Breast Self-Awareness: What You Should Know
Get to know your breasts, plus what changes to pay attention to.
By Lucy M. Casale, Contributing Editor
Every woman’s breasts are unique. And many women notice changes in their breasts throughout their lives. While sometimes these changes are a cause for concern, most breast changes don’t mean cancer or other problems. Still, it’s important for you to be familiar with how your breasts look and feel. If you know what is normal for you, you’ll be more likely to spot a potential problem early.
Your breasts are made up of different types of tissue — glandular, connective and fatty. Glandular tissue is made up of sections called lobes. Each lobe is divided into smaller sections called lobules. Lobules end in tiny bulbs that can produce milk.
Thin tubes called ducts connect the lobes and lobules. These ducts can carry milk. Connective tissue binds the lobules together while fatty tissue surrounds the lobules and ducts.
Your breasts also contain blood vessels and lymph vessels. Lymph fluid travels in the lymph vessels to lymph nodes. Lymph nodes are small, bean-shaped structures that filter lymph fluid and store white blood cells to help fight disease and infection.
The American College of Obstetricians and Gynecologists (ACOG) suggests that all women ages 20 and older practice breast self-awareness. This is not a substitute for recommended mammograms. It’s also not the same as a breast self-exam, which is no longer recommended.
Practicing breast self-awareness simply means you stay aware of how your breasts normally appear and feel. In contrast to a breast self-exam, you don’t need to examine them in any specific way or at any certain time of the month. You just need to know what is normal for your breasts, so you can tell if there are any changes.
Breast changes to pay attention to
If you notice any of these changes in your breasts, you should see your doctor:
- A lump in or near the breast or under your arm
- Tissue that is thick or firm in or near the breast or under your arm
- Dimples, puckers, itching, redness or scaling in the breast skin
- A nipple that turns in instead of sticking out
- Discharge from the nipple (other than milk)
- A change in the size or shape of a breast
Factors that contribute to breast changes
If you notice any unusual changes in your breasts and you’ve made an appointment to see your doctor, don’t panic while you’re waiting for that appointment. Most breast changes are not cancer. There are many reasons due to hormones and the normal aging process that can explain why you may notice changes in your breasts. They include:
- Menstrual periods. Your breasts may feel tender, painful or swollen before or during your period. You might also notice one or more lumps in your breasts. Normally, these changes should go away at the end of your cycle.
- Pregnancy. You may feel fullness in your breasts during pregnancy. Usually this is because the glands producing milk are getting bigger and increasing in number.
- Breastfeeding. Mastitis, or when a milk duct becomes blocked, can happen while breastfeeding. It may be caused by an infection and can often be treated with antibiotics. It can cause your breast to look red and feel lumpy, tender and warm.
- Menopause. Before menopause (when your menstrual periods stop), your breasts may feel lumpy and tender due to hormone changes. Usually, women no longer experience these breast changes once hormone levels drop, but remember to report ANY lump to your doctor.
- If you’re taking hormones. Birth control pills or injections and menopausal hormone therapy may make your breasts denser.
Still, it’s important to tell your doctor about any changes you notice in your breasts.
Don’t miss mammograms
Mammograms, or X-rays of the breasts, are important screenings that can help find breast cancer early. And finding breast cancer early means you’ll have the best chance of being treated successfully.
Recommendations may differ on frequency and what age to begin screening mammograms. Here is what the U.S. Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) recommend:
- The USPST recommends women ages 50 to 74 who don’t have symptoms AND haven’t been diagnosed with breast cancer or a high-risk breast lesion AND are not at high risk for breast cancer from a genetic mutation or a history of chest radiation at a young age get a mammogram every two years. Prior to age 50, a woman can decide if she wants to start screening, based on her personal values and risks. Talk to your doctor about what’s right for you.
The ACS states that women ages 40 to 44 be given the option of yearly mammogram screening – and should be provided information of the risks and benefits of this screening. The ACS also recommends yearly screening mammograms for women ages 45 to 54. For those women ages 55 and older, the ACS recommends screening mammograms every two years (or yearly for women who prefer this). Women should continue screening as long as they’re healthy and are expected to live at least 10 more years.
National Cancer Institute. Understanding breast changes: A health guide for women. Accessed: September 19, 2016.
U.S. Preventive Services Task Force. Screening for breast cancer. Accessed: September 19, 2016.
Centers for Disease Control and Prevention. Breast cancer. Screening. Accessed: September 19, 2016.
American College of Obstetricians and Gynecologists. Mammography and other screening tests for breast problems. Accessed: September 19, 2016.
Updated September 19, 2016