From the time you hit puberty until well after menopause, a woman’s breasts go through significant changes. Pregnancy, breastfeeding, hormonal imbalance - everything plays a role in your breast health. This is the reason why self-care and self-exams should be prioritized and taught to women from an early age, preferably around puberty.

If a girl learns to check her breasts, knows her body and understands how time, age and lifestyle habits can change her body, she will be better prepared for life. This type of self-care, especially where breast health is concerned, is of vital importance because of the high and still-rising incidence of breast cancer among women across the world.

According to the World Health Organization (WHO), breast cancer is the most common type of cancer among women - it affects about 2.1 million women each year. Breast cancer and oral cancer also cause about 25% of cancers among women in India, which is a huge number to consider.

While it’s difficult to prevent breast cancer, or any type of cancer for that matter, it’s important to take proper steps to avoid the risk factors throughout life. Awareness about breast health is therefore very important. Here’s everything you need to know about breast care, and all the steps you need to take to maintain it.

  1. Breast health at puberty
  2. Breast health in young women
  3. Breast health in perimenopause and menopause
  4. Importance of breast self-exam
  5. Why and when to get a mammogram?
  6. Health tips for breast care

A lot changes when you first hit puberty. For girls, this is the time when the pituitary gland creates luteinizing hormone (LH) and follicle-stimulating hormone (FSH), estrogen production starts in the body, and these changes lead to menstruation and the growth of breasts. Breast development occurs as the mound or breast buds below the nipple and areola start getting hormonal signals. The following things can be observed during the stages of breast development:

  • One breast may grow earlier and faster than the other. This is normal and nothing to be worried about. The difference in breast sizes reduces as the breasts develop fully.
  • The breasts might hurt and feel tender in the beginning. This type of sensation will go away once your breasts develop fully.
  • Rapid development of breasts can cause spoke-shaped stretch marks, but these tend to fade away once the breasts are fully developed.
  • Your natural breast development and size depends on your family (genes), hormones and weight.
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According to the National Cancer Institute, the breasts of young women tend to be denser, with less fatty tissues and more mammary glands and connective tissues. There are at least three natural periods of breast change among young women.

  • Menstruation: Your breasts are likely to feel fuller, tender and painful before and during menstruation. It’s likely that your breasts are filled with extra fluid at this point every month, which might make them feel lumpier than usual. 
  • Pregnancy: As your body starts producing prolactin, your breasts will prepare for breastfeeding after delivery, and your mammary glands and ducts will also be activated. This will cause your breasts to get fuller, feel tender and you might even experience some soreness. As your breasts change during pregnancy, it’s best to get fitted for a new, more comfortable maternity bra during the 10th week of pregnancy or after it.
  • Breastfeeding: Women tend to notice breast changes during breastfeeding their baby, and this is quite normal. Your breasts are likely to feel heavier before you feed the baby, and you can tell if the baby is eating properly by checking if your breasts feel lighter after feeding. It’s important to feed the baby with both breasts in turn. Breast milk leaks are also quite normal during this stage, so keep nursing pads handy. Many women also face issues like cracked and bleeding nipples while breastfeeding. It’s best to consult your obstetrician about which medications to take for this, since not all medicines can be used while breastfeeding. (Read more: Nipple pain while breastfeeding)

This apart, women who have hormonal imbalances and issues with their reproductive health - examples include conditions like polycystic ovary syndrome (PCOS), uterine fibroids, endometriosis, etc. - might observe changes in their breasts depending on their health status. Most women suffering from these diseases are given hormone therapy in the form of birth control pills, which can also affect their breasts. Most of these health issues are also linked to weight gain, which is another factor which can lead to changes in breasts.

Perimenopause is the time when a woman’s reproductive system begins to slow down. Menopause is the stage when estrogen production stops completely and the reproductive system shuts down. Both these life stages can produce significant changes in breasts.

Perimenopausal women might experience tenderness in the breasts even when they’re not menstruating, and the breasts might feel lumpier than before.

After menopause, the hormone levels in the body drop significantly, which in turn will stop the sensations of lumpiness, pain and nipple discharge (if any).

Early-onset menopause is a problem that many women face due to hormonal problems and other diseases. These women are also likely to experience similar changes in their breasts.

Read more: Female hormones and their role in women's health

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The idea of breast self-exam, especially when taught to young girls who have just reached puberty, is not to instil any sense of alarm about breast tumours and breast cancer. The purpose of conducting regular and proper self-exams is to help women become familiar with their breasts so that if and when changes - any changes - occur, they are immediately able to tell the difference and consult a doctor if needed. 

A breast self-exam is a visual and physical exam which involves standing in front of a mirror and feeling the breasts, nipples, underarms, etc., to understand the texture and layout of the body parts. (You can also lie down during the self-exam, as this will help to spread the breast tissue a little.)

If you conduct a breast self-exam regularly, you might be able to detect any changes, including unnatural breast lumps, in your breasts. If you do observe any lumps on or around your breasts, do contact a doctor immediately.

