Breast Awareness: Knowing What Is Normal for You

Breast awareness means getting to know how your breasts normally look and feel. When you know your normal, you are more likely to notice a change, and noticing changes early is what matters.

This is a calm, everyday kind of attention. You do not need a strict routine or a set of rules. The idea is simply that you are the person most likely to catch something that is different.

Breast awareness is about knowing your normal, not passing a test.

In the past, many people were taught to do a formal breast self-exam, a step-by-step check done the same way every month. The National Cancer Institute (NCI) now says self-exams are not enough on their own as a screening test. It does say to know how your breasts normally feel so you can report unusual changes.

The difference is the spirit of it. A formal self-exam follows a set routine. Breast awareness is more relaxed. It means you notice how your breasts feel during everyday moments, such as showering, dressing, or lying down. If something seems different, you speak up.

Some people still like a monthly routine, and that is fine. What counts is that you know your normal and report changes, however you get there.

Whether you follow a routine or stay generally aware, reporting changes is the goal.

Breast awareness does not replace mammograms. The two do different jobs.

• A mammogram is an X-ray that can find breast cancer before it causes symptoms.
• Awareness helps you notice changes between screenings, so nothing waits unnoticed until your next appointment.

Think of them as partners. Ask your doctor what mammogram schedule is right for you, and stay aware in between. Neither one alone is as strong as the two together.

Mammograms find the unseen; awareness catches what changes in between.

These changes can have causes other than cancer. Some people have no signs at all, which is why screening matters. Tell your doctor right away about any of these:

• A new lump in the breast or underarm
• Thickening or swelling of part of the breast
• Pain in any area of the breast
• A change in the size or shape of the breast
• Irritation or dimpling of the breast skin, or skin that looks like an orange peel
• Redness or flaky skin in the nipple area
• A nipple that pulls in, or pain in the nipple area
• Nipple discharge other than breast milk, including blood

You do not need to be certain something is wrong. If it is new or different for you, let a doctor take a look.

A new or different change deserves a call, even if you feel fine.

It is easy to feel anxious about breast changes. But awareness is meant to be reassuring, not frightening. Many changes have causes other than cancer. The point of awareness is not worry. It is simply knowing your body well enough to notice when something has changed, and trusting yourself to speak up.

If you are ever unsure whether something is worth mentioning, mention it anyway. Your care team would rather check a change that turns out to be nothing than miss one that matters.

Some changes call for a faster response than others. Use this guide to decide how soon to call.

• Call your care team the same day if one breast turns pink, red or purple, swells, or feels heavy or hot over the course of a few days. Also call the same day if the skin begins to look pitted like orange peel. Changes like these can come on rapidly and need a quick look (NCI).
• Call your care team the same day to book a visit if you find a new lump or thickening in a breast or armpit, see dimpling or flaky skin, notice a nipple pulling inward, or get nipple discharge that is not breast milk, including blood. CDC says to see your doctor right away for any of these signs (CDC).

• National Cancer Institute — Inflammatory Breast Cancer.
• National Cancer Institute — Breast Cancer Screening (PDQ).
• Centers for Disease Control and Prevention — Breast Cancer Symptoms.