Should you be doing breast self exams?


The world of gynecology used to vigilantly suggest doing monthly self breast exams. I remember my old nurse practitioner gave me a waterproof calendar with a waterproof pen and I was instructed  to hook it onto my shower head so that every month, one week after my period, I would check off that I did a self breast exam. That calendar never made it to my shower. Like many women, I know the importance of a self breast exam, but I find it hard to incorporate it into a monthly routine.
The good news for us is that it is no longer recommended to do a monthly self breast exam. The new school of thought encompasses many more aspects of breast cancer screening and is now termed self-breast awareness.  
For this blog post I will break down all the parts of self breast awareness and how to follow the new recommendations for self screening.   
Be aware of what increases or decreases your risk for breast cancer.
  1. Consuming more than 1 alcoholic drink per day. Alcohol increases your baseline risk for getting breast cancer. Consider cutting back on the cocktails and you will be doing yourself a favor!
  2. Inactive lifestyle.  Not moving your body increases your risk for breast cancer. Make 30+minutes of exercise per day your goal. Walking counts!
  3. Smoking. There is a direct link between tobacco use and many diseases, including breast cancer. The good news is that smoking is a modifiable risk factor, which means that you can reduce this increased risk by quitting now.
  4. Family History. Breast self awareness also includes knowing what your family history of breast and ovarian cancer is. Remember, family medical history can change every year. Let your healthcare provider know if any direct family members develop breast or ovarian cancer, or if any family members have a known genetic mutation which increases risk for cancer.  10-20% of breast and ovarian cancers are due to inherited genetic mutations. Other times, there is a strong family history, but no known genetic mutations.
  5. Age. Age is important when it comes to breast cancer risk. Most women develop breast cancer in their 50s and 60s, but breast cancer in women with a genetic predisposition often develops much earlier, starting in their 30s and 40s.
  6. Early onset of menstruation. Starting your period under the age of 12 is linked to an increase risk for breast cancer because it raises total lifetime exposure to estrogen.


Be aware of what decreases your risk for breast cancer.

  1. Pregnancy. Pregnancy stabilizes the breast tissue, lowering total lifetime exposure to estrogen, and therefore reduces the risk of cancer.
  2. Breastfeeding. Breastfeeding lowers total lifetime exposure to estrogen, thus reducing risk for breast cancer.
  3. Healthy BMI. Extra fatty tissue produces extra estrogen, which in turn increases risk for breast cancer.  Aim for a BMI between 18.5-25.


Be aware of what your breast look like and feel like.

How-the-Breast-Cancer-detected-by-self-exam_Final.jpg
Although it’s no longer recommended to do monthly self breast exams, breast self awareness does embrace knowing what is your normal, so that you are able to identify changes. Here at Mystick Women’s Health we tell our patients to check their breasts 4X a year. “When you notice the seasons change, check your breast!” Feel for any tissue that is not freely movable or “stuck”. It is normal to feel lumps in the breast tissue, however cancerous lumps tend to be more firm and solid.
The clinical breast exam is an important part of your annual GYN visit. Your provider will check your breast and can also teach you how to do it at home. So, we hope to see you at your annual visit where we can go over your personal breast cancer risk, and how to do self exams at home!
As always, please feel free to leave any questions or comments below.
Yours,
Serena Fasano, WHNP, MPH, CLC


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