Breast Cancer: Know what is Normal for You

Breast cancer is the most common cancer in women in 164 of 186 countries, according to the World Health Organization (WHO). In 2024, 2.4 million women were diagnosed and 694,000 died worldwide. WHO says mortality is reduced when breast cancer is detected and treated early, and that awareness of symptoms, so that women seek medical advice, is one of the two key parts of early detection.

What does "breast aware" actually mean?

It is simpler than most people think. The NHS advice is to check your breasts regularly so you know what is normal for you. There is no complicated technique to learn and no fixed day of the month required.

Look and feel, including up into the armpit and across the upper chest. Do it in a way that fits your life, for example in the shower or while dressing. The point is not to find cancer; the point is to become so familiar with your own breasts that a change stands out to you quickly.

Be clear about one thing: checking your breasts does not prevent breast cancer. It cannot stop it developing. What it does is help you notice a change sooner, so you can get it checked sooner.

Which changes should you get checked?

The NHS lists these signs:

• A lump or swelling in your breast, chest or armpit
• Dimpling of the skin, which may look or feel like orange peel
• A change in skin colour, which may look darker on darker skin and redder on lighter skin
• A change in the size or shape of one or both breasts
• Nipple discharge when you are not pregnant or breastfeeding, which may be bloodstained
• A nipple that has turned inwards, or a rash on or around the nipple that looks like eczema

WHO describes similar signs: lumps or thickening in the breast, changes in size, shape or appearance, skin dimpling, redness or pitting, and nipple changes or abnormal discharge.

The NHS notes that breast pain on its own is not usually a symptom of breast cancer. Many breast changes have causes that are not cancer at all. That is reassuring, but it is not a reason to skip the appointment, because only an examination can tell.

Who is at risk?

This is the fact that changes how people think about it: WHO says approximately 80% of breast cancers occur in women with no specific risk factors other than being female and their age. So "no family history" is not protection, and no woman should assume the advice does not apply to her.

WHO does list factors that increase risk, including obesity, alcohol use, family history of breast cancer, previous radiation exposure, reproductive history, tobacco use and postmenopausal hormone therapy. Several of these can be reduced, which is worth discussing with a doctor.

Does screening apply to me?

WHO describes mammographic screening in women aged 50 to 69 as the second key part of early detection, alongside symptom awareness. Organised screening programmes are not available everywhere, so ask your doctor what is offered locally and what is right for your age and history. Where screening is not available, symptom awareness carries more weight, not less.

When to see a doctor

The NHS advises seeing a doctor if you have:

• A lump or swelling in your breast, chest or armpit
• Any change in your breasts or nipples that is not normal for you
• Breast or armpit pain, especially if you have a family history of breast or ovarian cancer

Do not wait to see if a change settles by itself, and do not let embarrassment delay you. If a change has been there for more than a few weeks, book the appointment. If you have been referred for tests, go, even if you feel completely well. Early treatment gives the best chance, and most changes turn out not to be cancer.

For any sudden severe illness, such as high fever with a red, painful, swollen breast and feeling very unwell, get urgent care: call Rescue 1122 where available, or go to the nearest hospital emergency department.