They’re on you all the time, but how well do you really know your breasts?
If the answer is not very, then it is important to get into the habit of checking them. Breast cancer is the most common cancer in the U.K., affecting 1 in 8 women during their lifetime. The number of people diagnosed with breast cancer each year is rising but the number of deaths from it is falling. This is in part due to more awareness around early detection.
Many women fret over whether their breasts are too big, too small, lopsided... but expending mental energy comparing your body to a perfect ideal is draining. Knowing what is considered healthy is vital. “Everyone’s breasts are different, but what is important is knowing when yours are different than normal,” says Toni Hazell, a general practitioner from London.
When should I start checking my breasts?
Breast cancer is more common in older women; over 80% of breast cancer occurs in women over 50. Some breast cancers can be very aggressive in younger women, however, so they should check their breasts regularly too, says Hazell.
She advises her patients to check them once a month. And because breasts can change in size, tenderness and lumpiness throughout your menstrual cycle, getting to know what they are like at different times of the month is also a good idea. What's more, checking breasts is not just about lumps – there are many other things to look for.
How do I do it?
It is easier to check your breasts when there is moisture in the air, so try doing it during or after a shower or bath with a soapy, wet hand.
Standing in front of a mirror, start by lifting your arms above your head and study your breasts, looking for any changes in shape or size. Examine them with your arms by your sides, too. Bend forward with your hands on your waist, and also twist from side to side, to see if there are any changes to the skin on your breasts, like tethering or dimpling.
Having different-sized breasts is normal and nothing to worry about. However, if they are usually the same size and one seems bigger, or you notice a change in how they move, make a note of this.
Run the flats of your fingers or palms of your hands firmly along the breasts and under the armpit. Lots of women have lumpy breasts, which is completely normal, so check for new or hard lumps. One analogy often used to distinguish a concerning lump from normal breast lumpiness is "like finding a marble in a bowl of grapes". Take note of any tenderness or soreness.
Look for changes in the nipples too. If your nipples have always been inverted, then there is nothing to be concerned about. However, if it has recently become inverted then inform your GP. Likewise, if you spot any discharge or bleeding from the nipples.
It is quite normal to get skin rashes, like ringworm or eczema on your breasts. However, if you have a rash that does not heal, particularly around the areola area, notify your GP.
“Things that worry me the most are hard, craggy-feeling lumps, raised glands under the armpits and discharge from the nipples,” says Hazell.
If you are unsure of how to check your breasts, then ask your GP to show you. There are also many video demonstrations on YouTube, like this one, by Breast Cancer Care:
I’ve spotted something, what should I do?
The next step is to make an appointment with your GP. Don’t delay and don’t panic. “Most lumps, particularly in pre-menopausal women, will be benign,” says Hazell. According to Cancer Research, nine in 10 of them are not cancerous.
Your GP will then decide whether or not to refer you to the breast clinic, where further tests will be carried out.
What about screening?
Breast X-ray screening, known as a mammogram, is routinely carried out every three years for older women between the ages of 50 and 70. Women with a family history of breast and other cancers might be offered screening at a younger age. If two or more people in your family have had breast, ovarian and bowel cancer then inform your GP, says Hazell.