>The American Cancer Society recommends the following:
>1. Women 20 years of age and older should perform breast self-examination every month.
>2. Women ages 20-39 should have a physical examination of the breast every three years, performed by a healthcare professional such as a physician, physician assistant, nurse or nurse practitioner.
>3. Women 40 and older should have a physical examination of the breast every year, performed by a healthcare professional such as a physician, physician assistant, nurse or nurse practitioner.
>4. Women 40 and older should have a mammogram every year.
>Tumors are often removed surgically and treatment of malignant tumors may involve surgery, radiotherapy, chemotherapy - or a combination of two or three of these procedures.
>Both chemotherapy and radiotherapy can have toxic effects on the lung, surrounding tissue and body cells that have a rapid growth cycle such as blood cells.
>Fitness and Diving Issues
>Cytotoxic drugs (chemotherapy) and radiation therapy can have unpleasant side effects such as nausea and vomiting, and a prolonged course of therapy can result in greatly decreased energy levels. This makes diving while experiencing such side effects inadvisable. Radiation and some chemotherapeutic drugs can cause pulmonary toxicity.
>An evaluation to establish the safety of a return to diving should include an assessment of the lung to ensure that damage likely to predispose the diver to pulmonary barotrauma (arterial gas embolism, pneumothorax or pneumomediastinum) is not present.
>Finally, before diving, healing must have occurred, and the surgeon must be satisfied that immersion in salt water will not contribute to wound infection. Strength, general fitness and well-being should be back to normal. The risk of infection, which may have increased temporarily during chemotherapy or radiotherapy, should have returned to normal levels.