Breast self-examination and body awareness are important to your health and wellness. But if you notice a lump or change in your breasts, don’t panic. Most turn out to be benign (noncancerous) issues.
Amy Comander, MD, an oncologist, encourages people to check their breasts regularly and understand what to look for in their own unique bodies. Dr. Comander is medical director of the Mass General Cancer Center at Mass General Waltham and director of the Breast Oncology Program at Newton-Wellesley Hospital.
“Every person’s breast tissue will feel different. Many people do have lumps in their breasts, and that can sometimes change with their menstrual cycle. The majority of breast lumps are actually benign,” she says. “But it’s important that we are aware of our own bodies, so if we notice a change, we know what to do about it. The breast self-exam is another tool we can use to take charge of our own health.”
If you notice a lump, Dr. Comander suggests you consider several specific factors, such as shape, size, whether there is skin involvement, and whether the lump causes pain. But if you have any doubt or questions, make an appointment for a physical exam and mammogram.
“There’s a lot of misunderstanding and anxiety about performing a breast self-exam. People don't really know what they’re looking for, and they’re afraid they’ll find something that will make them panic,” Dr. Comander says. She describes several important characteristics to consider about your breast tissue.
Look for any skin changes on or around the breasts, such as:
Many things can cause skin changes, including infections, eczema, and allergies. So these symptoms are not necessarily signs of breast cancer. But it’s important to seek medical attention if you notice them, Dr. Comander says.
Most breast tumors do not hurt, although some might. Pain in the breasts may indicate an ingrown hair, clogged milk duct, cyst, swollen gland, or other issue.
If you detect a lump in your breast, Dr. Comander suggests trying to move it around. “If something is more fixed in place, that would be more of a concern, as opposed to a lumpy area that is more mobile,” she explains. For example, a lump that changes location or feels different when you push it around, raise your arm, or lie down is less likely to be a tumor.
Medical experts often debate the value of breast self-exam in detecting breast cancer early. But Dr. Comander has seen its usefulness in her own patients.
“Many of my patients did identify a lump in their breast which led to their diagnosis. So I do think breast self-exam is important,” she says. “We should be aware of our own bodies and what our breast tissue feels like. That way, if at some point you identify a lump or bump in your breast, you’ll know if it’s new, then you can report it to a health care provider.”
However, she says nothing replaces a mammogram. Regular mammography is the most effective tool to detect breast cancer.
Dr. Comander offers these step-by-step instructions for breast self-examination:
Dr. Comander recommends monthly self-exam for:
Guidelines are also emerging for transgender individuals, who may have increased risk due to hormone therapy. Transgender women should perform self-exams and be screened if they received estrogen/progestin therapy for more than five years, have a family history, or have a body mass index higher than 35. Transgender men who have undergone a bilateral mastectomy have a small but not zero risk of breast cancer, so clinical exams should include a chest wall exam.
If you notice any lumps or changes, remember that there are many possible causes. It’s important not to panic and to simply schedule an appointment with your primary care provider (PCP) or gynecologist.
“At Mass General Cancer Center, we have breast centers in many of our locations with surgeons and nurse practitioners who can evaluate any changes,” Dr. Comander says. “It is important that people feel empowered that if they feel something of concern, they should make an appointment for further evaluation.