How to check for breast cancer

Breast cancer is the most common cancer in women in the UK. Cancer Research UK recorded 55,176 new breast cancer cases between 2015 and 2017, and 11,547 deaths between 2016 and 2018, the vast majority in women, though around 1 in 100 cases occur in men.

The good news is that breast cancer is very treatable, especially when it is found early. Knowing how to check your own breasts, and what to look for, is one of the simplest things you can do for your health.

01What breast cancer is

Breast cancer typically forms in the lobules, the glands that produce milk, or in the ducts that carry milk to the nipple. It can also occur in the breast’s fatty tissue or its fibrous connective tissue.

Doctors describe most breast cancers as either invasive, meaning it has spread beyond the ducts or glands into surrounding breast tissue, or non-invasive, meaning it has not. Treatment depends on a number of factors, including the size and stage of the cancer and how far it has spread or is likely to spread, which is why, if you are diagnosed, you will usually be cared for by a specialist breast surgeon.

02Signs and symptoms to know

Many people associate breast cancer with a lump, and a lump is the most common first sign. But most breast lumps turn out to be benign, and a lump is not the only symptom worth knowing. See a doctor promptly if you notice any of the following:

• A lump or swelling under your arm
• Breast pain
• A sudden change in the shape or size of your breast
• Red, pitted or thickened skin over your breast
• A change in the appearance of the skin on your breast
• Nipple discharge, or a nipple that has turned inward
• Peeling, scaling or flaking skin on your breast or nipple

03Tests used to diagnose breast cancer

If a doctor identifies something that needs a closer look, one or more of the following tests may follow:

• Mammogram, an X-ray of the breast, usually used in women over 40, that helps your specialist see beneath the surface of the breast.
• Breast ultrasound, sound waves build a picture of the tissue deep in the breast, so your specialist can tell normal tissue apart from a solid lump or a cyst. It is often the first, or only, imaging test used in women under 40, or in those who are pregnant or breastfeeding; over 40, it is generally used alongside a mammogram, particularly to assess a specific symptom or in denser breast tissue.
• MRI and biopsy, used selectively, when ultrasound or mammography findings need further characterisation.

04How to check your breasts

Self-examination is the single most useful way to check your breasts. It helps you become familiar with how they normally look and feel, so you notice quickly if something changes. Aim to check once a month, at the same point in your cycle, breasts can look and feel different at different times of the month.

1. 1

   Look

   In the mirror, with your arms by your side, then again with your arms raised above your head. Has the shape changed? Does your nipple sit differently?

2. 2

   Feel

   Check each breast and armpit, sitting up and lying down. It is often easier in the bath or shower, when your skin is soapy.

3. 3

   Note anything new

   A new lump, a rash or skin change, or any pain or discomfort, worth mentioning even if you are not sure it means anything.

If you notice a lump or anything on this list that concerns you, see a doctor as soon as possible rather than waiting to see if it changes.

05When to see a specialist

If you identify a change, or you are simply in doubt, book to see a specialist breast surgeon, who will assess your risk factors and examine you. If an abnormality is found you will usually need an ultrasound, and a mammogram too if you are over 40.

The NHS also offers breast screening, a mammogram: every three years to women aged 50 to 71. Self-examination still matters between those invitations: most breast cancers are first noticed by women themselves, not at a screening appointment.