Know your breasts!
So what’s the deal with all this talk about checking your breasts?
The distinction between “awareness” (knowing your body so that you can notice and report changes) and “checking your breasts” (regularly, systematically feeling for lumps) is subtle and can be confusing for young women. Nearly 80 percent of young women find their breast abnormalities themselves. However, studies show that there are no changes to mortality between women who naturally notice and report a change that turns out to be breast cancer and those who are proactively checking for lumps and changes and find an abnormality that turns out to be breast cancer. Also, because breast cancer is so rare in women 40 and under, young women should be made aware that “checking” their breasts too frequently for lumps can result in an increased number of healthcare visits and twice the number of benign biopsy results.
Rethink Breast Cancer recommends that all young women should be familiar with how their breasts look and feel and promptly report any change to their healthcare provider. This does not need to be done in any specific formalized way.
Signs + Symptoms
The better you know what your breasts look and feel like, the easier it will be to notice unusual changes and have them checked out by your doctor. Here are some breast changes to look out for:
- Lump. A lump or hard knot in the breast or armpit
- Lumpy area. Bumpiness or unusual thickening that doesn’t go away after your period
- Pain. Pain in one spot that’s not associated with your period
- Swelling. Swelling, warmth, redness or darkening
- Size and shape. One breast might become larger or lower than the other
- Skin texture. Puckering or dimpling of the skin
- Appearance or direction of nipple. One nipple might become inverted (turned in)
- Discharge. Nipple excretes a blood-stained liquid (in one or both breasts)
- Rash or crusting. An itchy sore or scaling area on or around the nipple
If you experience any of the above symptoms, make an appointment with your doctor. You might find out it’s nothing – more often than not it’s harmless. But if your doctor can’t rule out breast cancer through a clinical breast exam, she will refer you to a breast cancer clinic for an assessment, which includes a physical exam, breast imaging (ultrasound and/or mammogram) and a biopsy if necessary. We know that young women’s breast concerns aren’t always taken as seriously as they should be by their medical team – if you are worried about your breast health, trust your gut, speak up and demand the appropriate referrals you need in order to get a definitive answer. Always remember that you are your own best advocate.
Your assessment can involve any or all of the following diagnostic tools, depending on your age and physical characteristics:
If you’re under 35, you’ll probably be scanned using ultrasound, which takes a picture of your breasts using sound waves. This method provides better images of younger breasts, which tend to be denser. It is also particularly useful for telling the difference between a solid lump and a cyst and for predicting the size of a tumour.
This is an X-ray of your breast tissue, so it involves some radiation. Each breast will be X-rayed at least once. It can feel a bit awkward, but it’s an effective tool for detecting breast cancer in its early stages.
This is usually the only way to tell for certain if a lump in your breast is benign or cancerous. With a biopsy, a sample of your breast tissue is removed and examined under a microscope. The standard method is core biopsy, where a small amount of tissue is removed with a needle. This is done under local anesthetic. Also common is fine needle aspiration (FNA), the easiest and quickest biopsy technique. A sample of cells is taken from the lump using a fine needle and syringe. This is an outpatient procedure that takes about 10 minutes. Other methods include excision biopsy and wire-assisted biopsy. Your doctor will recommend the most suitable type for you.
It takes a team!
The investigations and any subsequent treatment for breast cancer will involve a team of health care specialists, usually consisting of a breast surgeon, a breast care nurse, a radiologist, an oncologist (a cancer specialist), and a pathologist or cytologist (someone who specializes in diagnosing diseases by studying tissues and cells).
Your personal support is as important as your professional care, so make sure to include a friend or family member in the process.