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Beyond the bra: understanding and caring for your breasts

Many people associate breast health only with mammograms and breast cancer screenings, but good breast health starts at a young age. From regular screenings to healthy lifestyle choices, there are many things women can do to protect their breast health. 

In this article, Tryon Medical Partners gynecology specialist Dr. Philomena Salvemini provides three key areas of care for your breasts. 

1. Take a hands-on approach with breast self-exams.

Breast self-exams should start in your teens and early 20s, and you should perform them every month. Understanding your breasts’ unique architecture and recognizing any changes is crucial for early detection of breast cancer. Dr. Salvemini recommends starting at the areola and doing little circles around the breast, up to the clavicle and the armpit, which is a common place for malignancies to be located. However, you should avoid doing self-exams around your period as it is normal for your breasts to change during your cycle. If you experience any abnormal changes, even if you are younger than 40, reach out to your doctor.

“I often hear about tenderness from my patients who perform self-exams,” Dr. Salvemini notes. “While tenderness may sometimes be cause for concern, it is often due to either excessive caffeine intake or wearing an improperly fitting bra. I generally recommend patients wear a bra that fits well and limit caffeine intake to no more than 150 milligrams a day. If it’s something you’re worried about, come in to see us.” 

2. Size can matter – consider your options.

Dr. Salvemini says she often hears concerns from her patients about breast size. Some women have larger breasts that can cause back pain and unavoidable deep grooves in their shoulders from bra straps. On the other hand, some women may feel self-conscious about their smaller breasts. She encourages anyone struggling with breast size to consider their options: reduction or augmentation are possible solutions. For those considering breast reduction surgery, insurance coverage is often provided given they can be detrimental to overall health. For breast augmentation, while there is some risk of breast implant illness (BII), it is relatively uncommon. 

“I do like to point out that there is a lot of misinformation out there about breast implants causing illness,” Dr. Salvemini notes. “But of course, if you feel like you are struggling with breast implant illness, reach out to your surgeon or gynecologist immediately.” 

3. Treat your breasts to a check-up.

Breast cancer screening and risk assessment are crucial for early detection and prevention of any abnormalities. Women should have a clinical breast exam every year starting at age 18. Your primary care doctor can perform this exam, and you don’t need to make a separate gynecology appointment. It is also recommended to start mammogram screenings after the age of 40, especially if you have a family history of breast cancer.

If you are worried about an increased risk of breast cancer in your family, speak to a breast surgeon or geneticist. They can assess your risk by discussing any malignancies in your family and help determine your lifetime risk. If you are at a significant risk of breast cancer, you may need to start screening earlier, with an MRI and then a mammogram.

“If you are ever concerned about a lump, unusual tenderness, nipple discharge outside of lactation, or anything else abnormal, visit your doctor,” Dr. Salvemini emphasizes. “It’s always better to be safe than sorry.” 

Visit the Tryon Women’s Center website to learn more about lifelong breast care today.