Increasing breast awareness is one of the best things you can do for yourself if you are concerned about breast cancer. By becoming aware of what is normal for you, you’ll be better able to assess when something is abnormal. [4] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source Note that even things like breast asymmetry, where one breast is a slightly different size or in a slightly different position, are generally completely normal. [5] X Research source You generally should only have cause for concern if things change from the way they usually are (for example, one breast grows significantly larger, etc. ). If you have a spouse or partner, make him or her part of the process of checking your breasts and becoming more aware of your breast tissue. This is especially important because your partner sees and touches your body from a different angle and may be able to see things that you cannot. Ask your partner to communicate any changes s/he may notice or feel.
At present, the American Cancer Society and the US Preventative Services Task Force recommend that BSE should be done at your own discretion. These organizations also emphasize that the real key is to be aware of what is normal for your own breast tissue. [8] X Trustworthy Source American Cancer Society Nonprofit devoted to promoting cancer research, education, and support Go to source Part of the pushback against BSE is because it can lead to unnecessary testing (such as a biopsy), which can cause harm to the patient as well as a financial burden on the healthcare system. The problem is that BSE may draw attention to benign lesions, whereas mammograms can identify those malignant lesions that are real cause for concern and medical treatment. [9] X Research source Tiffany L. Allen, MSN, FNP-BC, WHNP, Brittany J. Van Groningen, MSN, WHNP,Debra J. Barksdale, PhD, FNP-BC, CNE, FAANP et al The Breast Self-Examination Controversy: What Providers and Patients Should Know, Journal of Nurse Practitioners, June 2010Volume 6, Issue 6, Pages 444–451. Be aware as well that a BSE should never be done in lieu of a physician’s clinical examination or mammogram. At best, doing a BSE can help you become more aware of what is normal in your breasts and can help you assist your doctor in detecting changes. [10] X Trustworthy Source Centers for Disease Control and Prevention Main public health institute for the US, run by the Dept. of Health and Human Services Go to source
Changes in breast size or shape - Swelling from a tumor or infection can change the shape and size of the breast tissue. This often occurs only on one breast but in some cases can occur on both. Your breasts may also change size during certain times in your menstrual cycle, so having an idea of what is “normal” for you at any particular time of the month is helpful. Discharge from the nipple - If you’re not breastfeeding, there should be no discharge coming from the nipple. If there is discharge, especially without squeezing the nipple or breast tissue, talk to your physician. Swelling - There are aggressive and invasive types of breast cancer that may cause swelling in breast, collarbone or armpit. In some cases, the swelling occurs before you can feel a lump. Dimpling - Tumors or growths in the breast near the surface of the skin or nipple can cause a change in shape and look of the tissue, including dimpling or puckering of the skin (like the skin of an orange, also known as peau d’orange). Look as well for a newly inverted nipple, which is also a sign of a problem. [12] X Trustworthy Source BreastCancer. org Patient-focused nonprofit organization providing resources for those affected by breast cancer Go to source (Some women have naturally inverted nipples, which are not a cause for concern; a change from your normal state is. ) Redness, warmth or itching - Inflammatory breast cancer is a rare but aggressive type of cancer that presents with symptoms similar to an infection in the breast: a warming sensation, itching or redness.
In front of a mirror, sit or stand without a shirt or bra on. Lift and lower your arms. Look for any changes to the size, shape, tenderness, and appearance of your breast tissue, using the above signs as your guide. Then place your palms on your hips and flex your chest muscles. Look for any dimples, puckers or other abnormalities.
Lie flat and place your right hand behind your head. Using the first three fingers of your left hand, palpate (feel) the breast tissue on your right breast. Be sure to use the pads of the fingers, not just the very tips. Feel for anything that feels hard and round. Start at your armpit area and work your way towards the center of each breast. Move across to the middle of your body until you only feel the sternum (breastbone). Use three different levels of pressure to feel the tissue: light pressure at the top for tissue just under the skin, medium pressure to check tissue in the middle of the breast, and deeper pressure to feel the tissue closest to the chest wall. Make sure to apply each pressure level to each area before moving on. Once you’ve done one breast, do the other. Put your left hand under your head and perform the same exam on your left breast. Squeeze each nipple gently to check for discharge. Remember that your breast tissue extends to the area near your armpit. This area can also develop lumps or cancer, so it’s important to check there as there during your manual BSE. [15] X Trustworthy Source BreastCancer. org Patient-focused nonprofit organization providing resources for those affected by breast cancer Go to source
During the beginning of the exam, give your doctor an updated medical history. Breast cancer is often hereditary, so your breast exams will be even more important if there is a history of breast cancer in your family, particularly among a mother or sister.
