What are the key tips for checking your breasts at home?
My special tip is TLC – touch, look and check. Touch your breasts – can you feel anything unusual? Look – are there any skin changes or puckering? Check – anything unusual needs to be reported to your doctor.
There is no special way to check and you do not need any special training but the important thing is to get used to checking regularly and noticing anything that is different for you. Check the whole breast area including up to the collarbone and armpits.
When should you start having your breasts checked professionally as a matter of routine?
A professional examination is important if you notice any changes in your breasts, either changes in the skin, any lumps or areas that seem more “lumpy” than usual or discharge from the nipple. And if you are not sure how to check yourself then you can make an appointment with a health professional to show you this. We can talk through how to check your breasts if you are seen at The Bronte Clinic for a well woman check. However a routine professional check is not as important as checking yourself at least once a month and knowing what is normal for you.
You should also attend for screening mammograms when you are called but the evidence is lacking for starting this screening earlier than 50 unless you are recommended to do so because of your family history.
What are the main tests you can have & what are the differences between them?
An ultrasound is usually done as a first test if you have a lump in the breast, if you have a lump in your breast that hasn’t shown up on a breast x-ray (mammogram) or to see if a breast lump is solid or if contains fluid (a cyst). It can also be used to locate a lump if you are having a biopsy. There are no risks of having an ultrasound.
These are done to check for cancer if you have symptoms. They are also done as part of the breast cancer screening programme which in the UK is every 3 years from the age of 50 to 70 (with some areas starting earlier at 47 as part of a pilot study).
Having mammograms every 3 years for 20 years very slightly increases the chance of getting cancer over a woman’s lifetime. Countries differ in their recommendation for the frequency of screening by mammogram.
Your doctor should request further tests if you have a new lump or thickening in your breast or armpit, a change in size, shape or feel of your breast, skin changes in the breast such as puckering, dimpling, a rash or redness of the skin, fluid leaking from the nipple when you are not pregnant or breast feeding or changes in the position of the nipple. Often a triple assessment is done if you have symptoms which includes an examination, Ultrasound scan and Mammogram at the same time.
If you have a lump or area of concern when you have a mammogram or ultrasound scan then sometimes a small sample of breast cells or breast tissue may be taken to help make a diagnosis which will usually be done using a core biopsy. Sometimes a fine needle aspiration (FNA) or another procedure, such as a punch biopsy, may be used. The sample is then sent to the laboratory where it is looked at under a microscope.
What are the best next steps for those who think they've felt a lump or are worried?
Always make an appointment with a doctor if you are worried about a lump and then you can be referred either on a two-week pathway on the NHS or privately if you prefer.
Dr Samantha Brown is a GP and menopause specialist with over 20 years medical experience. As a GP she has a special interest in Women’s Health for all ages. You can see her at The Brontë Clinic, Belgravia, London.
The Best London Addresses To Know
The Breast Clinic at 108 Harley Street: This clinic is highly regarded and often recommended by women’s health doctors across London. Offering a full range of integrated services for both benign and malignant disease, including all types of screening, surgery, radiotherapy, chemotherapy, reconstruction and aftercare.
The London Breast Institute at The Princess Grace Hospital: The London Breast Institute is another leading UK specialist centre for breast care. They have a renowned team of experts – including highly skilled surgeons, radiologists and clinical nurse specialists, making them able to offer comprehensive and exceptional care.
OneWelbeck: A state-of-the-art, consultant-founded facility offering in-depth tests and care across twelve heath specialities. One of them is women’s health and their breast healthcare is exemplary, giving patients exceptional care across routine tests, diagnosis through to treatment with the help of innovative technology and a calm environment.
The Lister Hospital One-Stop Breast Unit: Here they offer a highly specialised service covering all aspects of breast care, from diagnosis through to treatment and aftercare.