Experts advise women on how to examine their breasts: Image source: Pexels

SHOULD women be checking themselves every month for signs of breast cancer — and how should they do it?

Ask most women these two questions and chances are they'd answer ‘yes' to the first, but offer a confused mix of answers to the second. In fact, even the experts don't seem to agree on how often or the right approach.

This confusion may help explain the findings from today's survey, which suggest most women do not examine their breasts every month to check for signs of breast cancer.

Just 43 per cent of women check their breasts at least once a month or more often, and 15 per cent don't do it at all, according to the Ipsos MORI survey commissioned by the Mail in association with LloydsPharmacy.

Even those who do check regularly aren't sure they're doing it right.

A third (34 per cent) of women who regularly self-examine say they're not confident they're checking themselves correctly, with women aged 30 to 44 the most likely to be worried they're doing it wrong (49 per cent of this group expressed concerns).

‘Unfortunately, we know there is still some misunderstanding about what women should be doing to help look after their breast health,' says Eluned Hughes, head of public health and information at Breast Cancer Now.

‘Younger women, in particular, are not as confident about knowing the signs.'

Women were first advised to check themselves regularly over 60 years ago.

Concerned that women were being diagnosed with large, inoperable tumours, Cushman Haagensen, a U.S. breast surgeon, made a short film showing how self-examination was done. It led to a sea change in what women did.

Since then, there's been conflicting advice on how women should examine their breasts and debate about whether self-examination is helpful.

Previously, some doctors recommended examining the breasts in a spiral, starting at the nipple and working in a circular fashion outwards, while others advised feeling each breast while lying down or sitting up and dividing the breast into four quadrants, focusing on one area at a time.

Other techniques included feeling up and down the breasts in vertical strips.

There has also been different advice about the timing of checks, from weekly to once a month to before and after each period.

A number of studies have now discredited these approaches. A Cochrane review involving 388,000 women from Russia and Shanghai, from 2003, found no significant difference in the number of breast cancer deaths among women who checked or lumps compared with those who didn't.

However almost twice as many biopsies were performed in the self-examination group which turned out to be benign.

‘There's no evidence regular breast self-examination reduces the chance of dying from breast cancer or diagnosing it at an earlier stage,' says Kefah Mokbel, a professor of breast cancer surgery at the London Breast Institute. ‘There is evidence, however, that it increases anxiety and the chance of attending a breast clinic and the need for investigations, including negative breast biopsies. I advise my patients not to examine themselves for lumps.'

Today the emphasis is not on examination, but awareness, and knowing what's normal for you. The consensus is to check once every few weeks.

‘I would advise women to check their breasts from their 20s onwards,' says Eluned Hughes. ‘But it's particularly important for women from the ages of 45 to 50, as four out of five breast cancers occur in women over 50.

‘It's also important for women over 70, as they no longer get automatic invites for breast screening.'

Check under your armpits, right up to your collarbone, as this is all breast tissue. See your GP if you spot any changes.

Check your breasts in the mirror, straight on and from the side, with arms by your side and raised. 

Signs to look out for include:

  •   A change in the size or shape of your breast
  •  A change in the look or feel of your skin, such as puckering or dimpling (like the skin of an orange)
  • A lump that feels thicker than the rest of the breast
  •  Discharge from the nipple without squeezing
  •  Bleeding from the nipple
  •  Any change in nipple position, such as your nipple being pulled in or pointing differently
  •  Redness or rash on the skin or around the nipple
  •  Pain in your breast or armpit, particularly if it's new and doesn't go away (although pain is only a symptom of breast cancer in rare cases)
  • Swelling in your armpit or around your collarbone

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