October is Breast Cancer Awareness Month!
Now is the perfect time to consider your breast health. According to the National Cancer Institute, 310,720 women in the United States will be diagnosed with breast cancer in 2024. Practicing breast awareness throughout your lifespan can help you learn what is normal for your breasts and identify anything that seems unusual.
Early Puberty/Teen Years
During puberty, which usually occurs between 8 and 13 years, there are stages of breast development that occur. Stage I ranges from birth up to age 15 and is the pre-adolescent stage. Stage II occurs between ages 8 to 15 and is when the breast starts budding, the areola becomes bigger and breast tissue starts developing. Stage III, from ages 10-15, is when further enlargement occurs. As breasts develop, they may feel itchy or tender. During this developmental stage, breasts are usually cone-shaped. The risk for breast cancer increases with age so there is little concern for that during this stage.
Age 20 – 40
Proactive steps include becoming familiar with how your breasts look and feel. During this age, women need a clinical breast exam as a part of their health maintenance. A healthy lifestyle can reduce the risk of breast cancer. This means staying physically active, in a healthy weight range, limiting alcohol intake, and avoiding smoking. Between ages 20-30 breast exams should occur every 1-3 years, although yearly exams are recommended.
- Breast self-exams
There is an ongoing debate about the effectiveness of breast self-exams, but they do remain a valuable tool for many. This helps women stay familiar with their own breasts. The combination of both self and yearly clinical breast exams provides a comprehensive approach. This can be reviewed at your visit with your healthcare provider, and there are many online guides available. - Clinical breast exams
This is an exam that is done by your healthcare provider to check for any concerning changes. Generally, the provider will look at changes in breast size or shape, and nipple changes, check for changes in skin such as redness, rashes, or dimpling, and feel for lumps or masses in the breast and underarm tissue. - Pregnancy/lactation
During early pregnancy, the breasts may feel tender because of increased progesterone, a hormone that helps to maintain a healthy pregnancy. The areolas will darken and enlarge. Blood vessels become more prominent. The breasts will grow and feel heavier. You may have a yellowish discharge called colostrum from the nipple. Other normal changes in the breast involve development of stretch marks, itchiness as the skin stretches and small bumps on the areolas. You may prefer a supportive cotton bra. During this time, if you notice any unusual swelling or lumps, be sure to let your health care provider know.
Age 40 – 50
Women are encouraged to begin getting yearly mammograms starting in their 40s. Breast tissue is generally less dense, making the mammogram an effective tool for detecting things that are not normal, such as tumors that may be too small to feel. A scoring method is used to determine if you are considered high or low risk, which looks at multiple factors, such as your age when you started your period, when you had your first child, family history, breast density, past breast conditions, whether you’ve started menopause and more
- Breast MRI
MRI (magnetic resonance imaging) uses a magnet and radio waves to look at the breasts. This is a painless procedure, often done with a contrast dye that is injected into your arm. This tool is used if you are at a higher risk for breast cancer.
Age 50+
As women age, the breasts lose their firmness and begin to sag. Hormonal shifts affect breast health. The risk for breast cancer increases; the average age for breast cancer in the US is 62. During the post-menopausal stage, the breast tissue becomes more fatty. With all of these changes, the most important thing to keep in mind is continued care with exams and mammograms.
Optimal breast health will be a lifelong journey. Early detection is very important, which is why regular visits to your healthcare provider are so important. Be sure to keep yourself well informed and be proactive when it comes to your breast health.
For more information about breast health, contact Midwife Services at 515-309-6011.
Susan Hernandez, CNM, MSN, is a certified nurse midwife with UnityPoint Health – Des Moines Midwife Services. She is passionate about women’s health, including well-woman care, birth control, pregnancy care and beyond.