Written by Evelyn Wallace
Evelyn, a Registered General Nurse, is Operations Manager of AXA PPP healthcare’s Cancer Care team, where she is responsible for ensuring excellent customer service and continuing development of the team.
The lifetime risk of developing breast cancer for all women is 1 in 8, so you should be aware of any changes in your breasts and visit your doctor if something’s not right, even if you’ve had a mammogram. Cancer doesn’t always start with a lump – other subtle changes could be a warning sign. In most cases it will likely be nothing and there will be an explanation, but it’s better to be safe than sorry.
As part of your own breast awareness, you’ll know what is normal for you, but understanding more about your breasts may help alleviate any niggling worries you have. Our health at hand team hear from many women who are concerned about changes in their breasts and have suggested some useful advice to address some of the most common breast health worries.
1. “My nipples are different sizes”
It’s not uncommon to have different sized nipples and breasts (in men and women). Sometimes this can’t be attributed to any obvious reasons or health concern. Our body changes continuously because of age, hormones and other factors. You should look for any discharge from your nipples, any red area that does not heal easily, any change in the nipple position, such as your nipple being pulled in or pointing differently, or a rash around your nipple and visit your GP if you spot these signs.
2. “My breasts ache and are tender before my periods”
Fluctuating hormone levels normally account for most premenstrual breast swelling and tenderness. Your hormones rise and fall during a normal menstrual cycle. Oestrogen causes the breast glands to enlarge and progesterone causes the milk glands to swell – both these things may cause breast tenderness and swelling, typically between days 14 and 28 of your menstrual cycle. While most premenstrual breast pain and swelling is generally harmless, sudden or worrisome breast changes should be discussed with your GP as they could be signs of infection or other medical conditions.
3. “My breasts hurt all the time, even when my period isn’t due”
‘Non cyclical’ breast pain, the kind which doesn’t vary with your menstrual cycle, may come from the breast tissue itself, or you may be getting pain ‘referred’ from the muscles, bones or joints of the chest wall. Often the cause is not clear, but since there are several different treatments depending on what is found, we would recommend seeing your GP.
4. “Several family members have had breast cancer and I’m worried”
In the UK there are medical guidelines to help decide which patients are most at risk and who should be referred for extra testing and screening. If you are at all concerned, you should speak to your GP who will be able to discuss this with you in more detail. During your appointment, your GP will need details of your family members who have been affected including their age and gender so you should ensure that you take this information with you
5. “I have silicone implants and I worry that I wont be able to feel any lumps or that mammograms won’t see behind them”
Breast implants can make detection of breast cancer a bit harder, but they do not increase your risk of getting cancer. Detection difficulties depend on whether the implant has been put behind or in front of the chest wall muscle. The NHS breast cancer screening programme (which you should attend when offered) states that you should tell the technician doing the mammogram if you have implants, as a different technique needs to be used to see all of the breast tissue. If you are under the age of 40, an ultrasound scan is sometimes used instead of a mammogram to examine the breasts. Even if you have a mammogram, you should continue to be breast aware and examine your breasts regularly, reporting any changes or breast lumps to your GP immediately.
We’ve created a handy guide to help you familiarise yourself with breast cancer symptoms and how to check your breasts. If you are in any doubt, don’t ignore it or wait - visit your GP early.