October, as it is widely regarded by millions of healthcare providers, patients, survivors, and loved ones, is Breast Cancer Awareness Month. While one of the main aspects of this month is to raise awareness about the disease itself, one of the most important things a woman can do this, and every month, is to practice breast self-awareness.
Breast self-awareness, as defined by the Memorial Sloan Kettering Cancer Center, being familiar with how your breasts normally look and feel. In 2015, the American Cancer Society changed their breast cancer guidelines to include that “breast exams, either from a medical provider or self-exams, are no longer recommended.”
Since then, women have been encouraged to practice breast self-awareness, along with risk assessments (such as the Tyrer-Cuzick tool) and screenings.
However, some of the aspects of the self-exam remain part of breast self-awareness. Dr. Christina Casteel, the medical director of the Breast Health Center at Sharp Memorial Hospital, explains that women can still practice the visual portion, which includes standing in front of a mirror (with their hands on their hips or above their heads) and looking for any skin changes in their breasts, such as dimpling and puckering.
Other visual cues to be aware of, notes Lisa Ellsworth, MHS, PA-C, an advanced practice provider at the Rocky Mountain Cancer Centers, are redness/rashes that don’t resolve, asymmetry between the breasts, and bloody or non-bloody nipple discharge. (These visual awareness exercises can be done monthly by women who fall in the higher-risk categories.)
Dr. Casteel urges that if you do notice any physical changes to bring it to the attention of your primary care physician. In fact, seeing your doctor annual (especially if you are over 40 and in a higher risk group for breast cancer) is key.
Of course, if you do notice a lump in your breast while you are doing a visual exam, or you feel one (as Ellsworth points out, if you do feel for lumps, it should be done a week after the start of menses), Dr. Casteel reminds us, “Don’t panic….it doesn’t automatically mean it’s breast cancer.” These lumps could be anything from a benign cyst to irregular fat distribution in the breast to changes during your menstrual cycle.
As Ellsworth points out, “there is no one telltale sign” when it comes to lumps in the breast and lumps related to breast cancer can be painful or painless.
“With breast awareness, you should be reporting any changes [to your healthcare provider],” Ellsworth says, adding that any breast lumps that don’t go away or get bigger should always be made aware to your doctor.
After all, awareness is the main word here. As Ellsworth reminds us, “It is so important to detect cancer at lower stages when the cure rates are much higher. Remember that breast cancer is the most common cancer in women, and there does not need to be a family history.”
That’s why Ellsworth emphasizes annual screening mammograms, beginning at age 40, as “these can detect cancer at much lower stages than a self-exam [or simple breast awareness] can.”
If there’s a clear message to take away regarding self-awareness and breasts, as both our experts have emphasized: be aware of yourself and your body, know your risks and make your annual appointments with your physician.