What You Didn’t Learn in School About Breast Health #KnowYourNormal

If you’re like most women, you probably weren’t taught much about women’s health or breast health while in school. But that’s okay; we’ve got you covered. In this issue of Know More, we’ll go beyond puberty and break down how breast tissue changes over time, as well as what’s normal (and what might not be).

When it comes to early detection for breast cancer, knowing your normal is the foundation. This means understanding what shapes and textures are uniquely yours, and how they might evolve through the years, hormone shifts and other life changes.

Here are five things that probably didn’t make your health textbook but can help you become familiar with your body to know your normal and keep you on top of your breast cancer risk.

1. Your breast tissue is unique, and that’s normal

No two breasts are the same; not even your own. Breasts are as diverse as the people they belong to. Asymmetry, different sizes, stretch marks and varying nipple appearances are all common and normal. Embracing your body’s unique architecture is a powerful first step toward knowing your normal and honoring yourself.

As mentioned, asymmetrical breasts are extremely common as is lumpy tissue – especially in younger people. If you see either of these, it doesn’t automatically mean breast cancer. Lumpiness often comes with menstruation and goes away when the cycle restarts. There are also other benign (non-cancerous) breast conditions like cysts, fibrocystic changes and fibroadenomas that can impact how your breasts feel. Routine, structured breast self-exams are no longer recommended since they have not been shown to reduce death from breast cancer. Instead, breast self-awareness is encouraged, which means knowing how your breasts usually look and feel, and speaking up about any new changes. It’s always important to discuss new or changing lumps with your doctor. Lumps that feel harder or different from the rest of the breast (or your other breast) or lumps that feel like a change are a concern and should be checked. 

Takeaway 1: The first step in breast health awareness is knowing what’s normal for you.

2. Breasts can change throughout the menstrual cycle

Hormonal fluctuations that occur over the course of your menstrual cycle can affect the texture, size and tenderness of your breasts. It’s common for breasts to feel more sensitive, swell or have some lumpiness before menstruation. Around that time, they may even ache. While it’s normal, keep track of what becomes more typical for you, so if there are deviations from your normal, you can identify them and bring them up with your doctor. Some ways to keep track of these changes include paying attention to any changes to your breasts around the same time in your cycle and tracking symptoms to catch any new changes over time.

Takeaway 2: Paying attention to any changes to your breasts around the same point of your cycle is the best way to note changes over time.

3. Hormonal changes caused by birth control, pregnancy and breastfeeding can reshape breast tissue

Breast tissue is responsive to hormonal changes, whether caused by medicine or life events. For example, both pregnancy and breastfeeding cause long-term structural changes in breast tissue that often result in denser or softer breasts postpartum. Additionally, when the body prepares for milk production, the milk ducts and glandular tissue grow accompanied by tenderness and a potential for inconsistent texture. Many women also experience darkening of their areolas and more visible veins.

Birth control and hormone therapies can also cause changes in breast texture and size. These changes are often temporary or more noticeable when starting or stopping a treatment regimen, so it’s important to re-establish new baselines following any of these events.

Takeaway 3: Check in with your body when you experience major health and life changes.

4. Breast tissue changes with age

Breast tissue starts developing long before puberty. In fact, it begins to form in the fetus. During puberty, estrogen triggers the growth of glandular tissue, milk ducts and fat that give breasts their shape and function. This is when one might first notice tenderness, itching or uneven development (which are all normal parts of the process).

Everyone begins life with similar breast tissue. In people whose bodies produce higher levels of estrogen during puberty, breast tissue typically develops more fully. In those whose bodies produce higher levels of testosterone and lower levels of estrogen, breast tissue development is usually limited. Breast growth and changes continue throughout the teenage years and into the early twenties, and it doesn’t stop there.

It should be noted that younger women are more likely to have dense breast tissue, which can mean that detecting tumors is more difficult with a mammogram; however, research is underway to help solve this. Keep in mind that breast density is a measure used to describe mammogram images. It’s not a measure of how the breasts feel. As estrogen levels decline with increasing age, breast tissue often transitions to being more fatty and less dense. This typically begins to happen during perimenopause, which typically occurs in the mid-40s. After menopause, breast cancer risk increases, but breasts tend to be less tender and less dense. This makes mammograms easier to read and abnormalities easier to detect.

Takeaway 4: As you get older, your risk for developing breast cancer increases. Talk with your doctor about your personal risk of breast cancer.

5. Knowing your normal is the first step in early detection

At the end of the day, the most important lesson in breast health isn’t something that you can learn in a classroom. It comes from tuning in to your body, speaking up when something changes and trusting yourself enough to ask questions. The more you know your normal, the easier it is to notice when something’s different. If something feels off, trust your gut and talk with your doctor. Most breast changes are not cancer, but any change deserves your attention. By knowing your normal, you’re not only laying the foundation for early detection, but also practicing self-love by paying attention to your body.

Takeaway 5: Advocate for yourself if something doesn’t feel right.