Breast Cancer Self-Detection: How To Be Your Best Advocate

Routine mammograms are the gold standard for identifying breast cancer early. However, self-detection plays a vital role in noticing changes between screenings. No one knows your body better than you do, and being proactive about breast health can make all the difference.

During Breast Cancer Awareness Month, Baptist Health is spotlighting the importance of breast self-exams and how you can be your best advocate.

Providing insights on everything you need to know about self-detection are surgical oncologist Nadia Nocera Zachariah, M.D., with Baptist Health Cancer Care; and Kerry-Ann McDonald, M.D., breast surgical oncologist with Eugene M. & Christine E. Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health.

Nadia Nocera Zachariah, M.D., surgical oncologist with Baptist Health Cancer Care.

What to Look For During a Self-Exam

Both Dr. McDonald and Dr. Nocera emphasize the importance of being familiar with your breasts to identify any changes.

“Look for new lumps, thickening, or hardened areas in the breast or underarm. Pay attention to changes in size, shape, or symmetry, as well as skin changes like dimpling, redness, or scaling,” explains Dr. Nocera.

Dr. McDonald emphasizes: “Persistent pain or tenderness in one area; visible veins that are new or more prominent; and nipple changes such as turning inward (inversion), discharge (especially bloody), or rash should also be noted.”

The key is to recognize what’s normal for you. “Dense breast tissue or natural asymmetry can make breasts feel different, but the goal is to identify anything new or unusual,” said Dr. McDonald.

Kerry-Ann McDonald, M.D., breast surgical oncologist with Eugene M. & Christine E. Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health.

How and When to Perform a Self-Exam

Consistency is crucial when it comes to self-exams. Dr. Nocera recommends performing them once a month, ideally a few days after your period starts, when breasts are less tender. For those who no longer menstruate, she advises choosing a consistent day each month. Dr. McDonald echoes this, noting: “The best time is 3 to 5 days after your period ends, as breast tissue is less swollen.”

The technique involves both visual and physical checks. “Start by visually inspecting your breasts in front of a mirror with your arms at your sides, then raised overhead,” said Dr. Nocera. “Next, lie down and use the pads of your three middle fingers to feel the entire breast and underarm area in a systematic pattern—circular, up-and-down, or wedge-shaped.”

Dr. McDonald points out that “many women find it easiest to do the manual check in the shower when the skin is slippery.”

Self-Detection vs. Mammograms

While self-exams are a valuable tool, they are not a substitute for routine mammograms.

“While self-exams can help you become familiar with your breasts and notice changes, routine mammograms remain the gold standard for early detection because they can find small tumors before they are felt,” explains Dr. Nocera. “Self-exams are a useful supplement but should never replace regular screening mammograms. Early detection through mammograms has been shown to reduce mortality from breast cancer.”

Dr. McDonald: “Yes, self-exams can help you notice changes between screenings and lead to earlier evaluation. However, mammograms can detect tumors too small to be felt, so self-exams should be used in addition to regular screenings, not as a substitute.” 

Common Myths About Self-Exams

There are several misconceptions about breast self-exams. “One myth is that all lumps are cancerous. In reality, most lumps, especially in younger women, are benign cysts or fibroadenomas,” Dr. Nocera points out.

“Another misconception is that pain is a sign of cancer,” Dr. McDonald said. “Breast cancer is often painless, so don’t rely on pain as an indicator.”

Both doctors stress that self-exams do not eliminate the need for mammograms. “Even if you don’t feel a lump, regular screenings are essential,” said Dr. Nocera.

When to Contact Your Doctor

If you notice any new or unusual changes, it’s important to act promptly. “Contact your doctor if you find a lump that persists for more than one menstrual cycle, changes in breast shape or size, nipple discharge, or skin changes like dimpling or redness,” advises Dr. Nocera.

Dr. McDonald: “It’s always better to have it checked and be reassured than to wait.”

Adapting Self-Exams for Dense Tissue or Implants

For those with dense breast tissue or implants, self-exams may require some adjustments. “Dense tissue can make lumps harder to feel, so focus on identifying new or different areas,” says Dr. McDonald.

“If you have implants, use a gentle but thorough technique to feel the tissue over and around the implant, especially near the armpit,” Dr. Nocera said.

Both doctors emphasize the importance of regular imaging for these individuals. “Ultrasound or MRI may be recommended in addition to mammograms,” says Dr. Nocera.

Lifestyle Factors to Lower Risk

While self-detection is crucial, prevention is equally important. Dr. McDonald recommends maintaining a healthy weight, staying physically active, and eating a diet rich in fruits, vegetables, and whole grains. “Avoid smoking and limit alcohol intake,” she adds.

Dr. Nocera highlights the protective benefits of breastfeeding. “Limiting hormone replacement therapy and understanding your family history can guide prevention strategies,” she adds.

Resources and Support

If you detect a possible issue, Baptist Health offers comprehensive breast health services, including diagnostic imaging, biopsy procedures, and expert consultations. Services also cover patient education, support groups, counseling services, and survivorship programs to guide patients every step of the way.

“We have patient navigators to guide you through next steps after an abnormal finding,” said Dr. McDonald adds. “We have state-of-the-art imaging services, including contrast mammogram and artificial intelligence. We have an expert multidisciplinary breast cancer team for coordinated care and treatment if needed. We have one-of-a-kind support services that provide comprehensive care beyond treatment.”

Both doctors emphasize the importance of medical and emotional support.

“Our multidisciplinary team that includes breast surgeons, oncologists, radiologists, and nurse navigators, work closely with patients for timely evaluation and personalized care plans,” explains Dr. Nocera. “We offer patient education, support groups, counseling services, and survivorship programs to guide you every step of the way.”

Be Your Best Advocate

Breast cancer self-detection is about empowerment. By performing regular self-exams, staying informed, and seeking medical advice when needed, you can take charge of your breast health.

As Dr. McDonald puts it: “You know your body best. Trust yourself and don’t hesitate to act if something feels off.”

Dr. Nocera: “Early detection saves lives, and being proactive is the first step.”

Visit BaptistHealth.net/mammo to learn more or schedule your breast cancer screening this Breast Cancer Awareness Month.