Lumps, Bumps and Feeling Yourself Up

Today is the first of the month.

Do you know what that means?

It means, that if your periods have stopped, it's a good time to do your monthly breast self examination.  If they haven't then the first day after your period is the reccomended time to do it...ideally you want to make it the same day each month because changes will be more noticeable that way...but being a new month it seems like the perfect time to finally share this post with you!

To be honest I am kind of clueless in the area of breast self exam.  I always get my GP to check them out when I have my bi-annual pap smear and feel them regularly myself however I'm not completely sure I'm doing it the right way.  I am pretty proud of my rack so I'd like to look after them thankyou very much!

I had a few questions I felt too embarrased to ask anyone until it occured to me that my sister Sam is actually an expert in the area so I asked her if she would be kind enough to answer a few questions for me here :)

I originally planned this post for new year's day but reality didn't leave it an option and I am proud to finally share her awesome information with you!

Sam is mum to two gorgeous girls and her husband Luke is lucky enough to be my brother in law ;)  Sam is a radiographer with postgraduate qualification in breast ultrasound.  When she's not mumming, wifeing, running or radiographing she's probably sewing something lovely for her business Verri Charmed.

A funny thing about Radiography, is that you often get asked mid procedure “Is this what you do all day?”  I used to feel a little annoyed whenever I was asked as it felt a bit demeaning, like my job was not at all interesting or difficult, after 10 years in this profession I no longer feel that way.  In fact, now that I am primarily a Breast sonographer/ mammographer, I really do understand why I am asked this question with such incredulousness.  But, now I answer with pride, “Yes, yes, I do indeed look at boobs all day long.....”.

How often should we self examine?

Doing a self breast examination once a month is a good start, though while some suggest picking a certain date, like the first of the month, it's actually best to avoid mid menstral cycle.  In other words, do it after your period.  The reason is that your breasts tend to be at their most lumpy and tender just prior to and during your period, which is all completely normal, but it makes it much harder to self examine.

When should we start?

NOW. Trust me when I say that onset of breast cancer in one's 20's was not limited to the beautiful Belinda Emmett.

How do you go about it?

The shower is a good place, considering you are usually already nude (right?). Put your right arm up above your head make your left hand flat and firmly, using circular motions examine the right breast one area at a time (it maybe best to think of it as a clock face, 12 o'clock being the area directly above your nipple) making sure you cover the breast in it's entirity. 

Don't leave out your arm pit, check for lumps up there too. Then switch to the other side.

Boobs are pretty lumpy things anyway, how do you tell the difference between the lumps that are supposed to be there and the ones that aren’t?

I often hear from patients “Oh I don't self examine, I leave it up to the GP, my boobs are so lumpy I can't tell what is what”.  Yep, boobs are lumpy suckers, that is how they are made.  There are two kinds of tissue in the breast glandular tissue, the active stuff that does all the work, it's the tough fibrous stuff, and then we have a nice smooth fatty layer coating over the top.

In some parts of the breast we have more of the glandular stuff than other parts with less fat on top and that's why they feel lumpy.  That's why it's so important to check regularly, it gives you (the owner of the boobs) time to work out which lumps are always there, then if something new crops up, you will recognise it.  GP's are awesome but it's really hard for them to know if something is new for you if they haven't examined you for a year.

What do lumps typically feel like?

This is a hard one, lumps can feel all sorts of different ways.  As you'd expect, in my job I am directed to feel many different lumps, and more often than not I can tell what something is going to be before I start imaging.  BUT, there are times when I'm surprised, and that's what makes it hard.

A benign (non-cancerous lump) is more like to feel smooth and round and be a little mobile with in your breast.  A nasty lump will general feel harder, grittier and will not be mobile.  However, ANY new lump should ALWAYS be checked. It's not silly, it's smart and thorough.

Do lumps have any pain associated with them or are there any external changes to look for?

The most common benign lumps are cysts and they often do have some tenderness associated with them, cancer, however doesn't usually present with any tenderness. At times when cancer is present there can be a slight tethered or dimpled appearance to the skin associated with the region.  Or, if there is nipple involvement the nipple may become inverted (though that can just be a normal occurance too!).

How much does family history play a part?

If you have a family history you should be extra vigilant with your checking. You can even start your mammograms at 35 if you have a young family history.  Unfortuanately I see so many people who have or have had breast cancer that have no family history what so ever, someone always has to be the first.

Should we be checking anywhere else at the same time?

Don't forget those arm pits!!! You are looking for smooth round lumps there..

Anything else that you would like to tell us or any resources you might like to share?

Men are not exempt from breast cancer, they should check too, especially if they have a family history.

Boobs are tricky things and breast cancer can present in so many different ways that checking is just not an exact science, but if you are vigilant, you will have the best chance of catching it early.

WOW!  Thankyou so much Sam for sharing with me.

I hope that you have all gotten as much from this as I have!  As a follow up I have asked Sam to unveil some of the mystery surrounding the mammogram.

Tatum xx