When to check for breast changes

The three most important ways in which a woman can guard against breast cancer, finding it early in order to improve treatment protocols and out comes, is to have a regular mammogram starting at age 50, have a clinical examination by your gynecologist every year and do a self breast examination every month. It is a combination of these three things that will increase the likelihood that any changes are detected early to improve the success rate of treatment.

Once women have reached the age of 20 years they should begin doing breast examinations every month. The best time to check the breast is approximately 1 week after the end of your menstrual period. At this time the breasts are not swollen, lumpy or tender because of the secretion of hormones. Mark your calendar and check them on the same day each month if you are not having periods because of pregnancy or menopause.

Breast self-examinations should be done if you have had breast implants, are pregnant, are nursing or have gone through menopause. In fact, any woman over the age of 20 should do a breast self examination each and every month. If you’ve had a mastectomy, discuss your recommendations with your surgeon in order to determine if any breast tissue was left that should be examined.

The breast tissue is made up of glandular lobes that were designed to secrete milk for breast-feeding. During a self examination you will feel tissue that varies in consistency. It often feels firm and has a slightly rope like texture. Much of the nodular or glandular tissue is in the upper and outer regions of the breast which is contrasted with the softer tissue felt in the inner and lower portions of the breast tissue. Many women are able to feel this contrast in a more pronounced fashion just before the start of her menstrual period because of the hormonal influences on breast tissue.

Breast tissue changes also occur because of age, and not just related to hormonal secretion. The majority of women find that breast tissue becomes fattier and less dense over time. Women who have fibrocystic breast changes may notice significant differences in the way that their breast tissue feels both before their menstrual period and after their menstrual period. As women age they also may find differences in tenderness or lumpiness over the course of their menstrual cycle.

Many women also find that they have swelling and tenderness in both breasts during the second half of their menstrual cycle, just before their next period. This tenderness can range from the very mild to severe and will typically peak just before the menstrual period and improve immediately afterwards.

During the menstrual cycle the estrogen production increases and will peak just prior to mid-cycle. This causes the breast ducts to enlarge and, combined with the progesterone peak near day 21, will cause growth of the milk glands.

Some women who notice more significant premenstrual swelling and tenderness may also have premenstrual syndrome or fibrocystic breast changes. However, premenstrual tenderness and swelling does occur, to some degree, in nearly all women. It is this premenstrual swelling and tenderness which will decrease the ability of the woman to notice any significant changes in her breast tissue. This is why the breast self-examinations should be done in the weeks following her menstrual period.

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