Here at CORA, we recommend all women over the age of 20 perform self breast exams each month, best performed in the shower the first week after menses for premenopausal women. If you feel any change, you should contact your provider. Any focal concerns in the breast should be scheduled as a diagnostic exam with our doctors, where we will specifically image that area of concern and often use both mammography and ultrasound. A screening exam should not be performed in that setting.
Here’s what to look for in a self breast exam.
What are the common breast symptoms?
- Breast pain
- Palpable lump/thickening
- Nipple discharge or retraction
- Skin changes/ rash
This is extremely common, experienced by 70-80% of women. While most women with breast pain do not have cancer, diagnostic imaging is recommended particularly if your pain is less focal (less than one-quarter of your breast), persistent (noncyclic), and new.
Many women have pain in both breasts that comes and goes with menstruation, which is termed cyclic breast pain and is not suspicious for associated cancer. Other causes of breast pain include large bra cup size, low levels of fitness, cysts, benign inflammation called periductal mastitis, stretching of Cooper ligaments, cervical spine degenerative change, and heart disease.
Skin or Nipple Changes
If you develop an area of skin discoloration, thickening, scaling, or indentation, this should be evaluated by your provider and with diagnostic imaging. Skin changes are often related to benign dermatologic irritation or infection, although cancer should be excluded.
If your nipple becomes flattened or pulled in over a short period of time, typically weeks or months, you should undergo imaging. It is most often related to inflammation behind the nipple, although cancer may also cause this.
Lumps are also extremely common, although a new lump that you or your provider feel that persists for over two weeks should be evaluated with diagnostic imaging. Most lumps that we evaluate with diagnostic imaging are not cancer and we may find normal looking breast tissue, cysts, and benign (non-cancerous) masses like lymph nodes and fibroadenomas.
A small percentage of patients will have cancer and therefore imaging is important.
A few small cancers are not detectable on mammography and ultrasound imaging, so following up with your provider is important. A contrast-enhanced breast MRI or surgical consultation may be the necessary next step.
Discharge from the small pores in your nipple is not uncommon. However, if it is new, it should be evaluated with imaging. While still most often related to benign breast changes, discharge that is from one breast, from one pore of your nipple (there are several), and that is clear or red/bloody in color are more worrisome.
Physiologic/non-cancerous nipple discharge is typically bilateral, from multiple pore orifices, and white, green, or brown in color. It most frequently occurs when the nipple is manipulated. Milky bilateral discharge in the absence of recent breastfeeding may relate to abnormal prolactin levels that may be checked by your provider.
CORA is here for you.
Our subspecialized doctors have years of experience caring for patients with breast symptoms and asymptomatic patients undergoing routine breast cancer screening. Our clinic also performs risk assessment to determine if you may be at an increased risk of developing breast cancer based on your personal and family medical history.
Our goal is to educate our patients and improve access to excellent medical imaging so we can diagnose breast cancer early when treatment is more effective. We have been accredited as a certified “Breast Center of Excellence,” the highest standard of medical imaging.
If you have questions about our breast center or would like to schedule an appointment, please call 541.382.9383.