Should You Self-Examine Your Breasts?

As the new chief of breast surgery at LIJ Forest Hills, Susan Lee, MD, is charged with overseeing the breast health of her patients at the hospital and in her practice in Rego Park. She also treats patients at Peconic Bay Medical Center and at a practice in Riverhead on the east end of Long Island.

But what exactly does the term “breast health” mean?

Many people associate breast health with breast cancer, but there are other conditions besides cancer that can affect the breasts, like cysts, fibrocystic changes and fibroadenomas, which are benign (noncancerous).

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“Breast health includes both benign and cancerous conditions of the breast,” explained Dr. Lee. “It is any condition that is different from a person’s normal baseline breast condition.”

Part of knowing what normal is involves having good breast self-awareness — knowing how your breasts usually look and feel.

Ten years ago, that awareness would have also included a recommended monthly breast self-exam as part of formal screening for breast cancer. But times have changed.

“It used to be highly encouraged and advocated for everybody to do a breast self-exam,” says Dr. Lee. “Now, if somebody is comfortable doing it they should do it, but it’s not something that we’re saying ‘you must do this once a month.’”

That change was due to studies which did not show a clear benefit from breast self-exams; they did, however, lead to increased overall anxiety and more studies and biopsies for benign findings.

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Renewed emphasis on breast self-awareness

So now, with an emphasis on breast self-awareness, women are urged to familiarize themselves with what is normal for them throughout all stages of their lives. For example, the breasts of younger women can change during their menstrual cycle — they may be painful, lumpy or swollen before and softer afterward.

As women get older, breast self-awareness becomes even more important as the risk of breast cancer increases with age.

“Be aware of what is normal for you, and if there is anything that deviates from that norm, have it checked out,” said Dr. Lee. “Fortunately, most of the time it is nothing bad, but unfortunately there are occasions where it can be a sign of something more serious.” It is always better to err on the side of caution.

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Caution signs

Regardless of what age a woman is, these changes in her breast warrant a doctor’s attention:

• A lump or thickening in the breast or armpit.
• Changes in the skin, such as dimpling, puckering or redness.
• Changes in the nipple, such as inversion, discharge (especially watery, bloody, unilateral or spontaneous) or scaly skin.
• New, persistent pain. This is rarely associated with breast cancer if it is the sole symptom. If it is on the left side, cardiac causes may need to be ruled out.

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