Many breast cancers are detected through routine mammograms before any symptoms are noticed. During a regular screening, a mammogram may show a lump or a change in breast tissue even if you do not have any symptoms.

In some cases, changes are identified by your doctor during a breast examination, or you may notice a change yourself during self-examination. If you find any change in your breast that is unusual for you, it is recommended to see your GP without delay.

Your doctor may organise further tests to investigate the change. These tests can include a mammogram, ultrasound, and sometimes a biopsy to determine the cause. While most breast changes are not due to cancer, it is important to have them assessed to confirm the cause and determine if any treatment is needed.

Breast Self-Examination

Detecting breast cancer early can increase the range of treatment options available. One way to support breast awareness is through regular self-examination.

Women can begin performing breast self-examinations from around the age of 20 and continue throughout life. Self-examinations can be done monthly. The best time to perform a breast self-examination is when your breasts are least likely to be tender or swollen, such as a few days after your period ends. For postmenopausal women, choosing a consistent date each month, such as the first day of the month, can be helpful.

How to Perform a Breast Self-Examination

1.Standing in front of a mirror:

• Check each breast for any changes in size, shape, or appearance.
• Look for changes in the skin such as puckering, dimpling, or scaliness.
• Check for any nipple changes or discharge.

2.With hands on hips and shoulders forward:

• Press your hands firmly on your hips and bend slightly towards the mirror, pulling your shoulders and elbows forward.
• Look for any changes in the contour or shape of your breasts.

3.With arms raised:

• Raise your arms and place your hands behind your head.
• Check the underside of your breasts for any changes.

4.Lying down:

• Lie flat on your back with one arm placed over your head and a pillow or folded towel under that shoulder. This flattens the breast and makes it easier to examine.
• Use the pads of three or four fingers on your opposite hand to check the breast tissue.
• Press gently but firmly, feeling for any unusual lumps or masses under the skin.
• Move your fingers in small, overlapping circular motions, covering the entire breast and surrounding area.
• Follow a consistent pattern to ensure the whole breast is examined, such as using lines, circles, or wedges.

If you notice any changes that are unusual for you, it is recommended to see your GP for further assessment.

Regular breast self-examination can help you become familiar with what is normal for your breasts. If you notice any changes that are different from your usual breast appearance or feel, it is recommended to see your GP for further assessment.

The symptoms of breast cancer can vary depending on the location, size, and growth rate of the tumour. Changes in the breast that may need further assessment include:

• A new lump or area of lumpiness, especially if it is only in one breast
• Changes in the size or shape of the breast
• Changes to the nipple, such as crusting, ulcers, redness, or the nipple turning inward (inversion)
• Nipple discharge that occurs without squeezing
• Changes to the skin of the breast, such as redness or dimpling
• Unusual pain in the breast that does not go away

The exact cause of breast cancer is not fully understood, and it is difficult to determine why some people develop breast cancer while others do not. There are, however, certain factors that may increase the risk of developing breast cancer. Having one or more of these risk factors does not mean that you will develop breast cancer.

Known risk factors include:

• Being female
• Increasing age
• Inheriting a gene mutation that increases breast cancer risk
• Having a strong family history of breast cancer

Treatment for early breast cancer may include a combination of surgery, radiotherapy, chemotherapy, and hormonal therapy.

Surgery involves either breast-conserving surgery (removing the cancer and some surrounding tissue) or mastectomy (removal of the whole breast). Breast reconstruction may be an option after mastectomy for some patients.

Surgery for early breast cancer often also involves removing one or more lymph nodes from the armpit to check for the spread of cancer.

If an oncoplastic approach is not suitable, breast reconstruction may be considered. This surgery aims to recreate the breast shape after a mastectomy.

There are two main types of breast reconstruction:

• Implant reconstruction: Surgical insertion of a breast implant.
• Tissue flap reconstruction: Transfer of tissue, skin, and sometimes muscle from another part of the body to the chest area (known as a tissue flap reconstruction).