Should You Still Be Doing Breast Self-Exams?

There’s a lot of new information out there about breast self-exams and their role in fighting breast cancer. It can be confusing. Some experts say one thing, others something different. Should you still examine your breasts each month?

The short answer is: learn what’s normal for your breasts and stay on the lookout for changes. If you’re doing regular self-exams, keep it up. We’ll tell you why in a moment.

What Are the Current Recommendations?

Here are the American College of Obstetricians and Gynecologists breast cancer screening recommendations:

  1. Starting at age 20, women should have a breast exam by a health professional every 1-3 years.
  2. Women age 40 and older should consider getting a screening mammogram every year.
  3. Breast self-awareness is encouraged and can include breast self-examination. Women should report any changes to their health care providers.

There are additional recommendations for women with higher risk.

Today’s best evidence points to having mammograms starting at age 40. There are some good studies that show women who have them are more likely to survive breast cancer than women who don’t.

Experts and doctors with a lot of experience think this is a good recommendation, but there isn’t good scientific proof. Other recommendations are based on expert opinion.

It’s important to know that breast cancer can present in many ways. In 15 to 20 percent of breast cancer cases, a mammogram will not reveal any changes. This is more common with dense breast tissue. For these patients, self-awareness is important for detection and treatment.

What Does “Self-Awareness” Mean?

Most women know their breasts. You notice when something changes. Do they get larger or sore before your period? Have they always been a little lumpy? Those are some of the normal things you might notice about your breasts.

Other breast characteristics you should know:

  • What’s their texture? Are they firm or soft?
  • What’s their shape when you’re standing? When you bend over?
  • What’s the shape of your nipple? Does it point in or out?

That’s your breast “baseline,” your normal. If you know what’s normal for you and pay attention, you’ll notice changes if and when they occur.

Changes

Not all changes are bad. Pregnancy makes some pretty dramatic changes. But most other normal changes are gradual. As you age, breasts slowly get softer. They begin to hang lower. But it won’t happen overnight.

Pay attention to any sudden change you notice. If you notice one of the following changes, discuss it with your health care provider.

  • Swelling or a warm area
  • Skin redness
  • Puckering, a dimple or skin that looks like an orange peel
  • Rash, scaliness, itching
  • Bloody nipple discharge
  • Lump in the breast or armpit that you haven’t noticed before
  • Lasting pain in one spot

Why Do the Guidelines Say "Can" Include Self-Exam?

Current research shows that women who do self-exams each month have exactly the same chance of surviving breast cancer as women who do not do monthly exams. So the guideline says you should be aware of your breasts. It also says you still can do the monthly exam as a way to be aware.

Still a Good Idea

The reason we say keep doing those monthly exams? We know that when you do things on a regular schedule, you are more likely to keep the habit. The monthly exam is a good way to stay aware.

Here’s how to do a self-exam if you’ve forgotten.

Even if you don’t do monthly self-exams, make sure you know your breasts! They deserve your awareness. Ask your health care provider about the right breast screening and self-exam plan for you.

Meet the Author

Julie A. Kepple, MD is a board-certified, fellowship-trained breast surgeon at Aurora Health Care in Cudahy, Milwaukee, Summit, and West Allis, Wisconsin.

Read more posts from this author

The information presented in this site is intended for general information and educational purposes. It is not intended to replace the advice of your own physician. Contact your physician if you believe you have a health problem.

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