Breast Cancer Awareness: Know Your Risk, Recognise Change, Have a Plan

Know your normal

Breast awareness means knowing how your breasts usually look and feel, so that a change stands out. Breasts change naturally with the menstrual cycle, pregnancy, breastfeeding and age, which is why familiarity matters more than any particular technique.

CANSA recommends a monthly breast self-examination, ideally at the same point in your cycle, and a clinical breast examination by a healthcare professional as part of your annual check-up. Self-examination does not replace screening, but it helps you notice change between appointments.

A change deserves attention

You do not need to wait for pain. Most breast cancers are painless at first. The WHO and other cancer organisations list the following as reasons to see a clinician promptly:

• A new lump: a lump or thickening in the breast or underarm.
• Skin changes: dimpling, puckering, persistent redness or swelling.
• Nipple changes: a newly inverted nipple, or a persistent rash or scaling of the nipple.
• Unusual discharge: spontaneous discharge, especially if bloody or from one side.
• A change in shape: a new change in breast size, shape or appearance.

Keep perspective: most breast changes are not cancer. A new or persistent change still deserves prompt assessment, even if your last mammogram was normal. Men can develop breast cancer too, and the same signs apply.

Screening with purpose

Screening is for people without symptoms. Its aim is to find cancer before it can be felt, when it is usually smaller and easier to treat. If you have a symptom, you need an assessment now rather than a routine screening appointment.

Start with your risk

Your age, family history, previous breast findings, breast density and any chest radiotherapy in the past all influence which tests suit you and when to start.

Understand the tests

Mammography is the main screening test. Breast MRI may be added for people at high risk. Ultrasound is mainly used to assess a specific finding, and may be used as additional imaging in some situations, such as dense breasts.

Agree on a schedule

Guidelines differ between countries and organisations, so it helps to know what each says:

High risk includes, for example, a known BRCA1 or BRCA2 variant, a first-degree relative with one, a calculated lifetime risk of about 20% or more, or chest radiotherapy before the age of 30. Your doctor can help estimate your risk and agree a schedule using your history and local guidance.

Ask about breast density

Dense breasts contain more glandular and fibrous tissue and less fat. According to the American Cancer Society, about half of women who have mammograms in the United States have dense breasts. Dense tissue makes mammograms harder to read and is linked to a higher risk of breast cancer, so it is worth asking whether your report mentions density and whether it changes your plan.

Know the trade-offs

Screening can detect cancer earlier, but it can also lead to false alarms, extra tests and the diagnosis of some cancers that would never have caused harm (overdiagnosis). Understanding this is part of making an informed choice, not a reason to avoid screening.

Your family story and genetics

Family history on both sides matters, your father's as well as your mother's.

Write down the details

Note which relatives had cancer, what type, and at what age they were diagnosed. Include breast, ovarian, pancreatic and prostate cancer, and any male relative with breast cancer.

Ask about genetic counselling

The United States National Cancer Institute (NCI) notes that professional groups suggest considering genetic counselling and testing for people with, for example, a family member with a known BRCA variant, breast cancer diagnosed before 50 in themselves or a relative, ovarian cancer, male breast cancer, pancreatic or high-risk prostate cancer in the family, or Ashkenazi Jewish ancestry.

Understand what testing means

According to the NCI, about 13% of women in the general population will develop breast cancer during their lives, compared with more than 60% of women who inherit a harmful BRCA1 or BRCA2 variant. Genetic tests can identify inherited susceptibility like this. They do not diagnose breast cancer, and they cannot predict with certainty who will develop it. Results should be interpreted with professional support, because they can also have implications for your relatives.

Aurelia Private Health can coordinate genetic testing for inherited susceptibility through our clinical network partner, where it is clinically appropriate. A genetic test complements screening; it never replaces it.

Remember: no family history does not mean no risk. Most women diagnosed with breast cancer do not have a strong family history, which is why screening matters for everyone in the eligible age range.

Reduce what you can

Lower risk is not zero risk, but several factors are within your influence. The WHO lists obesity, harmful use of alcohol, tobacco use and postmenopausal hormone therapy among the factors that increase breast cancer risk.

• Drink less alcohol: alcohol increases breast cancer risk. Reducing or avoiding it is one of the most practical steps available.
• Keep moving: women who are physically active have a lower risk of breast cancer, according to the NCI.
• Support a healthy weight: avoiding excess weight is particularly relevant after menopause.
• Review hormone therapy: discuss the benefits and risks of menopausal hormone therapy with your clinician. Do not stop or change prescribed treatment on your own.

No blame: cancer is never a personal failure, and healthy habits cannot prevent every case. These steps are about improving the odds, not about guilt.

Your October action plan

Use Awareness Month to leave with a clear plan rather than a vague intention:

1. Record your history: gather previous breast reports and the cancer history from both sides of your family.
2. Raise any changes: tell your clinician about any new breast or underarm symptom.
3. Check your screening: confirm whether you are due, and which approach fits your risk.
4. Ask about breast density: find out whether it applies to you and whether it changes your plan.
5. Close the loop: know how you will receive your results and what follow-up is needed.

A test is one step; follow-up completes the plan. Breast awareness complements appropriate screening, and neither replaces the other.