The breast is one of the few organs in the body that can be easily seen and felt, making it possible for every woman to become familiar with her own breast health. Becoming aware of what is normal is the first and most important step towards identifying any change early.
To understand the breast, we must first know what it is made of. The breast is composed mainly of two types of tissue: fatty tissue, which gives the breast its size and softness, and glandular tissue, which is responsible for producing milk. The proportion of these tissues varies from woman to woman and also changes over time.
These changes are completely natural and are largely influenced by circulating female hormones such as oestrogen and progesterone. These are the same hormones that regulate the menstrual cycle, pregnancy, and menopause, and the breast is highly sensitive to their effects. As a result, the breast responds to hormonal fluctuations throughout a woman’s life, which explains the changes seen from puberty, through pregnancy and breastfeeding, and finally during menopause.
At puberty, rising hormone levels stimulate the breast glands to grow and develop, and the breasts begin to take shape and size. During pregnancy, hormone levels increase further, preparing the breasts for their primary function of milk production, and the breasts often become larger and fuller. During breastfeeding, the milk-producing glands are fully active, and the breasts may feel firm before a feed and softer afterwards as milk is released. With menopause, as hormone levels decline, active glandular tissue gradually reduces and is replaced by fatty tissue, making the breasts feel softer and sometimes smaller.
At every phase of a woman’s life, changes occur in the size, shape, and composition of the breasts. While most of these changes are normal, it is important for every woman to understand them and become familiar with her own breasts so that she can recognise when something feels different. Unfortunately, many women do not routinely examine or pay attention to their breasts.
Spending a few minutes each month examining the breasts can help in identifying unusual changes early. Self-breast examination is a simple habit that helps women become familiar with the normal look and feel of their breasts, making it easier to detect new changes. It can play a crucial role in identifying breast problems, including cancer, at an early and more treatable stage.
The ideal time to examine the breasts is about seven days after the menstrual period ends, when hormonal influence is least, and the breasts are less tender. Women who have attained menopause can choose a fixed date every month. Examination should begin by standing in front of a mirror with the arms by the sides and then raised overhead, observing for any change in size, shape, skin dimpling, redness, or nipple appearance. Next, using the flat part of the fingers, the entire breast should be gently palpated in small circular movements, covering the area from the collarbone to the lower part of the breast and into the armpit. This can be done while standing, such as during a bath, and again while lying down.
If a woman notices a new lump, persistent pain in one area, skin changes, nipple discharge, or nipple inversion, she should not panic but should consult a doctor without delay.
It is also important for women to understand that symptoms affecting both breasts are often related to hormonal changes rather than cancer. Pain, heaviness, or tenderness involving both breasts, or a general sense of fullness on both sides, is commonly due to normal hormonal fluctuations. Many women experience breast tenderness in the days leading up to their menstrual periods, and this usually occurs bilaterally. Such cyclical, bilateral symptoms are less likely to be cancer-related.
There is a common misconception that breast pain is a sign of cancer. In reality, most breast cancers do not present with pain in the early stages. More commonly, cancer presents as a painless lump. Because it does not cause discomfort, it may not interfere with daily activities, and many women ignore it, assuming it to be a harmless fatty lump or a benign growth. This is one of the most common reasons for delayed medical consultation and late diagnosis.
For this reason, awareness and regular self-examination are crucial. Any new lump, particularly one that is painless and confined to one breast, should be evaluated by a doctor without delay. Early assessment does not imply cancer but ensures that, if a problem is present, it can be detected and treated at the earliest possible stage, when outcomes are best.
Dr Swathika Rajendran
Junior Consultant – Breast Surgery,
Kauvery Hospital, Chennai
