October is Breast Cancer Awareness Month, and this week, we’re going to go through some of the things you can do to maintain that awareness, no matter what time of the year it is. Worldwide, breast cancer is the most commonly diagnosed cancer, with 2.3 million cases in 2020 alone1, but early detection can be key in improving outcomes. So how do we do that? There are a few simple, non-invasive exercises you can do yourself to keep an eye on your breasts, so you notice any changes early. And best of all, you can even do this while you’re still breastfeeding! It’s never too late to start, either – if you haven’t already, today’s a good day to try some of these out.
Before we get started, though, it’s worth mentioning that breastfeeding itself, alongside all those other amazing benefits, has been shown to help prevent this particular cancer, with the risk decreasing by 4.3% for every 12 months of breastfeeding2. How great is that?
Find your normal
Everyone’s breasts are different, and they are far from uniform and smooth. Beneath the skin are glands and other structures, so finding out what your breasts are usually like gives you a great starting point to determine if things start to change. Breast self-examinations are fairly quick and easy, and involve checking both visually and with your hands. You can do this in any order – whatever works for you is what is best. This process is what the Breast Cancer Foundation NZ refers to as “TLC” – Touch, Look, get it Checked. The overall idea is to gain a greater awareness of your breasts and what is normal for them. You can’t compare them to any guide, as each person’s breasts are unique. So, in doing these exams, it’s less about looking for specific things than it is about looking at the overall picture – and picking up any deviations from this. It’s also not recommended to do these exams every day – once a month is sufficient, especially since if you check too often, you’ll be more likely not to notice those tiny changes. It’s rather like your baby growing. You see your baby every day, so their growth is less noticed. A friend or family member’s baby that you only see every month or two? The changes in them are immediately much more noticeable to you.
1. Visual inspection
This is the easiest part – but it’s also extremely important. Lumps are a particularly well-known breast cancer symptom, but it’s far from the only one, and sometimes cancers show themselves in other ways before the lump gets big enough to be noticeable. You’ll need a mirror for this to make sure you can see everything. Start with your hands on your hips, then raise your arms over your head. Take note of the general shape and appearance. There are a few different indicators you should look out for over time. A nipple suddenly inverting, if it wasn’t already inverted, dimpled skin resembling orange peel, or skin that’s red, swollen and warm to the touch are all things you should get checked as soon as possible.
This is, of course, complicated sometimes by breastfeeding. Just because you have changes doesn’t mean it’s cancer – some of these can be caused by breastfeeding and its issues as well. That said, getting them checked anyway is a good idea – mastitis also causes localised red, warm swelling, and it’s no joke. Getting it treated as soon as possible is important.
Discharge is another thing to keep an eye out for. You’ll get used to the appearance of your own breastmilk, so if something different shows up, that’s another sign to head to your doctor. As mentioned above, what you’re really looking for are differences from your norm.
2. Checking for physical changes
The “T” part stands for touch, and this is the part you may be more familiar with. You can do this in any position, but those with larger breasts may find it easier to lie down for this check – though there’s certainly no obligation to do so. Another option is to do this in the bath or shower, as having your hands wet will make moving your fingers across your skin easier. Lift one arm above your head, then press gently into the breast tissue on that side with the flat of your fingers. This is where you’re looking for things like lumps or thickened areas – anything that wasn’t there last time you checked. Repeat on the other side. It’s important to remember to check everywhere there is breast tissue, including around your ribs and under your arms. Swollen lymph nodes can be a sign of illness, including cancer, so if you find the nodes on one side are a different size to the other side, it’s worth getting checked.
Regularly checking can make you much more aware when something changes – and again, the emphasis is on regular rather than frequent. For those still nursing, breastfeeding itself can lead to significant changes, and it’s good to bear that in mind. Doing your monthly check in the evening, after baby has drained your breasts can make things easier than in the morning when you may be more likely to be dealing with engorgement. Getting to know what your milk looks like at that time of the day will help you figure out if you’re looking at leaking milk (quite common and normal) or some other sort of discharge (which should be checked by a professional). Finally, there can be fluctuations in your breasts associated with your menstrual cycle and its hormones – if you have a relatively regular, stable cycle, checking at the same time each month can help take this into account.
1Arnold, M., Morgan, E., Rumgay, H., Mafra, A., Singh, D., Laversanne, M., Vignat, J., Gralow, J. R., Cardoso, F., Siesling, S., & Soerjomataram, I. (2022). Current and future burden of breast cancer: Global statistics for 2020 and 2040. The Breast, 66, 15–23. https://doi.org/10.1016/j.breast.2022.08.010
2Stordal, B. (2022). Breastfeeding reduces the risk of breast cancer: A call for action in high‐income countries with low rates of breastfeeding. Cancer Medicine, 12(4), 4616–4625. https://doi.org/10.1002/cam4.5288