We all want to be equipped with the knowledge to detect early symptoms of breast cancer. For decades, women were urged to do monthly self-breast exams. However, health care facilities and organizations are no longer teaching self-exams, but instead are getting behind the concept of urging women to be breast self-aware in the hopes of identify and stopping breast cancer in its tracks. Oncology Nurse Navigator Edra Fouts, RN, ONC, CBCN, UnityPoint Health, helps explain the differences.
Shifting in Thought
In 2009, the U.S. Preventive Services Task Force made the first shift away from routine or monthly breast self-exams. Fouts says experts reviewed several studies and identified the breast self-exam caused unnecessary imaging tests, more breast biopsies with false positives and caused increased anxiety for women. The studies also identified the self-breast exams didn’t increase breast cancer survival. Organizations, like the American Cancer Society, The Komen Foundation and the National Comprehensive Cancer Network, all followed suit in shifting their approach.
Breast Self-Exam vs Breast Self-Aware
According to The Komen Foundation, the breast self-exam is a step-by-step approach that can be used to inspect the breasts in hopes of catching early symptoms of breast cancer. The steps included feeling the breasts both standing and lying down. For years, recommendations encouraged women to perform breast checks once a month. While the breast self-exam can be a tool to developing breast self-awareness, the self-breast exam is no longer taught or pushed on a monthly basis. Instead, Fouts says you should be aware of how your breast tissue normally feels, so you can take action if you notice something concerning.
“Being breast self-aware means knowing how your breasts normally look and feel,” Fouts says. “It’s like having a mental map of your tissue.”
If you’re wondering how to check yourself for breast cancer, Fouts say to keep an eye out for any of the following symptoms.
- Puckering or dimpling of the skin
- Nipple retraction (pulling in of the nipple)
- Spontaneous nipple discharge
- Redness or darkening of the skin
- Accentuated pores
- Skin lesions that don’t heal
- Change in size or shape of the breast
- Pain in one part of the breast that doesn’t go away
- Lumps (tender or non-tender)
How to Check for Breast Lumps
While doing a breast check, lumps can be particularly confusing. According to the Komen Foundation, breast tissue naturally has a bumpy texture. If the consistency of the breast is the same throughout, it’s likely nothing to worry about. However, lumps that feel harder, different than the rest of the breast or are newly identified should be evaluated by your doctor.
“Lumps can vary in size, and they can be movable or fixed. It can be painful or non-painful to the touch,” Fouts says.
There are several non-cancerous lumps that can also happen in many women at some point in their lives. The lumps are caused by fibrosis and/or cysts. According to the American Cancer Society, fibrosis refers to a large amount of fibrous tissue, which may feel rubbery, firm or hard to the touch. Cysts are usually movable lumps that are fluid-filled. Many times, cysts increase in size right before a woman’s menstrual period.
Men can experience lumps, too. Fouts says the side effects of some medications or hormone changes in men can lead to a non-cancerous condition known as gynecomastia. It’s when the male breast develops a mass that is palpable and may or may not be painful. While this condition isn’t often associated with cancer, Fouts says men, too, can be diagnosed with breast cancer and need to report any changes to their provider.
Know Your Risk
For people without a family history of breast cancer, it’s recommended to have a clinical breast exam every three years starting at 20. Then, be prepared with knowledge of your family history to talk with your doctor about which screenings are right for you and when you should start them, including mammography.