Breast Self-Exam and Cancer Risks

How do I take care of my breasts?

Like so many topics in health care, there’s controversy on how helpful breast self-exams are in finding cancers. Regardless, it’s great to know how your breasts normally look and feel so you’ll be able to tell if something changes. Once you’re in your twenties, you may want to begin doing a self-breast exam every month at about the same time, 3-5 days after your menstrual period ends. This routine will help you get to know how your breasts feel normally. You will then be able to notice if there are any changes, including any new or different lumps. Remember, some lumps are normal, but if you’re worried at any time, talk to your health care provider.

Another great time to do an exam is the day you see your HCP for a check-up, and he or she has said that your breasts are healthy. Then you’ll know that what you feel on that day is normal and what you should expect to feel each time you do a self-exam. Here’s how to do a 3-part breast self-exam that takes only a few minutes.

Lying down:

• First, place a pillow under your right shoulder.
• Next, put your right hand under your head.
• Check your entire right breast area with the pads of the fingers of your left hand.
• Use small circles to feel all around your breast, and then feel up-and-down.
• You should feel the area from your collarbone down and in to your chest bone and around the side to underneath your armpit.
• Use light, medium, and firm pressure over each area of your breast.
• You should be able to feel deep down close to your ribs, and closer to the surface of your breast.
• Gently squeeze the nipple to check for any discharge.
• Switch arms and repeat these steps on your left breast.

In front of a mirror:

• Look in the mirror (without wearing your bra) then check for any changes in the shape or the appearance of your breasts.
• Note any skin or nipple changes such as dimpling, rashes, bruising, bumps, redness or nipple discharge.
• Look at your breasts in four steps: arms at sides, arms overhead, hands on hips pressing firmly to flex chest muscles, and bending forward.

In the shower:

• With soapy hands and fingers flat, raise your right arm.
• Check your right breast.
• Use the same small circles and up-and-down pattern described above in the “Lying Down” position.
• Switch arms and repeat on your left breast.

Your health care provider will likely do a breast exam once a year. While you may find this a little embarrassing, a breast exam is an important way for your HCP to learn what’s normal for your breasts and to look for anything that isn’t normal.

Is it normal to have lumpy breasts?

Normal breasts can be smooth or lumpy. Most lumps are due to normal changes in breast tissue that occur during development. Your breasts may also feel different or lumpy around the time of your period. If you do notice that a new lump appears in your breast and does not disappear after your period, you should make an appointment with your health care provider.

What if I notice a new lump or something different about my breasts?

Most lumps or changes in your breasts that occur when you are a teen or young woman are due to normal changes in the breast tissue. If you find a lump, it could be from hormonal changes, an injury, a breast cyst filled with fluid from a blocked mammary gland (milk-producing gland), an infection, or a benign (not cancerous) tumor called a fibroadenoma. If the lump is sore or the skin over it is red, you may have an infection and you should contact your health care provider. If your breast just feels lumpy, check it again after your next period, since your breasts may feel different or lumpy to the touch around or before the time of your period. If the lump doesn’t disappear after you finish your period, see your health care provider (HCP). Your HCP may order an ultrasound of your breast to figure out what kind of lump you have. If you have a fibroadenoma, your HCP will discuss whether it can be regularly examined and watched without any special treatment (most common), or if you need surgery to remove it.

What if I notice a hard lump and redness on my breast?

A hard lump in the breast with redness over it could mean you have an infection of the breast (cellulitis or a breast abscess), especially if you also have breast pain and a fever. Although a breast infection is usually a complication of breastfeeding, other things can cause breast infections, such as shaving, tweezing, or plucking hairs around the nipple area; sexual play that causes trauma; or getting a cut on the breast. Abscesses can also occur if a duct becomes blocked during breast development, or from bacteria getting into the nipple. It’s best to try to prevent a breast infection by avoiding things that could cause trauma or cuts to your breast(s). If you’re breastfeeding, keep your nipples clean and dry.

What if I have a lump on my breast(s) from a sports injury or fall?

Treat your breast injury as you would treat an injury on any other part of your body. If the lump is sore and black and blue, it’s probably from the injury. If you feel a lump but you don’t remember injuring yourself, or if the lump is still present after a week, see your health care provider. Don’t worry – there’s no link between breast injury and breast cancer.

Breast Cancer Risks

Who is at risk for breast cancer?

Anyone can get breast cancer, but some women with certain medical conditions, lifestyle habits, genes (information passed from one generation to the next), or traits (referred to as “risk factors”) are more likely than other women to get cancer. However, having risk factors does not mean you will definitely get breast cancer. Most women who develop breast cancer have no risk factors at all.

Overall, you are at a higher risk for developing breast cancer if you:

• Have close relatives (mother, sister, grandmother, or aunt) who have had breast cancer and/or ovarian cancer
• Have one of a few specific genetic mutations (altered genetic code) that are passed on from one generation to the next that increase your chances of getting breast cancer and ovarian cancer
• Have previously received radiation therapy to the chest/breast area in order to treat another cancer
• Drink alcohol excessively
• Are obese, which is primarily linked with menopausal status

How can I lower my risk for breast cancer?

You can lower your risk for breast cancer by keeping your lifestyle healthy. Don’t smoke, limit alcohol intake, exercise regularly, eat a healthy diet including lots of fruits and veggies, and have regular checkups with your health care provider.

Do I need to have a mammogram?

A mammogram is a special type of x-ray of the breasts, usually done to try to find early signs of breast cancer. Teens do not need to get mammograms. In fact, mammograms don’t work in teenagers and young adults because the breast tissue is too thick and too dense to get a clear picture. Most women start having mammograms when they are about 40. Some women younger than 40 years old may have a mammogram and/or MRI if they have a family history of breast cancer, if they have had radiation treatment for other cancers in the past, or if their health care provider recommends it for another reason. Talk to your HCP to decide if you need to start your screenings early. As a general rule of thumb, if a first-degree relative (your mom or your sister) has been diagnosed with breast cancer, you should begin to get breast cancer screening 10 years before the age at which they were first diagnosed. So if they were diagnosed with breast cancer at age 45, you would start your screenings at age 35. Otherwise, typical routine screenings begin at about 40.

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.