Breast Health. Breast Health. A Guide to Self-Care. Early Detection. Living a Healthier Lifestyle PROTECTING YOUR HEALTH

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1 Breast Health Breast Health A Guide to Self-Care Early Detection Living a Healthier Lifestyle PROTECTING YOUR HEALTH

2 Lifelong Breast Health Most breast conditions are not life threatening. But with any breast condition, early detection aids in treatment. It can also improve the chance of survival if cancer is found. Monitoring your breasts can help you find problems early. And leading a healthier lifestyle can help keep your entire body in good health. Keys to Good Breast Health Some breast conditions cause discomfort. Others, such as infection and abnormal tissue changes, can threaten your health. You can t always control your risk of breast problems. They may be inherited or related to aging. But with proper monitoring, problems can be caught and treated early. Still, some breast conditions are related to how you live your life, such as what you eat and drink. So, caring for yourself with a healthy lifestyle helps prevent certain problems and protects your health. This booklet will teach you about common breast problems and what you can do. Monitor Your Breast Health Breast screening exams help you find possible problems early: A clinical breast exam is done by your healthcare provider. He or she feels the breast tissue for changes. During the visit, you can also ask questions about your breast health. From age 20 to 39, have a clinical breast exam every 1 to 3 years. From age 40 on, have one every year. Mammography uses x-rays to create a picture of the breast. It may help find problems in the breast that are too small to feel. It can also be used to check a lump or other breast change found by you or your healthcare provider. Starting at age 40, have a mammogram every year or as advised by your provider. Recommendations in this booklet for monitoring breast health are based on guidelines from the American Congress of Obstetricians and Gynecologists. Note that other organizations have guidelines for monitoring breast health that may differ from what is described here. Be sure to talk with your healthcare provider if you have questions. 2 This booklet is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem. 2011, 2013, 2014, 2017 The StayWell Company, LLC All rights reserved. Made in the USA.

3 Take Care of Yourself Your breast health is part of your overall health. So the things you do to take care of your body each day also help keep your breasts healthy. Eating well, staying active, and maintaining a normal weight all help to improve breast health. Healthier living is a matter of making small changes that you can follow throughout your life. You can also stay on top of your breast health by watching and feeling your breasts for changes. 3

4 Learning About Your Breasts Each woman s breasts are different. But the basic features are the same for all women. Getting to know your breasts helps you learn what s normal for you. This makes it more likely you ll notice changes that need to be evaluated by your healthcare provider. Breast Anatomy Learn about breast anatomy and nearby structures. The nipple and areola are parts of the breast you can see. The parts you can t see include lobules (mammary glands), ducts, and fatty tissue. Together, these form a normal breast. Axillary lymph nodes filter lymph fluid from the breast. Rib Fatty tissue fills the spaces around the ducts and lobules. Clavicle (collarbone) Chest muscle Sternum (breastbone) Lobules (mammary glands) produce milk during pregnancy and breastfeeding. Ducts carry milk from the lobules to the nipple during breastfeeding. The nipple is where milk is released during breastfeeding. The areola is a dark circle of skin that surrounds the nipple. 4

5 Normal Breast Changes Breasts change over time. Their size and texture may vary with shifts in your body weight. Breasts also change as you go through different stages of your life. Puberty Breasts start growing before a girl begins to menstruate. This happens in response to hormonal changes. Each girl s breasts mature at their own pace. Menstrual Cycle Most women s breasts change during the menstrual cycle. Be fore each period, mammary glands may swell and become tender or lumpy. After the period ends, swelling, tender ness, and lumpiness are likely to lessen. Women who take birth control pills may find that their breasts become firmer and larger. Pregnancy and Breastfeeding During pregnancy, mammary glands en large to produce milk. This makes breasts larger and firmer. When breastfeed ing ends, breasts may become smaller than their original size and feel less firm. Menopause During and after menopause, ducts and mammary glands shrink. They re replaced by fatty tissue, making breasts feel less lumpy. Women who take hormone therapy (HT) may have fewer breast changes related to menopause. 5

