically for the eye

2．Eyelid Hygiene

● Wash your hands before and after cleaning

● Commercially available lid scrubs are usually pre-soaked in a cleansing solution and are ready to use

● You may alternatively have been advised to use "at-home" remedies such as diluted baby shampoo or baking powder. Due to the steps involved, many patients find these remedies inconvenient in day to day life, which can also be irritating to your eyelids

● When using lid scrubs, close your eyes and gently scrub your eyelid using side-to-side strokes for approximately 30 seconds. Repeat this for your other eyelid

● Lid scrubs may require you to rinse your eyelids after applying, please follow the manufacturer's instructions. There are many lid scrubs available, which your healthcare professional may be happy to recommend

As blepharitis is a long term condition, it is important that you continue this routine for as long as you have been told by your healthcare professional, in many cases this may be forever. While short term treatments will reduce the symptoms, the likelihood is that they will return once you stop performing regular eyelid hygiene.

Useful Information

● Remove any eye make-up before going to bed. The lid scrub pads mentioned are an excellent way of doing this while also keeping your eyelids clean

● Don't share your eye make-up or lotions with anyone else

● Don't share your facecloths or towels with anyone else

● Blepharitis is often associated with Dry Eye. Artificial tears will help to relieve these symptoms

Other Times When Hygiene is Important

If your healthcare professional has discussed the importance of eyelid hygiene with you, it may be because you have one of the following:

● Meibomian gland dysfunction (MGD)

● Stye (infection of a gland in the eyelid)

● Marginal keratitis (inflammation of the eye itself; often secondary to bacterial infection or blepharitis)

● Ocular rosacea (redness of the eyelids)

● Conjunctivitis (inflammation of the outer surface of the eye and inner surface of the eyelid－commonly caused by infection or an allergy)

If so, you should perform daily eyelid cleaning as detailed above for as long as your healthcare professional has advised. 

Your nursing staff created this information to show you a way to put in eye drops. By following these directions, you will keep this medication clean and prevent eye infections.