Breast awareness

All women should be aware of how their breasts normally feel and look so that they can detect any changes, even if they are having regular breast screening. Breast awareness is part of general body awareness. It is a process of getting to know your own breasts and becoming familiar with their appearance. Learning how your breasts look and feel at different times will help you to know what is normal for you.

You can become familiar with your breast tissue by looking and feeling your breasts – you can do this in any way that is best for you: for example, in the bath or shower with a soapy hand, or when you are getting dressed.

If you are not sure what to look for, or if examining your breasts makes you anxious, you can ask your practice nurse or GP to show you. You can also go to a well-woman clinic to learn how to check your breasts. NHS Direct (0845 46 47 or www.nhsdirect.nhs.uk|) can give you details of your nearest well-woman clinic.

There is no such thing as a 'standard' breast. What is normal for one woman may not be for another. Throughout your life your breasts will change; below are some descriptions of a normal breast at different stages of your life:

• Before the menopause Normal breasts feel different at different times of the month. The milk-producing tissue in the breast becomes active in the days before a period starts. In some women, the breasts at this time feel tender and lumpy, especially near the armpits.
• After a hysterectomy The breasts usually show the same monthly differences until the time when your periods would have stopped, unless your ovaries have also been removed.
• After the menopause Activity in the milk-producing tissue stops. Breasts normally feel soft, less firm and not lumpy.

• Appearance Any change in the outline or shape of the breast, especially caused by arm movements or by lifting the breasts. Any puckering or dimpling of the skin.
• Feelings Discomfort or pain in one breast that is different to what is normal for you.
• Lumps Any new lumps, thickening or lumpy areas in one breast or armpit, which seem to be different from the same part of the other breast and armpit, and that do not disappear after your monthly period.
• Nipple changes
  • Nipple discharge that is new for you and not milky.
  • Bleeding or moist, reddish areas that don't heal easily.
  • Any changes in nipple position – if the nipple is pulled in or pointing differently.
  • A rash on or around the nipple.

If you are aware of any change in your breast from what is normal for you, tell your doctor as soon as possible. If a cancer is present, the sooner it is reported, the simpler and more effective the treatment is likely to be. Remember, you are not wasting anyone's time.

There are many causes of changes in the breast. Most of them are harmless but all of them need to be checked by a doctor, as there is a small chance that they could be the first sign of cancer.