Be breast aware: Breast Cancer Q&A
Your morning routine might look something like this: roll out of bed, wash your face and throw your hair into a messy bun, pull on some jeans and then a bra. Here is where we’d like you to pause and have a think – when was the last time you checked your breasts?
You might have noticed your breasts have felt a bit tender or have changed size (up and down) and put this down to the time of the month – and while bodily changes can be linked to your menstrual cycle, it’s best to be breast aware.
In 2021, an estimated 19,866 women and 164 men in Australia were diagnosed with breast cancer.
Who should check and when?
As women, it is recommended that we start to get to know our breasts and begin to check for signs of changes from around age 25. The advice is different for women who have a very strong family history of breast cancer or known to be carriers of a breast cancer pre-disposition gene.
Chair of COSA’s Breast Cancer Group, Dr Susan Fraser, says these women may be advised to start this examination earlier, in general about 10 years prior to the youngest affected relative.
Dr Fraser has shared a wealth of knowledge on breast cancer in women and what we should look out for, so please keep reading for all the details.
What should we check for?
Dr Fraser says breast examinations should include looking in the mirror for changes in the skin, dimpling or changes in the breast on elevation of the arm. This might be before or after a shower, or when you are getting dressed and may involve looking at and feeling the breast, armpits and up to the collarbone areas for any signs of changes.
“The breast tissue extends under the armpit and forms the so called ‘axillary tail’ of the breast and this area can also be felt as part of breast self-examination,” Dr Fraser says.
Remember the breast tissue, although only thin, can extend up to the second rib so ensure you feel up to the collar bone as part of your check.”
The purpose of regular breast checks from early on is to have a baseline to be able to recognise changes if they arise.
What do we do if we notice a change?
Every woman’s body is unique, and there are several factors that can guide what to do if we feel or see a change in our breast area.
Dr Fraser says in young, pre-menopausal women, it is safe to wait one (1) menstrual cycle and see if the change disappears completely. If it doesn't, it's important to make an appointment to book an appointment to see your doctor.
“In post-menopausal women however, any change noticed in the breast whether it be thickening or nipple change should be investigated immediately and you should make an appointment to see your doctor for triple testing,” Dr Fraser says.
What if we notice something not in the breast area?
“If a woman has a past history of breast cancer, then it's probably important to see your doctor about any unexplained pain or symptom outside the breast area or indeed in the breast area itself,” Dr Fraser says.
What are common risk factors?
“In Australia, breast cancer incidences increase with age,” Dr Fraser says. There are also a multitude of risk factors for developing breast cancer; these may be genetic, hormonal or lifestyle.”
Dr Fraser says a family history of other types of cancer such as ovarian cancer or melanoma can also be a risk when they occur in immediate relatives, while hormonally, risk factors can include:
- Early menarche (the first menstrual cycle or bleeding, in females)
- Late menopause
- Nulliparity (never given birth)
- Years between menarche and first full-term pregnancy (the greater this interval the higher the risk of developing breast cancer)
- Maternal age of first pregnancy over 35 years
- HRT (hormone replacement therapy)
- Lifestyle factors
- Obesity (especially after menopause)
- Lack of physical exercise
High breast density increases the risk of developing breast cancer significantly.
Can we reduce our risk of breast cancer?
There are some recommended lifestyle changes that can reduce an individual’s risk of developing breast cancer, including:
- The avoidance of obesity by maintaining a healthy BMI range, following a Mediterranean diet, and the consumption of unprocessed foods
- Regular exercise
- Knowing your breast density so you can modify your screening regime appropriately in consultation with your GP (risk stratified screening).
“Breast screening will not reduce your risk of developing breast cancer but may pick up your cancer at an earlier stage when treatment and survival are much improved so talking to your doctor regarding commencing regular breast screening often from the age of 40 is important,” Dr Fraser says.