Awareness about ones breast is very important in detecting breast disease. The breast constantly changes owing to changes in hormone levels. Regular self-examination would help alert the patient of any changes, and will also familiarise the patient with her own anatomy. Most changes noted are harmless, but any concerns should be discussed with your GP.

Normal Changes

  • Menstrual cycle: The breasts tend to be bigger and lumpier before the period, only to return to normal once the period is over.
  • Pregnancy and Lactation: Breasts may get very enlarged during pregnancy.
  • Menopause: The breast become softer and smaller after menopause. Any unilateral change in size should be brought to the attention of your GP.

Breast lumps

Breast lumps may occur in any stage of life and should be checked by your doctor.

  • 'Lumpiness': Generalised lumpiness may be associated with tenderness or swelling, and tends to occur towards middle age.
  • Fibroadenoma: These are the most common breast lump. They are hard, mobile mass. They are benign, and don't warrant removal unless they cause discomfort or are very large. Removal is usually done as a day case.
  • Cysts: These are fluid filled cavities, especially prominent before menstruation. They may disappear spontaneously, but have to be brought to the attention of your doctor.
  • Fat necrosis: A firm lump may form especially after injury to the breast.
  • Any lump in the armpit or above the collar bone should be brought to the attention of your doctor.
  • Breast lump – link to Your visit/breast clinic section.

Breast pain and how to deal with it

Breast pain is a common symptom in both pre and post menopausal women. Pain in isolation (without a breast lump) is not a significant cause for concern. For indepth information regarding this symptom and advice on various measures that can help, please click on the following link - Breast Pain/Mastalgia.
See also Your Visit

Nipple changes

Nipples may be inverted at birth, which is not a sinister finding. However, new nipple inversions should be investigated.

Nipple discharges could be milky, yellow/green, or bloody. Yellow/green discharge are usually due to ductal infections, and may respond to antibiotics.

Bloody discharges may be caused by a benign papilloma. However, it may also point to a more serious pathology.

Skin changes

Any new moles or sore should be watched. Any tethering or in-drawing of the skin should be investigated.

In summary

The patient should be aware of any of the following:

  • Changes in size or shape.
  • Changes in the nipple
  • Changes in the skin
  • Lumps or swellings in the breast, armpit or above the collar bone.
  • Nipple discharges
  • Constant breast pain.

Such changes should be looked for regularly, once a month. The patient should examine herself in several angles, and should feel for changes whilst in the shower with a soapy hand.

The patient should:

  1. know what is normal for herself
  2. know what to look for
  3. Look and feel
  4. Contact her doctor without delay when needed,
  5. Attend routine screening programs at age fifty.

By adhering to the above, the patient should be 'breast aware', and should be better placed to spot problems with her breast in a timely fashion.