6 Breast Conditions Most breast conditions are benign (noncancerous), causing no serious harm to you. But all women are at some risk for breast cancer. This risk increases as women get older. So if you notice any breast changes that aren t normal for you, see your healthcare provider. This helps to ensure prompt treatment if there is a problem. Inflammation Papilloma Cysts Breast Infection Infections of the breast tissue can cause skin redness, warmth, and pain or tenderness. The most common infection is mastitis. It occurs when the mammary glands are inflamed. This can occur during breastfeeding. Mastitis and other breast infections are often treated with antibiotics. Nipple Discharge Many women can squeeze a small amount of a clear or milky discharge from one or both nipples. This discharge may be normal. But others may be symptoms of a breast condition. For instance, dark dis charge can be caused by an intraductal papilloma. This is a be nign growth in a duct near the nipple. Nipple discharge that is dark or bloody, or that happens without squeezing your nipple, should be checked by a healthcare provider. Fibrocystic Changes These benign changes may cause a thickening in the breasts. Breasts may be tender or painful. They may feel more dense in some areas than in others. Sometimes solid or fluid-filled lumps (cysts) may also form. Cysts may be smooth, soft or firm, and tender. They may become larger and more tender right before your period. 6

7 Fibroadenoma Cancer Early Detection Is Key Benign Breast Lumps Benign breast lumps come in all shapes, sizes, and textures. A fibroadenoma may be smooth, firm, and rubbery. It is a lump of fibrous tissue and mammary gland tissue. This type of lump is usually painless and movable. Have any lump checked by your healthcare provider. Breast Cancer Finding breast cancer early is one of the best reasons for monitoring your breast health. The following may be warning signs of cancer but they do not always mean that cancer is present. If you notice any of the following, call your healthcare provider right away: A firm lump or thickening of breast tissue A change in skin texture or color of the breast A dimple (skin depression) on the breast A nipple that becomes pulled in (retracted) Dark or bloody discharge from a nipple A change in the size or shape of the breast! With breast conditions, early detection increases the chance that treatment will help. That s why keeping up with clinical exams and mammograms is so important. If you have symptoms of a breast condition, contact your healthcare provider right away. 7

8 Clinical Breast Exam Your yearly checkup may include a clinical breast exam. A specially trained healthcare provider performs the exam. Breast exams help to ensure that breast conditions are found early. Your Provider s Role A healthcare provider knows the tests and follow-up care needed if a problem is found. Your clinical exam is also a great time to ask questions about breast self-awareness and breast self-exams (see page 11). If you do self-exams, you can find out if you re doing them in the most effective way. Or you may want to ask how pregnancy, breast implants, or breast reduction surgery affects the way you should examine your breasts. Diagnostic Tests If a clinical exam reveals a breast change, you may have other tests to find out more. These tests may include: Mammography: uses low-dose x-rays to create pictures of the breast (see page 9). Ultrasound: uses sound waves to create pictures of the breast. MRI: uses a strong magnet, radio waves, and computers to create detailed pictures of the breast. Biopsy: the removal of a small amount of breast tissue by needle, probe, or a skin incision. The tissue is then sent to a lab and studied under a microscope. Guidelines for Having Clinical Breast Exams Starting at age 20, have a clinical breast exam every 1 to 3 years. From age 40 on, have the exam every year. If you re at high risk for breast cancer, you may need more frequent exams. Some risk factors for breast cancer include: Being over age 50 or postmenopausal Having a personal or family history of breast cancer Having inherited certain genes, such as BRCA1 and BRCA2 Having had no pregnancies or a first pregnancy after age 30 Obesity Heavy alcohol use 8

