Understanding Breast Health Awareness

Breast awareness means being familiar with how your breasts normally look and feel, so that you notice if something changes. Most breast changes are not cancer, but getting a change checked promptly matters, because breast cancer is easier to treat when found early.

What is normal?

Breasts vary widely. It is common for one to be slightly larger than the other, and for them to feel different at different times of the month. Many women notice tenderness or lumpiness before a period that settles afterward. Breasts also change with pregnancy, breastfeeding, weight changes and menopause.

Changes to look for

The NHS advises seeing a doctor if you notice:

• a lump or swelling in the breast, chest or armpit;
• a change in the size or shape of a breast;
• a change in the skin, such as puckering or dimpling;
• a change in color, such as redness, which may be harder to see on darker skin;
• a nipple that has changed, for example become pulled in;
• a rash or crusting around the nipple;
• any unusual discharge from a nipple, which may have blood in it;
• pain in a breast or armpit that does not go away.

Most of these have harmless causes, such as cysts or infections, but they should always be examined.

How to check

There is no single correct method. The aim is familiarity, not a perfect technique.

1. Look. Stand in front of a mirror with your arms by your sides, then raised. Look for changes in shape, outline or skin.
2. Feel. Use the flat of your fingers to feel each breast, the area up to the collarbone and the armpits. Many women find this easiest in the shower with soapy hands or lying down.
3. Be regular. The NHS suggests trying to check about once a month. If you have periods, choose a similar point in each cycle, since breasts feel different before a period.

Men can develop breast cancer too, though rarely, and should also report changes in the chest area.

Awareness and screening work together

Expert organizations differ on the value of formal breast self-examination as a screening method, and MedlinePlus notes that experts do not agree about its benefits in finding breast cancer or saving lives. What is widely agreed is that women should know what is normal for them and report changes without delay. Awareness does not replace screening, and screening does not replace awareness.

Mammograms

A mammogram is a low-dose X-ray of the breast that can find cancers too small to feel.

• The U.S. Preventive Services Task Force recommends that women aged 40 to 74 who are at average risk have a mammogram every two years.
• Women at higher risk, for example because of a strong family history or certain gene changes, may be advised to start earlier or have additional tests such as MRI.
• Programs and ages differ in other countries.

Talk to your doctor about when to start and how often to be screened.

What happens at a mammogram

Each breast is placed between two plates and compressed for a few seconds while the image is taken. It can be uncomfortable but is quick. Avoid deodorant, powder or lotion on the day, since they can show on the image. If you have periods, the week after may be more comfortable.

Risk factors

Factors that raise the risk of breast cancer include:

• getting older;
• certain inherited gene changes, such as BRCA1 and BRCA2;
• a family history of breast or ovarian cancer;
• dense breast tissue;
• previous breast cancer or certain breast conditions;
• drinking alcohol;
• being overweight after menopause;
• physical inactivity;
• some forms of hormone therapy.

Many women who develop breast cancer have no known risk factors other than being female and getting older, which is why awareness and screening matter for everyone.

Reducing risk

• Stay at a healthy weight.
• Be physically active.
• Limit or avoid alcohol.
• Discuss the risks and benefits of hormone therapy and hormonal contraception with your doctor.
• Breastfeed, if you can and wish to.

Breast pain

Breast pain is very common and is usually linked to the menstrual cycle. On its own, it is rarely a sign of cancer. A well-fitting, supportive bra helps. See a doctor if pain persists, is in one spot or comes with other changes.

If you find a change

Do not wait to see whether it goes away. Make an appointment. Your doctor may examine you and arrange imaging, such as a mammogram or ultrasound, and sometimes a biopsy. Most women who are referred do not have cancer.

The bottom line

Get to know your breasts, report changes promptly and attend screening when it is offered. These three habits give the best chance of finding problems early. Explore wellbeing essentials in our women’s health range.

Sources

1. NHS. How to check your breasts or chest.
2. Centers for Disease Control and Prevention. Screening for Breast Cancer.
3. Office on Women's Health. Mammograms.
4. MedlinePlus. Health screenings for women ages 40 to 64.