As moms, we often spend endless hours worrying about the health of our family. But all too often, we forget to take the time to properly care for ourselves. I will spend hours researching even the smallest little ailment my kids are complaining about but then do my best to ignore any physical symptoms that I might be experiencing. And I will make sure that my kids always have their necessary annual physicals/bi-annual dental appointments while ignoring all of my own recommended screening guidelines.
As a radiologist and breast specialist at St. Luke’s Breast Center, I would like to take a little time to talk about breast health. Good breast health is important to our mental and physical well-being, yet we don’t often pay much attention to our breasts until something is wrong.
1. The first step to good breast health is a bra that fits properly.
The first step to good breast health is a properly fitting bra. The band, which is the hardest working part of the bra, is at the bottom of the bra and should wrap firmly around your body; it should not be resting on the breast tissue at all. The band should be snug; not so tight that you can’t breathe, but not so loose that it moves around. The straps are the next most important part of the bra. Whether you choose thin straps or wide straps is a personal preference. However, the straps should sit on your shoulders and be taut. The straps should not be so tight they are digging into your shoulders, but shouldn’t be so loose that they fall down and rest on your upper arms.
There are numerous styles of cups, each with their own purpose: contoured for giving extra shape; plunge for showing cleavage; sports bras for activities; padded for a smooth appearance. No matter the shape/color/texture of the bra, the cup should sit directly and firmly against the breast itself. You should not be able to put your finger between the cup and the breast, but avoiding spillage is important. The decision regarding an underwire bra versus no wire is a very personal decision; however, many prefer the feel of a non-underwire bra especially when maintaining an active lifestyle.
Bras should be replaced every year as they tend to lose their elasticity and stretch out with multiple washings. Additionally, if you gain or lose 10 pounds, you should probably reassess your bra and make sure that it is still fitting correctly. For help with a properly fitting bra, there are many stores, like Nordstrom, that offer bra fitters who can help you find your best fit.
2. Eliminating caffeine can help to decrease breast pain.
Breast pain can vary from being a small annoyance to a significant frustration and irritation. Nearly everyone has had breast pain at some point. Some women have cyclical pain around the time of their periods. Nearly everyone experiences some sort of breast pain during pregnancy while the body is experiencing humongous swings in hormones. Breast pain/discomfort is extremely common during breastfeeding. All breast pain should be discussed with your physician.
Most breast pain is caused by hormones, but not always. Rarely does breast cancer cause breast pain. After your doctor has evaluated your breast pain, there are some things that might help. Make sure you are wearing a good-fitting bra. Most women with breast pain find it more comfortable to wear either a sports bra or a two-cup non-underwire bra. As described above, finding a well-fitting bra can be complicated. However, the trouble/time/money spent can go a long way in helping to eliminate breast pain. A good-fitting bra is really the foundation to making sure your breasts are well-supported and this will help to eliminate, or certainly decrease, breast pain.
Another cause of breast pain can be from fibrocystic breast changes, which is a big fancy term for dense breast tissue with cysts (fluid-filled structures in the breast kind of like water balloons). Although there is nothing that can be done to “get rid” of the cysts or the fibrocystic changes, eliminating caffeine can help to decrease the pain from them. This includes all sources of caffeine, including coffee, tea, soda/pop, and chocolate. I know…who wants to give up all of life’s small indulgences? I always say it is important to put into perspective your breast pain versus your sanity and need for a little chocolate from time to time. Other suggestions to help with breast pain include stopping smoking and eating a healthy diet. There are some over the counter medications that you can speak to your physician about if the breast pain continues even after you have tried some of the above recommendations.
3.Breast self-exams are not a recommended screening tool for the detection of breast cancer.
It is important to realize that breast self-exams are not a recommended screening tool for the detection of breast cancer. There are no studies which have shown a difference in breast cancer survival for women who performed breast self-exams versus those who did not. Moreover, women who perform breast self-exams are more likely to have breast biopsies than women who do not perform breast self-exams and those biopsies are more likely to be benign (no cancer found).
