You can never be too young to learn about the signs, symptoms, and risks of breast cancer. In addition, every person has different risk factors that may need to be considered; there is no one-size-fits-all approach to breast health.
Here are some steps you can take to manage your breast health. You can start as early as your teens or twenties, whether you’re seeing a gynecologist for routine care or have symptoms such as a new lump or nipple discharge. There are three main steps to staying on top of your breast health:
Know your risk
• Talk to family to learn about family health and medical history.
• Talk to your doctor about your risks for breast cancer.
Know your breasts
• Know the “normal” look and feel of your breasts.
• Use a mirror to see all areas of the breasts.
• Discuss changes with your physician.
Get screened
• Make a plan with your doctor to determine at what age and how frequently you will need routine mammogram screenings and clinical examinations.
• Take into account your family and personal risk factors.
• Discuss what factors might change that plan in the future, such as new cancer diagnosis in the family or breast changes.
About risk and screening procedures
Typically, annual screening mammography starts at age 40 for patients with average risk. Imaging may start earlier for patients deemed high risk.
Know what’s normal for your breasts
While regular self-examinations in the shower are not encouraged like they were in the past, knowing your “normal” look and feel of your breasts is still important. Be sure to look in the mirror so you can see all areas of the breasts.
See your healthcare provider if you notice any of these breast changes:
- Lump, hard knot, or thickening in the breast or underarm area
- Swelling, warmth, redness or darkening of the skin of the breast
- Change in the size or shape of the breast
- Dimpling or puckering of the skin
- Itchy, scaly, sore, or rash on the nipple
- Pulling in of your nipple or other parts of the breast
- New nipple discharge, especially if bloody
- New pain in one spot that does not go away
Know risk factors for breast cancer
- Increasing age
- Family history of breast, ovarian, and other types of cancer
- Personal history of breast, ovarian, and other types of cancer
- Dense breast tissue on mammography
- Having a breast cancer genetic mutation
- Prior breast biopsy with finding of:
- Atypical ductal hyperplasia
- Atypical lobular hyperplasia
- Radial scar/complex sclerosing lesion
- Focal epithelial hyperplasia
- Lobular carcinoma in situ
- Intraductal papilloma (certain cases)
- Early menarche (beginning of periods before age 12)
- Late menopause (after age 55)
- Never having a baby or late first pregnancy.
- Menopausal hormone therapy with combination estrogen and progestin. Estrogen only pills do not increase risk.
- Certain ethnicities may have increased risk
- Obesity
- Alcohol consumption
- Dense breasts on mammography
- History of lymphoma with radiation to the chest
Know about mammography guidelines
While age guidelines for mammography are important, they can change. Discuss your screening plans at each yearly exam with clinician.
Please note, these guidelines are for women at average risk for breast cancer. For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase risk of breast cancer (such as in a BRCA gene), and has not had chest radiation therapy before the age of 30.
Supplemental screening
If you have one of the above risk factors or your physician has determined that you are high risk, you may benefit from supplemental imaging such as breast MRI or ultrasound.
If you have dense breast tissue on your mammogram, you may benefit from supplemental screening with breast ultrasound.
Mammograms
Everyone should know what to expect when getting a mammogram for breast cancer screening – what the exam can and cannot do. Mammograms are low-dose X-rays of the breast. Regular mammograms can help detect breast cancer at an early stage when treatment is most likely to be successful. A mammogram can find breast changes of early cancers years before a lump is felt or other symptoms develop.
Mammograms are not perfect. They can miss some breast cancers. There’s also a small chance of being diagnosed with a cancer that never would have caused any significant problems had it not been found during screening. (This is called overdiagnosis.) It's important that women getting mammograms know what to expect and understand the benefits and limitations of screening.