Are you breast aware?

Read our quick guide to checking your breasts and recognising what's normal for you.

Every woman should be breast aware throughout her adult life and it's an important part of caring for your body. Being breast aware means knowing how your breasts look and feel normally so you notice any unusual changes.

Detecting a change early means that if cancer is diagnosed any treatment may well have a better outcome. Most breast changes will prove to be benign (non-cancerous) but you should always report any concern to your GP. Men also need to be aware of any changes in their breast tissue, as approximately 200 men in the UK get breast cancer each year.

The checking code
Know what is normal for you

Know what changes to look and feel for

Report any changes to your GP without delay

Attend for routine breast screening if you are 50 or over

Practicalities
Breast awareness is about becoming familiar with your normal breast tissue and how it changes, for example at different times of the month. Get into the habit of looking at and feeling your breasts from time to time.

One way of looking is by using a mirror so that you can see your breasts from different angles. You may find feeling your breasts is easier to do with a soapy hand in the bath or shower, or you may prefer to do it lying down. You can decide when is convenient for you and what you are comfortable with.

Know what is normal for you
Your breasts will go through many perfectly normal changes throughout your lifetime. They are affected by hormonal changes during your menstrual cycle, pregnancy, breast-feeding, the menopause (change of life) and weight loss or weight gain.

The menstrual cycle
Each month, during your child-bearing years, your breasts prepare for pregnancy and breast-feeding. Breasts often become enlarged, tender and lumpy shortly before a period starts but return to normal once the period is over (although some women may have tender, lumpy breasts throughout their cycle).

The menopause
Breast tissue changes after the menopause; it is often less dense and firm, and becomes more fatty, making your breasts feel softer. As you grow older your breasts may get smaller. If you take HRT (hormone replacement therapy) your breasts may feel firmer and sometimes quite tender.

What changes should I be aware of?
These are the changes that you should be aware of when you look at and feel your breasts:

a change in size – it may be that one breast has become noticeably larger or noticeably lower a nipple has become inverted (pulled in) or changed its position or shape a rash around the nipple discharge from one or both nipples puckering or dimpling of the skin a swelling under your armpit or around your collarbone (where the lymph nodes or glands are) a lump or thickening in your breast that feels different from the rest of the breast tissue constant pain in one part of your breast or in your armpit.

What if I find a change?
You will know better than anyone how your breasts feel and look normally, so if you do notice a change, see your GP as soon as possible. Don't worry that you may be making an unnecessary fuss, and remember that most breast changes will be benign (non-cancerous) and harmless.

When your GP examines your breasts s/he may be able to reassure you that there is nothing to worry about. (If s/he thinks the change may be connected with your hormones, your GP may ask you to come back at a different time in your menstrual cycle.)

Alternatively, s/he may decide to send you to a breast clinic for a more detailed examination. For more information about benign breast problems, what happens at a breast clinic and the tests used to make a diagnosis, see Breast Cancer Care's booklet 'Making a diagnosis: breast problems and breast cancer'.

Screening for breast cancer
If you are between 50 and 64 you are entitled to be screened every three years as part of the National Breast Screening Programme. Your name will be taken from your GP's list and you will be sent an invitation to come for a mammogram (breast X-ray). This may not happen the year you turn 50 but it will within three years of you turning 50.

At present younger women are not invited for screening as part of the NHS programme. A clinical trial is underway to look at whether the NHS breast-screening programme should be extended to include younger women. However, breast screening is available for women over 40 from private health-screening centres.

If you are 65 or over you will not be invited for screening. However, you are still at risk of breast cancer and entitled to free breast screening every three years on request. All you need to do is ask your GP or practice nurse to arrange an appointment for you, or you can contact the breast-screening unit yourself.

You can find out where your local breast-screening unit is by calling the free Health Information Service on 0800 665544 (or the NHS Health Helpline on 0800 224488 in Scotland), or by contacting your GP practice.

Finding out more
If you want more information or practical advice about being breast aware, contact your practice nurse at your GP surgery. You can also phone the Breast Cancer Care helpline on 0808 800 6000 or visit the Breast Cancer Care website

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