Breast Self-Awareness: Screenings and Exams

One out of every 8 women will develop breast cancer during their lifetime, and breast cancer accounts for 27% of all new cancers diagnosed in women.  Therefore, this is a very important topic for every woman to be aware of.  Screening for breast cancer traditionally involves 3 components: self breast exams and breast awareness, clinical breast exams, and mammogram imaging.  When to initiate these types of screening exams is something that should be discussed with your doctor.  It is important for women to be aware of their family histories of breast cancer. It is helpful if you can notify your doctor of each person affected in your family, and the age at which they were diagnosed.  In general, breast self-awareness is recommended for women of all ages, clinical examinations can begin at age 20 and take place every 1-3 years, and mammogram screening should begin at age 40 and take place annually.

What is breast self-awareness?  This is defined as a woman’s awareness of the normal appearance and feel of her breast.  Greater than 70% of cancers diagnosed in women under the age of 50 are detected by women themselves. This is true for approximately 50% of women over the age of 50.  Women should be aware of their own breast and monitor them regularly for changes. This does not necessarily mean that a systematic examination should be performed, but does mean that when daily observation and monitoring reveals a change they should notify their physician even if they have had a recent clinical exam or mammogram that was normal. 8-17% of breast cancers will be missed by mammogram.

When practicing breast self-awareness you should notify your physician if you notice changes in the appearance of your breast. Changes of the shape or size, particularly if only present in one breast, are important as are changes in skin texture, streaking or dimpling on the skin. Changes in the nipples, if they become inverted or if they begin leaking, especially if the fluid is not clear or white, is also important.  If bloody discharge is noted from the nipples your physician should be notified immediately.  Then of course any lump or mass that is identified should undergo further evaluation.

Not every finding in breast will be cancer. There are several benign breast diseases commonly encountered in young women. These include fibrocystic breast changes, breast cysts, fibroadenomas, and mastitis.  Fibrocystic breast are diagnosed when the breasts feel swollen and lumpy. They are typically tender. There is no specific treatment for this condition, but a well-fitting bra, over the counter medications such as ibuprofen, and application of heat or ice can improve symptoms.  Breast cysts are small fluid filled sacs that can be present in a variety of sizes. Some feel soft and springy, others are more firm.  They are typically tender and may become more so around the time of your menses. Like fibrocystic breast, this is more common in women less than 50, but may be present following menopause in women on hormone therapy. When cysts become large or painful they may be drained by your physician, or can be surgically removed.  Fibroadenomas are breast masses that are solid.  They can be present in both breasts, and are not typically painful. They have a smooth and well defined shape. They do not require treatment but can be surgically removed. Lastly, mastitis is an infection in the breast most commonly caused by clogged milk ducts in women who are breast feeding. This is commonly treated with antibiotics.

In conclusion, breast cancer is a prevalent disease in women that is better treated when identified early. Self breast awareness, clinical examinations and mammograms are used to screen for this disease and are an important component of each woman’s health maintenance.  Not all breast findings are related to cancer, and there are a variety of benign conditions that can be identified in the breast. Nevertheless, all findings should be reported to your doctor to be appropriately evaluated and monitored when necessary.

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