If you feel uncomfortable, you can ask for a nurse or family member to be present during the exam. If you’re a female patient seeing a male doctor, this is typically standard procedure.
The doctor is not judging your breasts on any aesthetic qualities. She is only checking to see whether they are generally the same shape and size, or if there are any areas for concern.
Remind yourself as well that breast cancer has a higher success rate of being treated effectively when it is caught early and before it has spread to other organs, tissues, and the bones. Remember that you can always ask any questions about why your doctor is performing certain motions or exams. If you feel stressed out or uncomfortable, talk with your doctor.
Screen mammography for women aged 75 and older depends on the woman’s overall health. If she has a number of health problems, she is not likely not to be a candidate for treatment were cancer in fact detected. Thus, you should talk to your doctor about screening if you are 75 or older. [21] X Research source MARIA TRIA TIRONA, MD,Breast Cancer Screening Update American Fam Physician. 2013 Feb 15;87(4):274-2780 For women who know via genetic testing that they carry the breast cancer genetic mutation (BRCA1 and BRCA2), screening should begin at age 25 and may also involve an MRI of the breast tissue in addition to a mammogram. [22] X Research source MARIA TRIA TIRONA, MD,Breast Cancer Screening Update American Fam Physician. 2013 Feb 15;87(4):274-2780
Although the doctor may be looking for potential cancerous growth with a mammogram, the test can also detect calcifications, fibroadenomas and cysts in the breast tissue. [24] X Trustworthy Source BreastCancer. org Patient-focused nonprofit organization providing resources for those affected by breast cancer Go to source
Be sure to wear a loose top that will be easy for you to take off for the mammogram. Read up on the procedure to help calm yourself if you feel anxious. The test may be slightly uncomfortable but is over within a matter of minutes.
You’ll feel pressure and may experience some discomfort during the mammogram, but this is just temporary. A mammogram will be done on both breasts so the radiologist can compare both sides.
If the mammogram and MRI detect a tumor or growth, your doctor may recommend an ultrasound-guided needle biopsy to determine both the type of cell growth and the type of treatment needed to treat the cancer (i. e. , surgery, chemotherapy, radiation, etc. ). In a biopsy, tissue is removed from the suspicious area of the breast and analyzed in a laboratory. Most breast tissue biopsies are outpatient procedures, and you won’t have to stay overnight in a hospital. [29] X Research source
Age: Risk increase with age. Most people who have breast cancer are over 45 years old. Once you reach the age of 50, your risk increases ten-fold for each decade beyond 50. Menstruation: If you started menstruating before you were 12 years old, or entered menopause when you were older than 55, your risk is slightly increased. In both cases, the risk is higher because of the increased ovulation cycles. Pregnancy: An early pregnancy or multiple pregnancies can both reduce your risk. Having no children or getting pregnant after the age of 40 increases your risk of developing breast cancer. Hormone replacement therapy (HRT): Current or previous use for more than 10 years can increase the risk for breast cancer.
Whether someone is overweight or obese is determined by using the body mass index (BMI). BMI is a person’s weight in kilograms (kg) divided by the square of the person’s height in meters (m). A BMI of 25-29. 9 is considered overweight, while a BMI greater than 30 is considered obese. A BMI greater than 30 is considered a risk factor for developing breast cancer, since fat cells secrete estrogen, which feeds many breast cancers. There is also some recent evidence that long-term heavy smoking correlates with a higher risk of breast cancer. The risk is especially high among certain groups of smokers, such as women who began smoking before they had their first child. Research is still being conducted to determine the exact relationship between smoking and breast cancer. Alcohol has also been linked to increased risk of developing breast cancer. The risk increases the more you drink alcohol. Women who consume between two and five drinks every day have a 1. 5x higher risk than women who don’t drink. Recent research has suggested that women who work night shifts (such as nurses) may have an increased risk of breast cancer due to changes in melatonin levels. Further research is needed, however, before these findings will be considered conclusive.
Personal medical history: If you have had a previous diagnosis of breast cancer, you are three to four times as likely to develop a new cancer in the same or opposite breast. Family history: You are more likely to develop breast cancer if one or more close blood relatives in your family have had breast, ovarian, uterine or colon cancer. Your risk is doubled if you have a first-degree relative (sister, mother, daughter) with the disease. Having two first-degree relatives triples your risk. Genes: Genetic defects found on BRCA1 and BRCA 2 can dramatically increase your risk of developing breast cancer. You can opt to find out if you have these genes by contacting a genome mapping service. In general, approximately 5-10% of cases are related to heredity.
