Righto ladies, today in this second part of our Breast Cancer Awareness month series we are going to talk boobs – specifically, how to check your breasts for lumps. Sadly, in this country we are woefully behind on understanding how, when, why and where we should be copping a feel of our jugs so that we can check your breasts for lumps.
I became painfully aware of this when I recently tested positive for the BRCA1 gene mutation responsible for hereditary breast cancer in my family. Embarassed to realise that I probably hadn’t checked my boobs since life before the ‘vid, I got a rude awakening when I realised I had absolutely no idea what I was doing on the breast feeling front.
So with that said, this Breast Cancer Awareness Month, we have together this in depth guide on how to check your breasts for lumps with Dr Deborah Lee of Dr Fox Online Pharmacy. Remember ladies, knowledge is power and our breasts deserve more than just the occassional squeeze during a mid life romp.
And if you missed it don’t forget to catch on part one of our breast cancer series where we clear up all the things you wanted to know about breast cancer but never dared ask as well as common breast cancer misconceptions.
The 40 Now What guide on how to check your breasts for lumps
The best time to check your breasts
Breastcancer.org recommends you check your breasts once a month, a few days after your period has come to an end. This means that any premenstrual breast pain and tenderness should have settled. If you are not having periods, which could be for many reasons, choose a day – say the 1st day of each calendar month – to do this.
The best place to check your breasts
The best place to carry out your breast examination is in your bedroom or bathroom, where it is warm and private, and you have a mirror in which you can see your whole upper body, and a good light. You need to feel relaxed, confident and unhurried, and be able to get a good view of both breasts. You also need to be near your bed so you can examine your breasts sitting up and lying down.
How to check your breasts step by step
Undress completely to the waist, and stand in front of the mirror, so you can see your whole chest and both breasts. Stand square in front of the mirror and look at your breasts. It is normal for one to be slightly larger than the other.
Look at the shape and contours of both breasts. Look at the nipples. Is there any irregularity in the outline of the breasts, or any unusual dimpling or puckering of the skin, especially around the nipple area? Are there any red areas, swelling or rashes?
Next, slowly raise both arms above your head and hold them there, as you continue watching carefully in the mirror. The breasts should change shape in a symmetrical fashion. Again, can you see any changes in the breast as described above? Look under the armpits too. Now lower your arms to the resting position. Have you noticed any discharge from either nipple – this could be clear, milky, or blood-stained?
Your next step is to lie on the bed and put one hand behind your head and with the other, use the flat of your fingers to examine each breast. Feel round all four quarters of the breast rolling the tissue gently under your fingers against your ribs. Be careful around and under the nipple area, and make sure you feel right round under the arm into your armpit, and across the entire chest wall from the upper abdomen to the collarbone. You need to use a medium to firm pressure, but it should not be painful. Then change hands and examine the other breast.
Next, sit on the edge of the bed. Keep your arms by your side. Feel right around each breast carefully, including behind the nipple, into the armpit and up into the collarbone.
What to look out for
By doing self-breast examination, you will get to know what your breasts normally feel like, and this will hopefully mean you can notice quickly if anything changes.
You need to look out for any changes in the shape or contour of the breast, along with any puckering or dimpling of the skin, especially around the nipple. If you find a breast lump, try not to panic. Breasts can feel lumpy especially before a period. Benign breasts lumps such as breast cysts are very common. Check for any nipple discharge. Always remember to feel right round and into the armpit.
The average breast cancer is around 1 cm in diameter when it is felt in the breast – about the size of a kidney bean. However, the size of breast tumours does vary from smaller, to much larger. They can also increase in size quite quickly. They are usually mobile and not fixed in one place unless the disease has become advanced. Most breast cancers are painless.
If you find a breast lump, try not to panic. Around 80% of breast lumps are benign (noncancerous) – however, anything that is not normal for you, should be reported promptly to your GP.
