Know Your Lemons
Corrine Beaumont lost her grandmothers to breast cancer at the ages of 40 and 62. When she had a look for information on the signs of breast cancer she should be looking out for, there was surprisingly little out there to help her. She felt compelled to come up with something to help women like her – thus, the Know Your Lemons campaign was born.
Lemons became a metaphor for breasts as she tried to make a simple, visual way to show what breast cancer symptoms can look and feel like. According to Corrine, around one in three women are diagnosed with breast cancer because they found something between their regular mammograms (free breast screenings) and reported the change to their doctor. When found early, breast cancer survival rates are high – almost 100% when found in stage one – so being acutely aware of any changes is vital.
How Often To Check
Dr Ram Prasad, consultant breast surgeon who specialises in breast disease, breast surgery and reconstructive surgery at Pall Mall Cosmetics, says all women aged 50 and over are entitled to a mammogram and check-up every three years up to their 71st birthday. “In otherwise healthy women with no medical or family history of cancer, 50 is the ideal age for a mammogram. I would say women – and men – over 30 should be checking for abnormalities at least once a month. While studies suggest it is uncommon for breast cancer to develop before the age of 30, the sooner you get into the habit of checking the better.”
Understand What's Normal
Corrine explains some doctors don’t recommend self-examination because some women will find that if they don’t feel a lump, then there isn’t a problem, but a mammogram can pick up a cancerous lump before you can feel it. Others may swing the other way and worry about every little lump and bump. “Rather than recommend against self-exam, we should be better at explaining how it works and the purpose of it,” she stresses. “The main message is: don’t think of it as a ‘hunt’ to find breast cancer. Instead, see it as part of getting to know what is normal for you and how to be confident of the steps to take if a breast change doesn’t go away.”
Be Cycle Savvy
Dr Anne Bruinvels, founder of OWise, the first app to offer breast cancer patients personalised medical information throughout their treatment, also recommends checking at the right time in your cycle. “Due to hormonal fluctuations, breast tissue changes throughout the month. The best time to perform a self-exam is usually a week after your period finishes. After 50, mammograms should not replace checking your breasts and you should still do so regularly – try choosing a memorable day of the month when you can routinely perform your self examination.”
What To Look For
Corinne explains there are 12 signs of breast cancer to keep an eye out for. These changes are reflected in the Know Your Lemons campaign:
Hard Lump Within The Breast: “This is the most common sign of breast cancer. It’s a lump that is deep in the breast, which often feels hard and is immovable. Many lumps are harmless, being a cyst or a fibroadenoma (lump made of various tissues), but if you notice a hard lump or any change that doesn’t change along with your menstrual cycle, contact your doctor.”
New Size/Shape: “It’s common for breasts to be different in size, but if one breast changes size, swells, flattens or unexpectedly droops, and these changes do not seem to relate to your menstrual cycle, this may be a sign of breast cancer.”
Dimples: “Dimples – or indentations in your breast – can be temporarily caused by wearing tight clothing. However, if it doesn’t go away, it can be a sign of breast cancer. To better spot dimples, lift your arms up above your head to see if the skin of the whole breast moves with you as you raise and lower your arms.”
Nipple Crust: “Look out for a scab-like red or white crusted surface that can be sore and doesn’t go away.”
Red Or Hot: “Most of the time this is a sign of infection or a symptom common to breastfeeding or eczema. If antibiotics or other treatments don’t improve symptoms, see your GP.”
Unexpected Fluid: “Discharge from the nipple is fairly common, but if not related to an infection, pregnancy or breastfeeding – or if it’s clear or has blood in it – contact your doctor.”
A Thick Area: “Part of the breast may feel denser compared to the rest. This can occur during menstruation and breastfeeding, but keep an eye out for thickening that doesn't go away or worsens.”
Skin Sores: “Breast cancer can break down the skin of the breast to form an open wound. Infection of this may cause a bad smell and/or leakage. Skin sores are usually accompanied by a hard lump.”
Bumps: “Cancerous lumps can grow on the surface of the breast. Other causes of lumps are cysts or lumps made of various tissues that are harmless. Keep an eye out for changes.”
Sunken Nipple: “If you notice a change in your nipple where it is sinking, flattening or turning, speak with a doctor.”
‘Orange Peel’ Skin: “The skin may or may not change colour, but the skin may appear dimpled, like the skin of an orange.”
Growing Veins: “More pronounced blood vessels are usually from weight gain or breastfeeding. In rare occasions this may be a sign of breast cancer.”
How To Do It
To check your breasts, Anne recommends starting by removing your clothes from your upper body and standing in front of a mirror. “Keep your shoulders straight and put your arms on your hips. Look at your breasts in the mirror and check their size, shape and colour. Then raise your arms and look for the same changes.”
Anne also recommends feeling your breasts while lying down. “Using a firm, smooth touch with three of your fingers, keeping the fingers flat and together, move your fingers in a circular motion, about the size of a penny. Cover the entire breast from top to bottom, side to side, and include under your armpit and collarbone, as breast tissue extends to here. Going up and down vertically in rows is a good technique to make sure the whole breast is checked. Finally, repeat the same technique whilst standing or sitting with your arm raised.” Many women find the easiest way to feel their breasts is when their skin is wet and slippery, so you may want to do this final step in the shower.
Try An App
It might be more helpful to get acquainted with checking your breasts using something more visual – the Know Your Lemons app will coach you through self-examination, guiding you through every part of the breast, armpit and collarbone, and what you should be feeling. You’ll also find a three-minute training video, which goes over the different lumps and bumps in the breast, so you can work out what’s normal and what’s not.
Know When To Get Help
What is important, the experts say, is being aware of how your own breasts feel normally and then looking out for any unusual changes. “Our bodies aren’t completely symmetrical, so it’s normal for your breasts not to be identical, but if you notice a lump or any of the 12 signs, visit your GP,” says Anne. And if you are over 50, don’t wait until your next mammogram.
For more information on Know Your Lemons and to download the app, visit KnowYourLemons.com, and for more information on OWise, visit OWise.uk. Get further advice from Breast Cancer Care, Breast Cancer Now and Cancer Research UK.
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