How often should women check for signs of breast cancer? What is the correct technique? These are the common questions asked of doctors, says breast surgeon Associate Professor Sanjay Warrier.
Research and statistics clearly show that the health outcomes of women diagnosed with breast cancer are better if the disease is detected earlier before symptoms even appear.
This is a key factor to encourage women to undertake regular scans and self-examinations at home.
For women who are menstruating, I suggest undertaking an exam about a week to 10 days after each menstrual cycle starts, as this is when the breasts are least tender and lumpy.
For women no longer menstruating, the key is routine. Pick a day such as the first day of each month and remind yourself to do it.
Regardless of life stage, it is important for women to know their breasts. Check in the mirror to note their shape and colour and undertake a self-examination in the same way each month to become familiar with them and be better placed to detect any changes in the breast or on the skin and nipples.
Common reasons for colour change include general ageing and/or pregnancy. However, one of the more overlooked reasons for changes in nipple colour is associated with the presence of breast cancer. It’s especially abnormal if it’s occurring in only one nipple and not evenly on both breasts.
Any changes should be checked by a health professional as soon as possible.
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A woman’s risk of developing breast cancer increases with age. Over 75% of breast cancers fall into the 50 to 74 years age group. Regular breast screens are the best way to find cancer early.
Women aged 40 and over and who do not have any breast symptoms are entitled to a free mammogram every two years through BreastScreen.
BreastScreen Australia is the national breast screening program and actively invites women aged 50-74 to have a free two-yearly mammogram. Women aged 40-49 and those aged over 74 are also eligible to receive a free mammogram but do not receive an invitation.
Risk factors
Some risk factors may increase the need for annual screening and additional forms of screening. Some risk factors can’t be changed, and these include:
- a family history of breast or ovarian cancer
- inherited genetic factors
- medical history, such as previous radiation therapy for another type of cancer
- reproductive history, such as starting menstruation very young, reaching menopause late, or not having a baby
- getting older; and
- having dense breasts.
Other considerations
Hormonal changes during menopause can affect breast tissue, so it is important that women continue regular checks and discuss any changes with health professionals.
Regardless of age, if they notice any unusual changes during their self-exam, such as lumps, thickening, discharge or changes in skin texture, they need to contact their healthcare provider promptly.
A healthy diet undoubtedly improves wellbeing and combined with regular exercise, women will not only feel better but lower their risk of breast cancer as an increase in body fat can also mean that their body is storing extra oestrogen, which can stimulate tumour growth.
If breast cancer runs in the family, the risk of developing breast cancer may be higher. However, this research is dependent on so-called ‘breast cancer genes’ (BRCA1 or BRCA2).
Most breast cancer diagnoses have no known family history of the disease. Even if their family does not have a history of breast cancer, it is important they flag with their GP any other cancers that have affected the family, including prostate cancer, pancreatic cancer, colon cancer, ovarian cancer or melanoma. This counts for both sides of their family.
REALTED: Family history of breast cancer
It is globally accepted that smoking causes lung cancer, but it also increases the risk of developing other cancers as well. Studies have shown that people who have smoked for 10 years or more were at least 16% more likely to develop breast cancer than non-smokers.
Women should also be encouraged to exercise regularly. Just 30 minutes of exercise five days a week can dramatically cut their breast cancer risk. Regular exercise not only helps to keep weight in check but can also lower oestrogen levels and boost the immune system, which helps to prevent abnormal cells from growing and spreading in the body.
ED: Associate Professor Warrier is a Sydney breast health and breast cancer surgeon. He is a past president and current committee member of Breast Surgeons of Australia and New Zealand. His views are his own, not BreastSurgANZ.
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