A mammogram is a low-dose X-ray that allows specialists to observe and identify any changes in breast tissues that are not deemed normal. This is the best technique to understand if there are any tumours in your breast. However, a mammogram is not recommended to everybody at all times.

The American Cancer Society recommends that women should start with one mammogram a year when they reach the age of 45 years. Once they get to 55 years, these women can get a mammogram done every other year. This apart, only women at high risk of developing breast cancer are recommended mammograms early and more frequently. According to the American Cancer Society, you would be considered high-risk if you have the following issues:

  • History of breast cancer in the family
  • Dense breast tissue
  • Benign breast conditions
  • Alcohol abuse
  • Obesity or being overweight
  • Sedentary lifestyle
  • Not having children
  • Not breastfeeding
  • Use of birth control
  • Hormone therapy after menopause
  • Breast implants

Even if you’re not at risk, but do observe any changes or lumps in your breasts, consult your doctor and check if you should get a mammogram done. Women of all ages should be aware of breast changes and keep a check on said changes.

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According to the US Centers for Disease Control and Prevention (CDC), staying healthy throughout your life is the best way to reduce the risk of any and all diseases, including cancer. Doing this will also increase your chances of surviving cancer if it does occur. The same goes for maintaining good breast health all your life. The following are some health tips you should keep in mind and practice regularly to maintain good breast health.

  • Maintain a healthy weight: Hormone secretions and body weight are intricately linked, and your weight might also affect your breast size and development. Hence, it’s very important to maintain a healthy weight according to your body mass index (BMI) and age. (Read more: How to lose weight fast and safely)
  • Exercise regularly: Being physically active is the best way to ensure that your weight is naturally managed and you can keep stress at bay. Exercising at least 30 minutes a day for four-five days a week is considered to be beneficial.
  • Limit alcohol consumption: Women who drink more than one alcoholic beverage a day are at a greater risk of developing health issues, including breast cancer. It’s therefore important to limit your alcohol consumption to one drink per day, no matter what your age or health status.
  • Know your history: It’s very important to find out if members of your family suffered from any type of cancer, especially breast cancer. If you inherit changes in the BRCA1 and BRCA2 genes which put you at risk of breast cancer, knowing about it earlier rather than later is better.
  • Breastfeed: The World Health Organization (WHO) recommends breastfeeding infants exclusively for the first six months of their life. Unless your doctor recommends otherwise, breastfeeding is good for the mother as it reduces the chance of breast tumours and cancers.
  • Monitor hormones: Knowing your body and understanding how it functions can keep diseases at bay. Hormonal changes are linked to breast health, so get hormone testing done if you find any changes. This will help you get timely treatment and reduce the risk of major breast-related diseases.
  • Eat fruits and vegetables: Maintaining a healthy diet, with five to eight servings of fruits and vegetables every day is very important. Increasing your fiber, vitamin, mineral and antioxidant intake is as important as cutting off refined sugar, processed foods and fatty foods from your diet. 
  • Do not smoke: Smoking has a causal link with breast cancer and a number of other diseases among young and premenopausal women, according to the findings of multiple studies. It’s best not to smoke yourself, and to avoid second-hand and third-hand smoke as well. Third-hand smoke is the smoke that reaches you from a lit cigarette (whether it is in someone's hand or in the ashtray) whereas second-hand smoke is exhaled by a smoker.
  • Choose the right bra: Research shows that if you've never worn a bra, your body will create the proper support structures on its own. However, if you've been wearing a bra for years, it is not a good idea to discontinue now. That said, it is important to wear a bra during some activities (example, while playing sports) and stages (example, during pregnancy) for the right amount of support.
    If you do wear a bra, then wearing the right bra - one that fits you is important for breast health. Since your breasts go through multiple changes throughout your life, it’s important to measure your breast size at least once every six months and get fitted for a proper bra according to the measurements.
  • Maintain breast hygiene: This should go without saying, but make sure your breasts are clean. If you observe any acne or skin rashes, it’s best to consult a doctor immediately instead of covering up your breasts. (Read more: Itching under breast fold)
  • Avoid artificial breast changes: It’s safe to say that the less exposed your breasts are to toxins and chemicals, the better your breast health will be. So, say no to breast piercings, tattoos, implants and enhancement creams and accept your body as it is instead of looking for artificial ways to enhance them.

References

  1. Cleveland Clinic. [Internet]. Cleveland. Ohio; 5 Ways to Boost Breast Health
  2. Dignity Health [Internet]. San Francisco. California. United States; Breast Health Tips for Women of All Ages
  3. Aurora Health Care [Internet]. Milwaukee. Wisconsin. United States; 10 Ways to Enhance Breast Health, Cut Cancer Risks
  4. Centers for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; What Can I Do to Reduce My Risk of Breast Cancer?
  5. National Breast Cancer Foundation [Internet]. Texas. United States; Healthy Habits.
  6. World Health Organization [Internet]. Geneva (SUI): World Health Organization; Breast cancer
  7. National Cancer Institute [Internet]. Bethesda. Maryland. United States; Breast Changes and Conditions.
  8. American Cancer Society [internet]. Atlanta (GA), USA; What to Know About Getting a Mammogram
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