Doctors are encouraging 'breast self-awareness': what that means

Major medical organizations no longer recommend BSE as a screening tool for early breast cancer detection in women who are at average risk of the disease.

Mark Pearlman, MD, professor in the department of obstetrics and gynecology at the University of Michigan Hospital and Health Systems in Ann Arbor, was involved in writing ACOG’s breast cancer screening guidelines, which reflect the risk of harm from false-positive test results and lack of evidence of benefit.

Still, Dr. Pearlman notes that half of women over age 50 and 70% of women younger than 50 find their own breast cancers. “So we can’t really say, OK, just ignore your breasts.” That gave rise to the concept of breast self-awareness, he says.

What does it mean, exactly, to be breast self-aware? Actually, there’s no standard definition.

ACOG describes it as knowing what is normal for your own breasts and paying attention to changes you might feel.

Susan G. Komen, the national breast cancer research and patient advocacy group, defines it very broadly. Women need to know their breast cancer risk, including any family history of the disease, it says. They should have regular mammograms and clinical breast exams. They need to make healthy lifestyle choices, and they ought to know what’s normal for them.

“It’s important to know the warning signs of breast cancer,” adds Susan Brown, RN, managing director of Komen’s health and mission program education. Look for a lump, hard knot, or thickening in the breast; a change in shape or size of your breast; or signs like swelling, redness, or nipple discharge, for example.

Dr. Pearlman advises average risk patients to be aware of anything that feels odd while putting on a bra, washing in the shower, or being intimate with a partner. “If anything feels different, call your provider, he says. “It’s a relatively simple message.”