The importance of self-exams

The American Cancer Society’s (ACS) most recent guidelines reflect that self-exams haven’t shown a clear benefit, especially for women who also get screening mammograms, even when doctors conduct those exams. Still, some men and women will find breast cancer and be diagnosed with it as a result of a lump detected during a self-exam.

If you’re a woman, it’s important for you to be familiar with how your breasts look and check them regularly. This will help you become aware of any changes or abnormalities as they occur.

All breast lumps deserve medical attention. Unusual lumps or bumps in breast tissue are something that should be examined by a doctor. The vast majority of lumps aren’t cancerous.

Breast cancer lumps don’t all feel the same. Your doctor should examine any lump, whether or not it meets the most common symptoms listed below.

Most commonly, a cancerous lump in the breast:

  • is a hard mass
  • is painless
  • has irregular edges
  • is immobile (doesn’t move when pushed)
  • appears in the upper outer portion of your breast
  • grows over time

Not all cancerous lumps will meet these criteria, and a cancerous lump that has all of these traits isn’t typical. A cancerous lump may feel rounded, soft, and tender and can occur anywhere in the breast. In some cases, the lump can even be painful.

Some women also have dense, fibrous breast tissue. Feeling lumps or changes in your breasts may be more difficult if this is the case.

Having dense breasts also makes it more difficult to detect breast cancer on mammograms. Despite the tougher tissue, you might still be able to identify when a change begins in your breast.

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In addition to a lump, you may experience one or more of the following most common breast cancer symptoms:

  • swelling on part or all of your breast
  • nipple discharge (other than breast milk, if breastfeeding)
  • skin irritation or scaling
  • redness of the skin on the breast and nipples
  • a thickening of the skin on the breast and nipples
  • a nipple turning inward
  • swelling in the arm
  • swelling under the armpit
  • swelling around the collar bone

You should see your doctor if you experience any of these symptoms, with or without the presence of a lump. In many cases, these symptoms aren’t caused by cancer. Still, you and your doctor will want to do some tests to find out why it’s happening.

Breast cancer is the most common cancer diagnosed in women in the United States. Most breast lumps aren’t cancerous, however. You should visit your doctor if you see or feel anything new or unusual in your breast during a self-exam.

Despite the statistics and ACS guidelines, many women still choose to continue performing self-exams. Whether or not you choose to do self-exams, you should talk to your doctor about the appropriate age to begin screening mammograms.

Following recommended breast cancer screening guidelines is the most important thing you can do to ensure early detection of breast cancer. The sooner breast cancer is detected, the sooner treatment can begin, and the better your outlook will be.

Make an appointment with your primary care doctor or gynecologist. Tell your doctor about the new spot you’ve identified and the symptoms you feel. Your doctor will likely conduct a full breast exam and may also check nearby spots, including your collarbone, neck, and armpit areas.

Based on what they feel, your doctor may order additional testing, such as a mammogram, ultrasound, or biopsy.

Your doctor may also suggest a period of watchful waiting. During this time, you and your doctor will continue to monitor the lump for any changes or growth. If there’s any growth, your doctor should begin testing to rule out cancer.

Be honest with your doctor about your concerns. If your personal or family history puts you at a higher risk of having breast cancer, you may want to move forward with the appropriate diagnostic testing so you can know for sure if your breast lump is cancer or something else.

Certain risk factors can increase your chances of developing breast cancer. Some risk factors can’t be changed; others may be reduced or even eliminated based on your lifestyle choices.

The most significant breast cancer risk factors include:

  • Gender. Women are more likely to develop breast cancer than men.
  • Age. Invasive breast cancer is more common in women over age 55.
  • Family history. If a first-degree relative, such as a mother, sister, or daughter, has had breast cancer, your risk is doubled.
  • Genetics. A small percentage of breast cancers may be caused by genes that are passed generation to generation.
  • Race. According to the National Cancer Institute, Hispanic/Latina and Asian women are slightly less likely to develop breast cancer than White and African-American women. African-American women are more likely to be diagnosed with triple-negative breast cancer, which is highly aggressive and more likely to develop at a younger age. African-American women are also more likely to die from breast cancer as compared to White women.
  • Weight. Being overweight or obese increases your risk for breast cancer.
  • Benign breast conditions. Certain benign (noncancerous) breast conditions may impact your risk for later developing breast cancer.
  • Hormone use. If you used or are currently using hormone replacement therapy (HRT), your risk for breast cancer is likely higher.
  • Menstrual history. An early menstrual period (before age 12) may raise your risk for breast cancer.
  • Late menopause age. Delayed menopause (after age 55) may expose you to more hormones, which could increase your risks.
  • Dense breast tissue. Studies suggest women with dense breast tissue are more likely to develop cancer. The tissue may also make detecting the cancer more difficult.
  • Sedentary lifestyle. Women who do not exercise regularly are more likely to develop breast cancer than women who exercise often.
  • Tobacco use. Smoking increases the risk for breast cancer, especially in younger women who have not gone through menopause yet.
  • Alcohol consumption. For every drink you have, your risk for breast cancer might climb. Research suggests drinking some alcohol might be OK, but heavy alcohol use is associated with a higher risk of breast cancer.

