Breast Health

Becoming breast aware

It is important that every woman is breast aware. This means knowing what is normal for you so that if any unusual change occurs, you will recognise it. The sooner you notice a change the better, because if cancer is found early, treatment is more likely to be successful. Get into the habit of looking at and feeling your breasts from time to time.

What changes should I be aware of?

A good time to look at your breasts is about one week after your period or around the same time each month if you are no longer having periods. These are the changes you should be aware of when you look at and feel your breasts:

• A lump, any size, or thickening in your breast
• Constant pain in one part of your breast
• A change in size or shape – it may be that one breast has become larger
• Changes in the nipple – in direction or shape, pulled in or flattened nipple or an unusual discharge, especially if bloodstained
• Changes on or around the nipple – rash, flaky or crusted skin
• Changes in the skin – dimpling, puckering or redness
• ‘Orange Peel’ appearance of the skin caused by unusually enlarged pores
• Prominent veins that have become more noticeable
• Lump or swelling or constant pain in your armpit
  

How to look for changes

During each of these stages you should turn from side to side while carefully looking at your breasts in the mirror.

1. Place your hands by your sides
2. Raise your arms above your head
3. Place your hands on your hips with your elbows pushed forward

How to feel for changes

Feel each breast in turn. Keeping your fingers together and flat, firmly move over the whole breast, including the nipple and armpit. You may find feeling your breast is easier to do with a soapy hand in the bath or shower. Some women prefer to feel for changes while lying down.

The 5 point breast awareness code

1. Know what is normal for you
2. Know what changes to look for
3. Look and feel
4. Discuss any changes with your GP without delay
5. Attend for routine breast screening if you are aged between 50 and 64

Know what is normal for you

Your breasts will go through many normal changes during your life. For example, they are affected by changes in your hormones during the following times:

The menstrual cycle

Each month, when you are having periods, your breasts often change. They can become bigger, tender and lumpy usually before a period starts and return to normal once the period is over. Some women, however, may have tender, lumpy breasts throughout their cycle.

Pregnancy & breast-feeding

The changes that occur during your menstrual cycle continue during pregnancy. While breast-feeding, your breasts may be very enlarged, firm and tender; this is normal at this time. However, you should continue to check your breasts and discuss any unusual changes with your GP.

The menopause

After the menopause your breasts will feel softer and they may get bigger or smaller. If there is a change in only one breast, you should discuss this with your doctor. HRT hormone replacement therapy may cause your breasts to feel firmer and quite tender.

What to do if you find something

If you do notice any change in your breasts, see your GP as soon as possible. Remember that most breast changes are not cancer and are harmless. When your GP examines your breasts she or he may be able to reassure you that there is nothing to worry about. If the change could be connected with your hormones, your GP may ask you to come back at a different stage in your menstrual cycle. Alternatively, you may be sent to a breast clinic for a more detailed examination.

Don’t worry that you may be making an unnecessary fuss and remember that nine out of ten breast lumps are harmless

Did you know

• Early diagnosis is a key to surviving breast cancer.
• More than 1,700 new cases of breast cancer are diagnosed in Ireland each year.
• Irish women have a 1 in 13 chance of developing breast cancer in their lifetime.
• 74% of Irish women with breast cancer discovered the lump themselves.
• Only about five to ten per cent of breast cancers are believed to have a family link.
• The risk of developing breast cancer increases with age. Approximately 80% of breast cancers occur in women over 50 years.
• Around 16 men develop breast cancer in Ireland each year.

The best questions to ask your doctor if you have noticed a change:

If your GP refers you for investigation or tests, ask

• Why are you referring me for investigation?
• Can I be referred to a specialist breast clinic?
• How quickly will I be seen?
• Is my referral urgent or non-urgent?
• Which tests will I need (ultrasound, mammogram,biopsy ) and why? Ask about Triple Assessment.
• Will I stay overnight in hospital for any of these tests and will I need a general anaesthetic?

If your GP does not refer you for tests, ask

• Can you explain why you’ve decided not to refer me to a breast specialist?
• How can you be sure I don’t have breast cancer?

Screening for breast cancer

Breast screening involves a mammogram x-ray of the breasts, which can detect early signs of cancer before it can be seen or felt. Screening has been proven to reduce the number of deaths from breast cancer, as the disease is very treatable if detected early. BreastCheck : the National Breast Screening Programme, began offering free mammography to women aged 50-64 in 2000. The programme invites eligible women, on an area by area basis, for free screening every two years.
The Programme currently offers free mammography to eligible women living in the Republic of Ireland.
Programmes similar to BreastCheck have significantly reduced deaths from breast cancer in other countries. Action Breast Cancer would encourage all women invited for screening to attend their appointment.

Women can check that they care on the BreastCheck register by calling freephone 1800 45 45 55 .

Healthy lifestyle

While doctors still do not know what causes breast cancer, indications are that a healthy lifestyle may provide some protection. In general you should maintain a healthy body weight, eat a balanced diet with plenty of fresh fruit and vegetables, take regular exercise and if you drink, limit alcohol to 2 units a day or less (a unit equals a small glass of wine, a measure of spirits or half a pint of beer)
For further information on early detection and prevention please call the National Cancer Helpline Freefone 1800 200 700