No two women are the same in their personalities, life experiences or breasts. There’s actually a wide range of ‘normal’ breasts of different sizes, shapes and density.
Here, we encourage you to know what’s normal for you and to conduct regular self-examinations of your breasts to pick up any changes in them. We’ll also explain breast density and its link to breast cancer risk.
First, though, let’s take a look at Breast Cancer Awareness Month.
October is Breast Cancer Awareness Month
Each October, we mark Breast Cancer Awareness Month (BCAM), which aims to highlight the impact of this disease on Australians and their families.
According to the National Breast Cancer Foundation:
- 20,000 Australians will be diagnosed with breast cancer in this year alone – that’s 57 a day
- Over 3,200 Australians will die from breast cancer this year.
The 5-year survival rate from breast cancer is now 92% and rising – that’s a big increase on the 76% who survived 5 years in 1994 but it still means 8% of breast cancer patients are not hitting that survival milestone.
More research is needed – and that takes money. We encourage you to donate to BCAM to enable vital research to take place so that we can eventually reach zero deaths from breast cancer.
What’s normal for your breasts?
Breasts come in all shapes and sizes. It’s quite normal to have:
- One breast that’s larger than the other
- Breasts that are different shapes to each other
- One or both nipples pulled in (inverted)
- Lumpy breasts.
The most important thing is to know what’s normal for you. What do your breasts usually look and feel like?
To answer that question, you need to be familiar with your breasts. Try to get used to looking at them and feeling them regularly. You might do that when you’re in the bath or the shower, when you’re getting dressed or as you get ready for bed.
When you’re familiar with your breasts, you’re more likely to spot changes that should be investigated.
How to check your breast health
When you check your breasts, remember to check every bit of them – then check your armpits and up to your collarbone.
What are you looking for? Anything that feels different than usual. Try to do this once a month.
Signs of breast cancer can include:
- a new lump in your breast or armpit
- thickening or swelling in a part of your breast
- irritation or dimpling of your breast skin
- redness or flaky skin in your nipple area or your breast
- pulling in of your nipple or pain in your nipple area
- nipple discharge other than breast milk
- any change in the size or the shape of your breast
- pain in any area of your breast.
If you do find a concerning change in your breast, then make an appointment to see your GP as soon as possible.
There may be nothing to worry about but it’s best to get it checked out. We like to diagnose and treat breast cancer as early as possible when there are more treatment options available to you.
What are the risk factors for breast cancer?
There are many different risk factors for breast cancer. They include:
- Being a woman – breast cancer can affect men but is far, far more common in women.
- Getting older – most breast cancers occur after menopause
- Having relatives with breast cancer – it’s important to remember, though, that most people who develop breast cancer do not have a strong family history of the condition
- Inherited a gene mutation – people with an abnormal BRCA1 or BRCA2 gene are more at risk
- Being overweight or obese – more fatty tissue after menopause means higher oestrogen levels, which may increase risk
- Drinking alcohol regularly – this may damage cell DNA and increase oestrogen levels
- Personal medical history –
- If you’ve had cancer in one breast, you’re at higher risk of developing the condition in the other breast.
- Several benign breast conditions can also increase your breast cancer risk
- Radiation treatment to the chest area for other cancers can increase breast cancer risk
- Getting your period before 12 or not starting menopause until after 55 can increase your risk
- Later motherhood – women who have their first baby before 30 are less likely to develop breast cancer than women who become mothers in their 30s or who never have kids
- Having dense breasts – if your mammogram shows that you have dense breasts (meaning there’s more glandular and fibrous tissue and less fatty tissue), you’re more at risk of breast cancer.
Equally, there are protective things you can do to reduce your risk of breast cancer. These include:
- Regular exercise
- Having children
- Breastfeeding – the longer the better as far as breast cancer risk goes.
A bit more on breast density and breast cancer risk
Breast density is often a confusing topic so it’s worth explaining a little more about it.
Breast density has nothing to do with the size or firmness of your breasts. It’s about their composition – and about how that tissue shows up on a mammogram.
Your breasts are made up of fatty tissue, glandular tissue (milk ducts and lobules) and connective tissue (which holds it all together). Dense breasts have less fatty tissue and more glandular and connective tissue. You can’t tell that by looking at them but we can tell on a mammogram.
On a mammogram:
- Fatty tissue looks dark
- Glandular and connective tissue looks white – and so do cancer cells, meaning they can be hidden by the healthy tissue.
If you have dense breasts, your cancer may not show up on a mammogram, meaning that it’s not picked up by regular screening. It may continue to grow until you start noticing symptoms and go to your doctor.
The good news is that breast density alone does not seem to make most women any more likely to develop breast cancer.
A 2015 study reported in Annals of Internal Medicine followed more than 365,000 women over 11 years to explore the association between breast density, the 5-year risk of breast cancer and the rate of interval cancers (detected within 12 months of a routine screening mammogram).
They found that, among women aged 40-74 with dense breasts, above half proved to be at low or average risk of developing breast cancer in the next 5 years. That’s quite reassuring.
About 25% of women did seem to be at higher risk of developing an interval breast cancer. These women had extremely dense breasts and other risk factors such as a family history of breast cancer.
The take-home messages on breast density are:
- Ask if your mammogram shows you have dense breasts
- If you do, ask your doctor if you should have additional or different screening tests such as an MRI where breast density doesn’t influence findings
- Remember that breast density is only one of the many factors that influence your risk of developing breast cancer.
How Gault Surgery can help
At Gault Surgery, we’ve helped many women through a diagnosis of breast cancer. We’re here for you if you need us. We work closely alongside you to allay your fears, answer your questions and recommend treatment options that are most likely to help you. We offer a high level of empathetic support and evidence-based care.
If you’d like to know more, please contact us.