9 Mammography Mammography is used to screen for problems in women with no symptoms. A mammogram can show changes in the breast that are too small to feel. It can also help to diagnose a lump or other change found during a breast exam. Mammograms may be done at a clinic, hospital, or surgical center. They may also be done at a screening center. Before Your Test If you have had breast surgery, tell the doctor or technologist ahead of time. Also mention if you have breast implants or large moles. Any of these may affect test results. Try to schedule your mammogram for the week after your period, when your breasts are less tender. On the day of your test: Wear a two-piece outfit, since you ll be undressing from the waist up. Don t use deodorant, talcum powder, or cream on your breasts or underarms. These can interfere with your test results. Guidelines for Having Mammograms Starting at age 40, have mammograms every year or as advised by your healthcare provider. If you re at high risk for breast cancer (see page 8), you may need to start mammograms and other screening exams sooner. What to Expect During the test, your breast is gently flattened between two plastic plates. This ensures that all breast tissue can be seen. You may feel some discomfort, but it lasts just a few moments. An x-ray ma chine sends a small amount of radiation through your breast to create an image. Two or more views may be taken of each breast to provide a complete picture. Your healthcare provider will discuss the test results with you. Be sure to ask any questions you may have. 9

10 Living a Healthier Lifestyle Commit today to healthier living. It can help you stay strong and active now and as you get older. Good lifestyle habits may help prevent or control the symptoms of common breast conditions. The tips on these pages may even help reduce your risk of developing breast cancer. Tips for Healthy Eating Maintain a Healthy Weight A balanced diet includes foods from all the food groups: dairy, grains, fruits and vegetables, and protein. Maintaining a balanced diet is the best plan for overall health. Here are some things you should know about diet and breast health: Caffeine may cause breast tenderness and discomfort. If you have these symptoms, limit your intake of caffeine. Alcohol can cause breast symptoms and may increase breast cancer risk. You may want to avoid or limit alcohol. Salt makes your body store extra water and may cause breast swelling. Eating low-fat foods may decrease breast cancer risk. Women who are obese are more likely to develop breast cancer, especially after menopause. So it s important to maintain a healthy weight. When your weight is in a healthy range, your overall health improves. If you need to lose weight, talk to your healthcare provider or a dietitian to set safe goals. 10

11 Know Your Body Be Active You know your body best. If you ever notice a problem with your breasts, tell your healthcare provider right away. To make finding a problem easier, get to know how your breasts look and feel. This is called breast self-awareness. Pay attention to how your breasts change at certain times of the month. Knowing what s normal for you helps you recognize a potential problem. Choosing to do breast selfexams (BSEs) may help you detect changes or lumps early. Ask your healthcare provider about BSEs. Exercise is good for your body and mind. It increases the amount of oxygen in your body, which makes you feel better and gives you energy. Exercise helps regulate hormones, which can relieve breast symptoms. Exercise has also been shown to reduce breast cancer risk. And when you re active, it s easier to maintain a healthy weight. You don t need to join a gym or use fancy exercise equipment. In fact, walking is one of the best forms of exercise. Try to be active for at least 30 minutes a day, most days of the week. Wear a supportive sports bra to protect your breasts during activity. Don t Smoke Smoking weakens your immune system (your body s defense against disease). This means smokers are more likely to develop health problems. And studies show that smoking may raise the risk of breast cancer in some women. So if you smoke, quit. It s one of the best things you can do for your health. Prescription or over-the-counter medication can make quitting easier. Joining a support group or a class to stop smoking can give you the help and skills you need to quit for good. Talk to your healthcare provider for more information. BSE is an easy way to learn what s normal in your breasts. 11

12 Protecting Your Health Monitoring your breast health and taking care of your body helps ensure a healthy future. It can help you feel strong and secure about your health. To learn more about breast health and other women s health concerns, contact the organizations listed below. Resources Office on Women s Health American Cancer Society With contributions by: Andrea Diedrich, RNC, MS Mary S. Dolan, MD, MPH, Obstetrics and Gynecology Thomas J. Gibson, MD, FACS, General Surgery Ruth E. Hoddinott, MD, Family Practice Kimberley Mulvihill, MD, Obstetrics and Gynecology Diane Pratt, RN, BSN, MA, Breast Health Jennie McLaughlin Tarica, RN, MSN, Breast Health Take our Patient Survey. Help us help other patients. Please visit to provide your feedback on this booklet