When are you really supposed to start having breast exams? And how do I do it myself? I’ve heard some women have benign cysts and doctors tell them not to worry because they just have “lumpy breasts.” How can I tell if something I find myself should get checked out?
Keeping an eye out for breast changes is really important and it starts with knowing your body.
Breast self exams used to be all the rage. Do you remember those hanging tags that you could put over the showerhead to remind you to do your exam? And now you barely every hear about them.
So what’s the deal?
Basically, there was a study that came out showing that doing self exams didn’t seem to have an effect on breast cancer survival rates and so they kind of lost their sense of importance.
That said, it is often a woman or her partner who first notices a change, so being familiar with your own normal is key. Also key is to understand that there is a huge variation in “normal.” Yes, lumps and bumps can be normal — some women are just lumpier than others. Changes also can be normal.
Things like the menstrual cycle, birth control, pregnancy and aging can all change our breasts. Which is why regular breast exams are so important — so that you can stay “abreast” of what your normal feels and looks like. Your provider can do an exam with you to help you understand what feels normal if you aren’t sure. But it’s probably safe to assume that if you’ve had that same lump since you were 20, especially if both of your breasts feel similar, it’s probably normal. It’s more concerning to find a new lump, a unilateral lump, or one that is growing. If your provider isn’t sure, they may send you to get an ultrasound. Often times, lumps that had you freaking out end up just being a benign cyst or fibrous tissue, which is nothing to worry about. But it’s always better to get a professional opinion and confirm that this is your normal breast, so you can continue watching for any further changes. If in doubt, better to check it out.
The general recommendation is that starting in your 20s, do a breast self exam about once per month. You can do it in the shower, in front of a mirror, or lying down. There are lots of good diagrams and educational videos online, but the reality is that the specifics of when you do it and which technique you use doesn’t matter a ton. The important aspects are that you are doing it regularly, that you remember to check the entire breast as well as the nipple and the armpit. (You can start at the nipple and slowly work your way out in a spiral or you can move your fingers up and down in a grid type pattern to make sure you don’t miss any spots.) If you see any skin changes like puckering or change in texture, any nipple discharge, or notice any new lumps, schedule an appointment to get it checked out.
It’s pretty common to have your provider do a breast exam every few years when you go in for your PAP smear and most women start getting mammograms every 1-2 years once they are between 40 and 50. If you have a family history of breast or ovarian cancer in a first-degree relative, like a mother, daughter or sister, you probably want to talk to your provider about starting breast cancer screening earlier.
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Corinna R. Michels earned a master’s of science in nursing at the University of California San Francisco. She was a Fulbright grant recipient in Colombia in 2013 and now works as a nurse practitioner in Yakima, where she lives with her family.