When I was a freshman in college, someone hung instructional breast exam posters in our communal bathroom during Breast Cancer Awareness month. The pink and white sign had cartoon drawings of women performing the five steps of a self-breast exam. The signage noted that the shower was a great place to perform a quick breast exam — I’m assuming that’s why the posters were up in our bathroom. Being the good oldest-child-rule-follower that I am, I completed a cursory self-exam in the shower several times that October. Each time, I concluded that I had breast cancer.
To clarify: I did not have breast cancer. I still do not have breast cancer. But what I do have are fibrocystic breasts. Basically, my breast tissue is lumpy or “ropey,” and there are notable nodules within the breast tissue, and I felt them when I performed my self-exams. However, because the prospect of contracting breast cancer during my freshman year of college was so completely terrifying to me, I did nothing. (Let’s be clear, this is not advised.) When my annual exam rolled around the following April, I made sure to bring my findings up to my doctor.
What I learned during that appointment was the beginning of what is now referred to as breast self-awareness, which, according to the Susan G. Komen foundation, is defined as “women’s awareness of the normal appearance and feel of their breasts.” At that time, self-breast exams were still recommended. Physicians suggested that women perform a monthly breast exam at the same time during the menstrual cycle, so you can see if any inconsistencies occur from one month to the next, and, of course, identify any lumps or growths early. However, after several definitive studies, doctors no longer recommend that routine monthly self-exam.
I spoke with Dr. Amanda Underwood, a gynecological resident at Indiana University School of Medicine, who noted that the USPSTF (United States Preventive Services Task Force, an organization that makes recommendations on screening guidelines) has also recently modified its recommendation on self-breast exams. The USPSTF actually recommends against teaching breast self-exams. Dr. Underwood said that this change in recommendation is “based on lack of evidence to show benefit from breast self-exam, as well as the potential harm associated with false-positive findings.” Apparently, I’m hardly the only woman to perform a self-exam and worry about their findings. It’s quite common for women to seek medical attention and subject themselves to additional invasive and stressful testing as a result of self-exam findings. Accordingly, doctors are moving away from the previously recommended routine in favor of breast self-awareness.
So what does breast self-awareness mean, exactly?
So what does breast self-awareness mean, exactly? To start, Dr. Underwood recommends that you familiarize yourself with your own anatomy. Know what your breasts and breast tissue looks and feels like at different times of the month. Are your breasts more lumpy during different points in your menstrual cycle? Are your nipples darker at some points than others? Some women experience swelling or soreness during the menstrual cycle, for example. These hormonal changes are important to note. After several months of random checks, you should be able to establish a baseline for normal within your body.
Dr. Underwood still suggests that you perform a complete self-breast exam prior to your annual exam. Your doctor will also perform a breast exam during your annual Well Woman visit. At this point, you can discuss with your doctor what you have found to be normal or consistent in your breast tissue. This open communication and education between doctor and patient is all part of breast self-awareness. Once you’ve established what is normal for you, then you’ll know what to expect and if you find something that is out of the ordinary.
While the actual look and feel of the breast are the primary elements in breast self-awareness, family history also plays an important role. If you have a history of breast cancer in your family, share that information with your doctor. Dr. Underwood added that “groups who are at higher risk of developing breast cancer, such as those who have a strong family history of breast cancer or a genetic proclivity to developing breast cancer are often encouraged to perform more routine self-exams.”
Additionally, knowing the signs and symptoms of breast cancer are another important element in taking charge of your own health. While it’s important to know what “normal” looks like on your body, it’s also really crucial to know what abnormal looks like. Knowing your body is key to caring for your body. Even though doctors are no longer recommending the routine monthly self-exam, and you might not see those pink breast exam instruction posters tacked up this October, you still need to show your boobs some love. If you find something concerning in any of your exams, please contact your doctor right away.