Early detection saves lives. Knowing your breasts is one of the most important things you can do for your health.
Understanding Your Risk
Breast cancer is the most common cancer in women worldwide. While the risk increases significantly after age 55, young women need to be aware and proactive.
Risk factors you can’t control:
- Age (risk increases with age)
- Family history (especially mother or sister with breast cancer)
- Genetic mutations (BRCA1 or BRCA2 genes)
- Dense breast tissue
- Early menstruation or late menopause
Risk factors you can influence:
- Exercise regularly (20% risk reduction!)
- Maintain healthy weight
- Limit alcohol consumption
- Know your family history
Good news: Most women who get breast cancer have NO family history. Most lumps found are NOT cancer. But awareness and early detection are crucial.
Breast Self-Examination (BSE)
Why BSE Matters
You know your body best. Regular self-exams help you learn what’s normal for you, making it easier to notice changes.
BSE helps detect:
- New lumps or thickening
- Changes in size or shape
- Skin changes
- Nipple changes or discharge
When to Do BSE
If you menstruate: Days 5-7 after your period starts (when breasts are least lumpy and tender)
If you don’t menstruate: Pick the same day each month (first of the month is easy to remember)
How often: Monthly
Set a phone reminder so you don’t forget!
How to Perform BSE: Step-by-Step
Step 1: In the Shower
Why: Wet, soapy skin makes it easier to feel changes.
- Raise your right arm
- Use flat pads of 3 middle fingers on left hand
- Press gently in small circular motions
- Feel entire right breast and armpit area
- Check for lumps, thickening, or changes
- Repeat on left breast with right hand
Move in a pattern:
- Up and down (like mowing a lawn)
- Circular (like a clock)
- Wedges (like slices of pizza)
Choose one pattern and use it every time.
Step 2: In Front of Mirror (Arms at Sides)
Look for:
- Changes in size or shape
- Dimpling, puckering, or bulging of skin
- Inverted nipple or nipple position changes
- Redness, rash, or swelling
Step 3: In Front of Mirror (Arms Raised)
Raise both arms overhead. Look for the same changes listed above.
Step 4: In Front of Mirror (Hands on Hips)
Place hands firmly on hips and press down. This flexes chest muscles. Look for the same changes.
Step 5: Lying Down
Why: Lying down spreads breast tissue evenly, making it easier to feel all areas.
- Lie on your back
- Put a pillow under your right shoulder
- Raise right arm above your head
- Use left hand to examine right breast
- Use the same circular or up-and-down pattern
- Press with light, medium, then firm pressure at each spot
- Feel the entire breast area from collarbone to bra line, armpit to cleavage
- Repeat on left breast
Step 6: Check Nipples
Gently squeeze each nipple and check for:
- Discharge (fluid)
- Blood
What You’re Looking For
Normal Breast Changes
It’s normal for breasts to:
- Feel lumpy (especially before periods)
- Change size during menstrual cycle
- Feel tender before periods
- Have small bumps (Montgomery glands around nipples)
- Be slightly different sizes
Warning Signs – See a Doctor
Call your doctor if you notice:
Lumps:
- New lump or thickening
- Lump that feels different from other breast tissue
- Lump that doesn’t go away after your period
Skin Changes:
- Dimpling or puckering
- Redness or rash
- Orange-peel texture (peau d’orange)
- Swelling
- Warmth
Nipple Changes:
- Nipple turning inward (new inversion)
- Rash on or around nipple
- Discharge (especially bloody or from one breast only)
- Scaling or flaking
Other Changes:
- Lump or swelling in armpit
- Change in breast size or shape
- Unexplained pain (especially in one spot)
Don’t panic if you find something. Most breast changes are NOT cancer. But always get checked by a doctor.
Clinical Breast Examination (CBE)
BSE is not a replacement for professional examination.
When to Get CBE
Ages 20-40:
- Every 3 years by healthcare provider
- Annually if you have family history of breast cancer
Ages 40+:
- Annually
CBE is part of your regular health checkup. Don’t skip it.