HOWEVER, this is not to say that you should not be familiar with your own breasts – and with your entire body for that matter. You are your best advocate! You should know what your breasts look like. That’s right…take some time to exam your breasts: look at them in the mirror, feel them, know what is normal for you. Breast tissue extends into the armpits, so make sure you also look and feel there. Breasts are like snowflakes – no two are exactly the same. So, notice if there is something different. Note changes in size and contour of the nipples. If you always had outies, they should stay outies. If one of your nipples inverts, or becomes inward instead of pointing out – let your doctor know immediately. Take note of any changes in your breasts – nipple discharge, a rash or skin changes, dimpling or puckering of the skin, swelling. If something doesn’t seem right or you feel as though there is a change, talk to your doctor. That is what they are there for. If your doctor agrees, then additional testing will be performed. It is always better to be safe than sorry.
When you are checking your breasts out or in the shower or shaving or for whatever reason, and you discover a lump, it is important to contact your physician. Again, the vast majority of lumps are not related to cancer. But there are some breast cancers that are only detected by feel. It is very important to follow up with your doctor about any lump you may discover. Most lumps will be caused by either dense breast tissue or cysts. However, I cannot stress enough to contact your physician. Every year or two, I will see a patient ignored a lump until it became so big that it could not be ignored anymore. Again, you are your best advocate!
4. Mammograms save lives!
Having a mammogram is the most important step in detecting breast cancer. We know that mammograms save lives. It is now estimated that 1 in every 8 women will develop breast cancer in their lifetime. Over the past few years, there has been a lot of misinformation in the press about mammograms. All of the controversy has led to great public confusion. As a Breast Radiologist who went through a year of dedicated breast imaging training, I believe that annual mammography should begin at the age of 40. This means that at 40 you should get your mammogram…and then have one every single year.
It is never fun, but for a few minutes (and literally, I do mean only a few minutes) of unpleasantness, the benefit is tremendous. A few thoughts about mammograms – although it can be scary, it doesn’t need to be. Everyone at St. Luke’s Breast Center is here for you and wants to make your appointment a pleasant experience. If you have questions or concerns, just ask!
It’s best to not schedule a mammogram when you know you will be having period-related breast sensitivity. If you are worried about the discomfort, then you can take an ibuprofen prior to having your mammogram. Most of the time, after women have their mammogram, they feel a sense of relief that they have done something proactive for their own health. A mammogram appointment can actually leave you feeling empowered.
While mammograms starting at age 40 is the general recommendation, some women benefit from mammograms starting before age 40 and some women benefit from additional exams like an MRI or ultrasound of the breast. Please talk with your provider if you have any of these issues: a strong family history of breast cancer, a personal history of breast or ovarian cancer, you or a family member have been tested and found to carry the gene associated with breast cancer, or you have a history of radiation therapy to your chest. By talking with your provider, you can decide the best plan for monitoring you for breast cancer.
The way traditional mammograms were obtained was to take two images of each breast. Now, we have new technology called tomosynthesis or 3D mammography. This improved type of mammogram looks and feels very similar to a traditional mammogram. The machine takes multiple images of your breast and then I can see your breast tissue at 1mm (extremely thin) slices. This allows me to detect even more and even smaller breast cancers. This also decreases the number of call-backs, meaning fewer women will have to return for additional images after their screening mammogram. This is great technology that does not increase the amount of radiation to the breast tissue when compared to traditional mammography. This is not an addition to the screening mammogram, but is rather a tool that can be utilized at the time of your mammogram. The good news is that many insurance companies are now covering the cost of this state-of- the-art technology.
5. Taking the time for yourself so you can be there for your family!
Hopefully, I have helped answer some questions about your general breast health. If you have any questions or concerns about your breast, please contact your physician. Remember to take time for yourself and your breast health. The healthier you are, the more present you can be for your family!
Dr. Kerri Harting is a breast specialist who works at St. Luke’s Breast Center. A recent ribbon cutting with the Duluth Area Chamber of Commerce celebrated the addition of tomosynthesis or 3D mammography. St. Luke’s Breast Center is located inside St. Luke’s Hospital.