Written by Luan Lawrenson-Woods
Australia has one of the best survival rates in the world for breast cancer, partly due to early detection. The earlier breast cancer is diagnosed, the more effective treatment can be.
Self-examination is one of the ways you can check for signs of breast cancer. Even if you have regular screening or scans, or you’ve had a mastectomy, you still need to do regular self-checks.
Pink Hope has an automated Self-Breast Check tool that will send you a reminder to check your breasts so that you can become ‘breast aware’.
Be ‘breast aware’
Being ‘breast aware’ means knowing what’s normal for your breasts and getting anything unusual checked out by your GP.
Women’s breasts change during their menstrual cycle and their ‘normal’ can be different at different times of the month. Specialist Breast Surgeon, Dr Sam Sood (FRACS), advises that you “examine yourself regularly, but don’t be stuck on that one same day each month – mix it up a bit”.
Dr Sam also highlights that women need to check under their arms, as a ‘tail’ of breast tissue extends into the armpit. Men should also regularly check their chests and know what their ‘normal’ is.
It can be daunting when you first start to self-check. Everyone’s ‘normal’ is different, so how do you get to know what’s normal for you? It comes down to three simple steps.
Self-check your breasts: look, feel, move
“It’s important for women of any age to be ‘breast aware’ and familiar with their own breasts, self-check regularly and know how their breasts look, feel and move”, says Dr Sam.
Dr Sam advises that you stand in front of a mirror with your arms by your side and look to see if there are any changes to the shape or size of your breasts. Check for any changes to the skin of the breast or your nipples – do you have a rash, is your nipple inverted or has it changed direction?
Some women naturally have breasts that are different in size or shape, or have an inverted nipple, but the key is that you’re looking for something that is new and different for you and is a “new finding”, says Dr Sam.
If you have unexplained redness or see discharge or blood coming from your nipple, you need to get it checked out.
Next feel your breasts using the flats of your fingers. “Do whatever movement it takes, whether that’s a circular movement or radial movement. You want to cover the entire breast, the nipple and into the armpit.”, says Dr Sam. “You can use one or two hands. It’s really a very light motion that glides over the surface of your skin, it’s not a very firm grip on the breast. It’s just gentle strokes back and forward to see what your breast feels like”.
Lumps aren’t always the signs of something sinister. “It’s normal to have a lumpy breast, but it’s important to know where your lumpy bits are, so that you know what is normal for you. If there’s something new, get it checked”, Dr Sam adds.
Then you need to move. Dr Sam recommends that you “Put your arms up and look under your breast. Then put your hands on your hips and push down and clench to accentuate your pec and chest muscles”.
Look at how your breasts move – do they move equally, are there any dimples, puckering or indents? “When you accentuate your pec muscles it helps you to see if there’s anything ‘stuck down’ or ‘tethered’ to your muscle internally in the breast”, explains Dr Sam.
It’s not only about what you feel with your hands, but how your breasts feel when you move
It’s important to pay attention to any pain, discomfort, or new sensations when you move or feel your breasts, even when you’re doing everyday things.
It’s often said that pain is not a symptom of breast cancer, however, Dr Sam says “That was a traditional way of thinking and I feel we need to change that statement”. Some women may experience pain or tenderness with their period cycle, but if you have constant, unexplained pain that does not dissipate in your breast or armpit, then “it’s something that we can’t ignore as it can be associated with breast cancer” adds Dr Sam.
If you notice anything that is not ‘normal’ for you and there are changes to your breasts that are unexplained, new to you or weren’t there before, you need to get them checked out by a GP.
If you’re checking your breasts for the first time and you notice any of these signs, go and see your GP for a breast assessment.
What happens when you have a ‘new normal’?
A woman’s ‘normal’ can change because of pregnancy or breastfeeding. “It can be tricky because the breast becomes uniformly swollen getting ready for the birth of the baby and in the breastfeeding stage the lobules and all the ducts are engorged”, says Dr Sam. Women may assume that any lumps are blocked ducts or mastitis, but Dr Sam says that “Just like anyone else, whether it’s in your pregnancy stage or breastfeeding stage, any new lump needs to be assessed”.
Dr Sam assures new mammas or mammas-to-be that if further investigations are needed, an ultrasound instead of a mammogram can be used so that women who are pregnant aren’t exposed to radiation, and women who are breast-feeding don’t have to worry about their breasts being ‘squeezed’.
If you’ve had a mastectomy, you still need to self-check, whether you’ve had a breast reconstruction or not. “A mastectomy doesn’t remove 100% of the breast and there are some breast cells below the skin. Anyone who’s had a mastectomy should check themselves by running their hands over their chest if they’ve remained flat, or breast if they’ve had a reconstruction. And they still need to check under their armpit”, Dr Sam reminds us.
Know your ‘normal’ and be the expert of your breasts
Through regular self-checks you will become the expert of what’s normal for your breasts and notice when changes happen that could be a sign of breast cancer. Pink Hope can help.
Sign-up for Pink Hope’s automated Self-Breast Check We’ll send you a reminder every 6 weeks, so that you get to know your ‘normal’ at different times of the month.
If you haven’t started to self-check yet, that’s OK, it’s never too late to start! Check out our ‘How to Screen Yourself for Breast Cancer’ if you’d like some further guidance.
This article has been reviewed by Dr Samriti Sood, a FRACS qualified Specialist Breast Oncoplastic and General Surgeon who is a full accredited member of the Society of Breast Surgeons of Australia and New Zealand Dr Sam is a Senior Clinical Lecturer at the University of Sydney a member of the ANZ Breast Cancer Trials Group and a Medical Officer with BreastScreen NSW