During a breast self-exam, you examine your own breasts in an attempt to detect any cancer if it is present. Breast self-awareness is a less formal process of knowing the normal look and feel of your breasts and reporting any changes.

There are expected to be about 180,000 new cases of breast cancer and about 40,000 deaths from breast cancer in the United States in 2008. Most doctors feel that early detection of breast cancer can be life-saving. Breast self-exam or self-awareness may play a role in early detection.

There are many guides to the breast self-exam. The test is probably easiest after your menstrual period when breasts are softest and least tender. The American Cancer Society offers a detailed guide with illustrations at www.cancer.org/docroot/CRI/content/CRI_2_4_3X_Can_breast_cancer_be_found_early_5.asp. For breast self-awareness, a formal technique and schedule are not followed, but women are encouraged to know the look and feel of their breasts and report any changes as soon as possible to their doctor.

You should let your doctor know right away. Things to report would include any lump in the breast and any change in the size, shape, color, or skin of the breast. Skin changes might be dimpling, puckering, or scaling. Also you should report any nipple discharge, changes, or pulling to one side.

• Female
• Age > 40 and especially age > 50
• Personal history of breast cancer
• Family history of breast or ovarian cancer
• Gene mutations including BRCA1 and BRCA2 mutations
• Family history of male breast cancer
• Ashkenazi Jewish ancestry
• Prior abnormal breast biopsy
• Ethnicity (highest incidence in Caucasians, highest death rate African-American)
• Prior chest radiation therapy
• Menarche < 12
• Menopause > 55
• DES intake
• First child after age 30 or no children
• > 1 alcoholic beverage per day
• Obesity especially after menopause
• Hormone therapy (some controversy); strongest association in people on recent or current combined estrogen/progesterone therapy
• Sedentary lifestyle
• High fat diet (maybe)
• Many others remain controversial: anti-perspirants, pollution, night-shift work, underwire bras, induced abortion, breast implants, smoking, secondhand smoke