Most breast cancers are diagnosed in women. However, men do have breast tissue and can develop breast cancer. Still, less than one percent of all breast cancers occur in men.

Symptoms of breast cancer in men are the same as the symptoms of breast cancer in women. These symptoms include:

  • a lump in one breast
  • a nipple that turns inward (inverts)
  • nipple pain
  • discharge from the nipple
  • redness, dimpling, or scaling on the breast’s skin
  • redness or sores on the nipple or ring around the nipple
  • swollen lymph nodes in armpits

As with women, breast cancer in men can spread or metastasize to other parts of the body. Diagnosing the cancer in early stages important. This way, you and your doctor can quickly begin treating the cancer.

While breast cancer is rare in men, some common risk factors are known.

Screening techniques help you and your doctor identify suspicious spots in your breast. A mammogram is a common screening option. A breast self-exam is another.

The self-exam was considered an important part of early breast cancer detection for many decades. Today, however, it may lead to too many unnecessary biopsies and surgical procedures.

Still, your doctor may recommend a self-exam to you. At the very least, the exam can help you familiarize yourself with your breasts’ appearance, shape, texture, and size. Knowing what your breasts should feel like could help you spot a potential problem more easily.

1) Pick a date. Hormones impact how your breasts feel, so it’s a good idea to wait a few days after your menstrual cycle ends. If you do not have a period, pick a date on the calendar you can easily remember, such as the first or fifteenth, and schedule your self-exam.

2) Take a look. Remove your top and bra. Stand in front of a mirror. Observe how your breasts look, inspecting them for changes in symmetry, shape, size, or color. Raise both arms, and repeat the visual inspection, noting the changes to your breasts’ shape and size when your arms are extended.

3) Inspect each breast. Once you’ve completed the visual exam, lie down on a bed or sofa. Use the soft pads of your fingers to feel for lumps, cysts, or other abnormalities. To keep the inspection uniform, start at your nipple and work your way out, to your breastbone and armpit, in a spiral pattern. Repeat on the other side.

4) Squeeze your nipple. Gently squeeze on each nipple to see if you have any discharge.

5) Repeat in the shower. Do one final inspection in the shower. Let warm water and soap make the manual examination easier by gliding your fingers over your breasts. Start at your nipple and work your way out in a spiral pattern. Repeat on the other breast.

6) Keep a journal. Subtle changes may be hard to detect, but a journal might help you see developments as they occur. Jot down any unusual spots and check them again in a few weeks. If you find any lumps, see your doctor.

Some health organizations no longer recommend women perform regular self-exams.

Breast cancer is not the only condition that can cause unusual lumps in your breasts. These other conditions might also be responsible:

  • swollen lymph nodes
  • cysts
  • bacterial of viral infection
  • a skin reaction to shaving or waxing
  • allergic reactions
  • a noncancerous tissue growth (fibroadenoma)
  • a fatty tissue growth (lipoma)
  • lymphoma
  • leukemia
  • lupus
  • swollen or clogged mammary glands

A lump in your armpit or breasts is unlikely to be breast cancer, but you should talk with your doctor about any unusual spots to find. Your doctor will likely perform a physical exam and rule out possible causes for unusual lumps.

Your body is your own, and it’s the only one you have. If you find a lump or you’re experiencing any unusual symptoms, you should seek out your doctor’s guidance.

Your doctor may be able to determine from a physical exam whether your lump is likely to be cancerous. If you’re at all concerned about the new signs and symptoms, you shouldn’t be afraid to request additional testing to diagnose your lump.

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