In 2020, take charge of your breast health

At the start of every new year, many people are focused on leading healthier lives, and that should include breast health, which leads us to our first topic of 2020:  breast self-awareness, or what the Komen organization often refers to as “BSA.”

Breast self-awareness is a way to be proactive about breast health and includes four areas or steps.  The steps are:  knowing your risk, getting screened, knowing what is normal for you, and making healthy lifestyle choices.

The first step is to know your risk. There are many factors that can increase the risk of breast cancer. The two biggest risk factors for developing breast cancer are being a woman and getting older.  Other risk factors include age at first period, age at the onset of menopause, alcohol intake, bone density, height, inherited gene mutations, and ethnicity.  This may seem like a long list of factors that may cause breast cancer, but there’s an even longer list of things that have no relation to breast cancer or may even reduce the risk of breast cancer.  For example, breastfeeding, exercising, and eating fruits and vegetables can actually reduce your chances of developing breast cancer.  Genetics is a cause for about 10% of breast cancers, so have a conversation about your family’s health history, including both your mother and father’s side of the family, to understand that aspect of your breast cancer risk. Sometimes there are gaps in a family medical history and that is okay:  it’s better to have an incomplete picture than no picture at all. It is also important to have a discussion with your healthcare provider, especially if there is a lack of family history, about your own personal medical history to help determine any further risk factors.

The next step to breast self-awareness is getting screened. There are several different screening methods, and a discussion with your healthcare provider can help you to determine which screening test is right for you. For most women at average risk, a mammogram is the most widely used screening method. A mammogram is an x-ray of the breast that can detect tumors, even if they are very small. Generally, women at average risk start having mammograms around age 40, but you should talk to your doctor to determine the right screening schedule for you based on your personal risk and family history.  The exam will take two x-ray images of each breast and will last only a few minutes. When having a mammogram done, it’s important to be open with your technologist, alerting them of any changes or concerns you have of your breasts.  We know that mammograms are not perfect.  But right now, they’re the best tool we have to detect breast cancer when women get screened early and regularly.

A clinical breast exam or CBE is another screening method that is a physical exam done by a health care provider and usually done performed during a regular medical check-up. This exam consists of both visual and physical examinations and should be is normally done every 3 years starting at age 20 – again, talk to your doctor about your breast health screening schedule and every year starting at age 40. The exam will also include both personal and family health history. Both mammograms and clinical breast exams can complement each other and it is important to have a conversation with your doctor about which exam is right for you.

For women with above average risk of breast cancer, you may get screened at a younger age, or have different screening methods like ultrasound or MRI.

Knowing what is normal for you is the third step of breast self-awareness. Every woman is unique and each woman can have different signs of breast cancer. Visual changes are one of the first signs that your breast may need to be checked by your doctor. Knowing how your breasts normally look and feel can help you to notice when there are changes that need to be brought to attention. Any lump, hard knot or thickening inside the breast or underarm area are all examples of changes that need to be checked. Swelling, warmth, redness and darkening of the breast can be mistaken for an infection, but can actually be signs of a rare form of cancer that needs to be examined by a doctor. Other changes of the breast that need to be addressed include change in the shape and size of the breast, dimpling or puckering of the skin, itchy, scaly sore or rash on the nipple, pulling in of the nipple, nipple discharge that starts suddenly and new pain in one spot that does not go away. All of these changes to the breast can be warning signs and it is important to acknowledge them by seeking medical attention.

The last step in breast self-awareness is making healthy lifestyle choices. As discussed in previous videos, diet and exercise play a factor in breast health. Gaining weight as an adult can increase your risk of postmenopausal breast cancer, making it important to maintain a healthy weight. Also, incorporate exercise into your routine, because research shows that being physically active can help reduce your risk of breast cancer. Maintaining a healthy diet includes limiting alcohol intake, as risk for breast cancer increases with increased alcohol intake. It is also important to discuss with you doctor risks and benefits of taking menopausal hormones. Some hormones like estrogen plus progestin can increase your risk of developing and dying from breast cancer so it is important to discuss with your doctor what is right for you.

Breast self-awareness is an important topic when it comes to being proactive about your overall breast health. If you would like to learn more about the topic go to komen.org. There you can learn more about breast self-awareness and also find resources about breast health and breast cancer.