Breast checks and screening

Know your normal

Breasts come in all shapes and sizes, and they change over your cycle, in pregnancy, while breastfeeding and after menopause. Many people's breasts feel lumpier or more tender before a period.

Rather than following a strict technique, health organisations encourage you to be breast aware: get to know what's normal for you, so you can spot anything new. Checking at a similar point in your cycle each time, such as a few days after your period, can make changes easier to notice.

How to check your breasts

You can check in the shower, while getting dressed or lying down — whatever is easiest for you.

• Look in the mirror with your arms by your sides, then raised. Notice any changes in size, shape, skin or nipples.
• Feel each breast using the flat of your fingers, moving in small circles. Cover the whole breast, using light, medium and firmer pressure.
• Include your armpits and the area up to your collarbone, because breast tissue extends there.
• Check your nipples for any changes or discharge.

There's no need to worry about doing it perfectly. Regular checking is what matters.

Changes to get checked

See a doctor if you notice:

• a new lump or thickening in your breast or armpit
• a change in the size or shape of a breast
• dimpling or puckering of the skin, or skin that looks like orange peel
• redness, a rash or crusting on the skin or around the nipple
• a nipple that has become pulled in (inverted) or changed position
• discharge from the nipple when you're not breastfeeding, especially if it's bloody
• swelling in your armpit or around your collarbone
• pain in one area of your breast or armpit that doesn't go away

Most breast changes turn out to be harmless, such as cysts or other benign lumps. But it's always worth getting them looked at quickly.

When does mammogram screening start?

Screening guidelines vary between countries and organisations. For example:

• In the US, current national guidance recommends mammograms every two years from age 40, continuing into your 70s.
• In the UK, the NHS invites women for screening every three years from age 50 up to their 71st birthday.
• Many other countries invite women from around 45 or 50, usually every two or three years.

Guidelines change as new evidence emerges, so check with your doctor or local screening programme. Screening is for people without symptoms — if you notice a change, see a doctor rather than waiting for a screening appointment.

If you're at higher risk

Some people may be offered earlier or more frequent screening, or different types of scans, such as MRI. This might apply if you have:

• a strong family history of breast or ovarian cancer
• a known gene change, such as BRCA1 or BRCA2
• previous radiotherapy to the chest at a young age
• had breast cancer or certain breast conditions before

If any of these apply, talk to your doctor about your risk and the right screening plan for you. Dense breast tissue can also make mammograms harder to read, so ask about this if it's mentioned in your results.

What happens when you see a doctor

Your doctor will ask about the change and examine your breasts. If needed, they'll refer you to a breast clinic, where you may have a mammogram, an ultrasound or a small tissue sample (biopsy). Waiting for results can be stressful, so it can help to bring someone with you and write down questions beforehand.