Mammography Guidelines
Mammography is an X-ray of the breast that can detect cancer before you or your doctor can feel it.
Who Needs Mammograms?
For average-risk women:
- Generally not recommended before age 40
- Age 40-50: Discuss with your doctor
- Age 50+: Every 1-2 years
For high-risk women (family history, BRCA genes):
- May start at age 30 or earlier
- May include MRI in addition to mammogram
- Follow your doctor’s recommendations
If you’re under 40 with no family history, focus on BSE and CBE. Mammograms are generally not needed yet.
Know Your Family History
Critical information to gather:
Ask your mother, grandmother, aunts, and sisters:
- Any breast cancer? At what age?
- Any ovarian cancer?
- Any male relatives with breast cancer?
- BRCA gene testing results?
Why it matters:
- 5-10% of breast cancers are hereditary
- Family history determines your screening schedule
- You may be eligible for genetic testing
Create a family health tree and share it with your doctor.
Genetic Testing (BRCA1/BRCA2)
Who Should Consider Testing?
- Multiple family members with breast or ovarian cancer
- Family member diagnosed before age 50
- Male relative with breast cancer
- Ashkenazi Jewish heritage with any family history
- You or relative with BRCA mutation
What the Test Tells You
BRCA mutations significantly increase risk:
- 45-65% lifetime breast cancer risk
- 35-46% second breast cancer risk
- Increased ovarian cancer risk
If you test positive:
- Enhanced screening (MRI + mammogram starting age 30)
- Risk-reduction strategies
- Informed decision-making about preventive surgery
Talk to your doctor or a genetic counselor if you’re concerned.
Reducing Your Risk Through Lifestyle
Exercise: Your Best Defense
20% risk reduction with regular physical activity!
- 30-60 minutes moderate activity daily
- Walking, cycling, swimming, dancing – anything that raises your heart rate
- Consistency matters more than intensity
Maintain Healthy Weight
- Excess body fat produces estrogen, which can fuel breast cancer
- Even a 5-10 pound loss can make a difference
- Focus on sustainable, healthy habits
Limit Alcohol
- Even one drink per day increases risk
- If you drink, limit to special occasions
- Choose non-alcoholic alternatives
Don’t Smoke
- Smoking increases risk, especially if you started young
- Never too late to quit
- Seek support if you need help quitting
Debunking Breast Cancer Myths
MYTH: Underwire bras cause breast cancer TRUTH: No scientific evidence whatsoever. Wear whatever bra is comfortable.
MYTH: Antiperspirants cause breast cancer TRUTH: No link has been found in research studies.
MYTH: Small breasts have lower cancer risk TRUTH: Breast size has no impact on cancer risk.
MYTH: Only women with family history get breast cancer TRUTH: 85% of women diagnosed have NO family history.
MYTH: Finding a lump means I have cancer TRUTH: Most lumps are benign (not cancer). But always get checked.
MYTH: Caffeine causes breast cancer TRUTH: No evidence linking coffee to increased risk.
MYTH: Breast cancer only affects older women TRUTH: While risk increases with age, young women can get breast cancer too.
Your Breast Health Action Plan
This Month:
- Do your first BSE (or your regular monthly exam)
- Set a monthly reminder on your phone
- Gather family history information
This Year:
- Schedule CBE with your doctor (if it’s been more than 3 years)
- Discuss your family history with your doctor
- Commit to regular exercise (that 20% risk reduction!)
Every Month:
- Perform BSE on schedule
- Be aware of any changes
- Report concerns to your doctor immediately
Remember
Finding breast cancer early gives you the best chance for successful treatment. Monthly self-exams, clinical breast exams, and knowing your family history are your best tools.
Your hands can save your life. Use them.
Don’t let fear stop you. Early detection is your power.
Questions or concerns? Talk to your doctor. Never ignore changes in your breasts.