Common benign lumps include –
- Breast cysts – the breast is a gland- the mammary gland – consisting of lobules that can fill with fluid to form a cyst. The cysts will feel a bit like a squashy balloon. These can be aspirated with a needle and a syringe.
- Fibroadenoma – These are benign tumours made of glandular and connective tissue, that often feel hard and gritty. They tend to be near the surface of the breast. They are often removed with a lumpectomy – usually to check the pathology and ensure they are benign.
- Fibroadenosis – this is just a general lumpiness you can often feel in the breast, which is sometimes a bit tender and often worse before a period. Sometimes on a mammogram the are contains calcification.
- Mastitis – this is a painful infection in the breast. It is often related to breastfeeding. Although generally benign, it does need to be distinguished from an inflammatory breast cancer.
- Sclerosing adenosis – a small painful lump that develops due to overgrowth of breast lobules.
- Duct ectasia – this is common in the premenopausal and menopausal period, when the milk ducts around the nipple become clogged and the tissue shrinks. The nipples can be retracted inwards.
- Fat necrosis – this can occur usually as a result of surgery when scar tissue causes a hard lump that may be associated with a nipple discharge.
There are some other benign conditions that can occur in the breasts such as lipomas (fatty lumps), and haematomas (bruises – a collection of blood under the skin).
There are also a range of premalignant conditions which need to be picked up and removed before they become malignant. Examples include intraductal papillomas, ductal hyperplasia and ductal carcinoma in situ.
Unfortunately, having benign breast disease does increase our lifetime risk of breast cancer. It is imperative you continue to check your breasts regularly throughout your lifetime and attend regularly for breast cancer screening when you are invited.
Getting to know your breasts
Breastcancer.org suggests you need to get to know ‘the different neighbourhoods of the breast.’ They say the upper outer portion of the breast is the area likely to be the easiest to feel, in terms of lumps and bumps. They describe the lower half of the breast feels like a sandy or pebbly beach, and that the area under the nipple feels like a collection of large grains. Other parts of the breast, they say, may feel like lumpy oatmeal. Having examined many breasts in my working lifetime, I really like these analogies.
The idea here is not to be afraid of your body. You need to love and respect it and know every nook and cranny. You are the best person to notice if something is wrong. Don’t be fearful of checking your breasts. If there is any abnormality, the sooner you get this checked out at the GP surgery, the quicker you can get on and have treatment.
What else you need to know
Caring for yourself is vitally important. When you reach the age of 50, please go and have your breast screening mammograms. Breast cancer screening saves 1 life for every 200 women screened. This means the programme saves 1300 lives every year.
Breast cancer screening has the advantage of detecting cancers early, meaning they can often be treated with minimal surgery. 80% of women whose cancers are picked up with screening mammograms, have lumpectomy and if needed, radiotherapy, meaning they do not need to undergo a full mastectomy.
At the moment, breast cancer screening in the UK starts at 47, meaning all women should get their first invitation before the age of 50, and continues every 3 years, until the age of 70 years. Over the age of 70 women can still request a 3 yearly mammogram – they just don’t get an automatic invitation. However, Breastcancer.org has always recommended breast cancer screening should start at age 40.
Unfortunately, screening mammograms are not 100% accurate and can result in overdiagnosis of breast cancer, resulting in unnecessary investigations and sometimes surgery. So, it’s not as simple as just a blanket recommendation to screen women at younger and younger ages. Also, breast cancers can occur during the 3 year screening interval, which is why continuing to examine your breasts regularly is so important.
For the best outcome, women need to be familiar with their own breasts and be able to spot quickly if something has changed or is not quite right. Once this has been reported to the GP, they can be fast-tracked if needed to the Breast Clinic for further investigation and treatment.
For more information
- NHS – How should I check my breasts?
- Breastcancer.org – Breast self-exam
- Breast changes in older women
- Examining your own breasts
- How should I check my breasts
- Understanding breast lumps
- Breast screening pros and cons
- Why is the breast screening age changing
So go on, cop a feel….it could just save your life.