Leading breast surgeon urges women to undertake self-examinations monthly

Research and statistics clearly show that the health outcomes of women diagnosed with breast cancer are better if the disease is detected earlier.
 

"Put simply, if we are able to diagnose breast cancer in its early stages before symptoms even appear, this is ideal," Associate Professor Sanjay Warrier said.
 

"This is a key reason why it is important for women to undertake regular scans and self- examinations at home."
 

Associate Professor Warrier is one of the world's leading breast health and breast cancer surgeons who has built a highly respected practice in Sydney. The practice spans three locations with its main surgical centre located at the Chris O'Brien Lifehouse in Camperdown, and the other sites at BMA House, Macquarie Street, Sydney and Bondi Junction Medical, Oxford Street, Bondi Junction.
 

In addition to Associate Professor Warrier's breast health and surgical work, he also dedicates considerable time to research exploring and developing advancements in breast cancer detection and treatments to improve outcomes for patients. He also developed the world's first Master of Breast Surgery which is delivered through the University of Sydney.
 

It is recommended that women perform breast self-examinations on a regular basis. Here are some tips for performing a self-exam.
 

Frequency
 

"It is recommended for women of all ages to undertake regular breast self- examinations. For women who are menstruating, I suggest undertaking an exam about a week to 10 days after each menstrual cycle starts. This is when the breasts are least tender and lumpy," Associate Professor Warrier said.
 

"For women no longer menstruating, the key is routine. Pick a day such as the first day of each month and remind yourself to do it."
 

Importance of knowing your breasts
 

"Regardless of what stage you are at in life, it is important to know your breasts. When undertaking a regular self-examination, look at your breasts in the mirror and take careful note of their shape and colour," Associate Professor Warrier said.

"Try to undertake a self-examination in the same way each month this way you will become familiar with your breasts and be better placed to detect any changes in the breast or on the skin and nipples.
 

"Common reasons for colour change include general aging and/or pregnancy. However, one of the more overlooked reasons for changes in nipple colour is associated with the presence of breast cancer. It's especially abnormal if it's occurring in only one nipple and not evenly on both breasts.
 

"If you detect any changes at all in your breasts, book an appointment with your health professional as soon as possible."
 

Screening
 

"A woman's risk of developing breast cancer increases with age. Over 75 percent of breast cancers fall into the 50 to 74 years age group. Regular breast screens are the best way to find cancer early," Associate Professor Warrier said.
 

"Women aged 40 and over and who do not have any breast symptoms are entitled to a free mammogram every two years through BreastScreen."
 

BreastScreen Australia is the national breast screening program and actively invites women aged 50—74 to have a free two yearly mammogram. Women aged 40—49 and those aged over 74 are also eligible to receive a free mammogram but do not receive an invitation.
 

Risk factors
 

"Some risk factors may increase the need for annual screening and additional forms of screening, Associate Professor Warrier said.
 

Some risk factors can't be changed and these are called non-modifiable risk factors. These include:

• a family history of breast or ovarian cancer (ovarian cancer risk is often linked to breast cancer risk),
• inherited genetic factors, such as a faulty or mutated gene 
• medical history, such as having previously had radiation therapy for another type of cancer 
• reproductive history, such as starting menstruation very young, reaching menopause late, or not having a baby 
• getting older; and
• having dense breasts. 

"When we consider the biggest non-modifiable factors, these include getting older and being female," Associate Professor Warrier added.
 

Tips for self-examinations
 

"I have formulated an easy system to help women undertake self-examinations at home and I call it 'LOOK, LIFT, FEEL," Associated Professor Warrier said.

"LOOK, LIFT, FEEL only takes a few minutes and should be done regularly. Look at your breasts in the mirror to identify any changes in shape, colour or texture. Stand in front of a mirror with your shoulders straight and your arms on your hips. Look for any changes in the size, shape or symmetry of your breasts. Check for dimpling, puckering or changes in the skin texture.

"Then lay flat and lift your arm up over your head and with two fingers together, using the pads of each finger, place gentle pressure on the breast moving your fingers around in a circular motion. Cover the entire breast from top to bottom and side to side. Also feel up under the armpit. Change sides and repeat.
 

"Take your time and feel for any lumps or changes in the breast. Remember that your breasts may be dense and will naturally feel uneven. If you encounter any changes or unusual lumps, thickening or hardened knots, or nipple discharge, book an appointment with your doctor. The majority of issues are benign, but it is always important to check things with your doctor."
 

"Regular self-exams can help you become familiar with how your breasts normally look and feel, making it easier to notice any changes."
 

Additional considerations
 

"Hormonal changes during menopause can affect breast tissue, so it's important to continue regular checks and discuss any changes with your health professional," Associate Professor Warrier said.
 

"Regardless of age, if you notice any unusual changes during your self-exam, such as lumps, thickening, discharge or changes in skin texture, contact your healthcare provider promptly for further evaluation."
 

Further information about undertaking breast screening and detecting breast cancer can be found at https://www.drsanjaywarrier.com.au.
 

About Associate Professor Sanjay Warrier
 

Associate Professor Sanjay Warrier is a past President and current committee member of Breast Surgeons of Australia and New Zealand (BreastSurgANZ). His views are those of his own, not BreastSurgANZ. Associate Professor Warrier's surgery is located at the Chris O'Brien Lifehouse and he also has clinics at Oxford Street, Bondi Junction and Macquarie Street, Sydney. He is published in numerous peer-reviewed journals and won the Royal Prince Alfred Hospital's Patron's Prize for best scientific research.