What is the Breast made of? - The New Zealand Breast Cancer Foundation

Priorities in Breast Awareness

Until breast cancer can be prevented and cured, all New Zealand (NZ) women need to be proactive, and make breast awareness part of their life. The New Zealand Breast Cancer Foundation recommends all women follow three ‘Priorities in Breast Awareness’:

Mammogram
Know your breasts
Your family doctor

The aim of the ‘Priorities’ is to detect a breast cancer - if it should develop – early. It is important to be breast aware as the earlier a breast cancer is detected, the sooner treatment is given, and the higher likelihood you will survive this disease.

The New Zealand Breast Cancer Foundation has a free ‘Priorities in Breast Awareness’ card which you can view or download by clicking here. Copies can be requested by phoning 0800 902 732, or by emailing us.

Priority One – have a regular screening mammogram

A screening mammogram is the best method for the early detection of unsuspected breast cancer in women who have no signs or symptoms of breast cancer, in other words, ‘well’ women.

The Foundation recommends a screening mammogram as follows:

Every year for women aged between 40 and 49 (for further information click here to view our Position Statement on Yearly breast screening mammograms for women 40-49 years of age)
Every two years for women from the age of 50 onwards

Free Screening Mammograms: NZ Public Health System

The Foundation strongly supports the National Breast Screening Programme, BreastScreen Aotearoa (BSA), which provides free screening mammograms to New Zealand women 45-69 years of age every two years. To register for this programme, Phone: 0800 270 200 or visit www.breastscreen.govt.nz

Women who are outside the screening age should discuss their breast screening options with their family doctor.

Free Diagnostic Mammograms: NZ Public Health System

Diagnostic mammograms are for women at any age who:

Have significant signs and/or symptoms of breast disease which require investigation

OR
Have no signs and/or symptoms of breast cancer, but are considered to be at high-risk for the development of breast cancer. High-risk women are those who have had:
- A previous breast cancer
- A breast histology demonstrating an at-risk lesion, for example, atypical ductal hyperplasia
- A mother or sister with:
  - Pre-menopausal breast cancer
  - Bilateral breast cancer
  - A breast histology demonstrating an at-risk lesion (Cunliffe Dec 2007)
  
  A high risk woman should discuss with her family doctor the age at which she should commence annual diagnostic mammograms.

Note: Only NZ citizens or NZ residents are entitled to free diagnostic mammograms through the NZ public health system (at a hospital). Most importantly, a referral from a family doctor is required.

Screening and Diagnostic Mammograms: NZ Private Practices

Screening and Diagnostic Mammograms are available throughout NZ at private breast clinics. The cost of a screening or diagnostic mammogram is approximately $100 - $175. Some (but not all) NZ private health insurance companies will reimburse the cost of a screening or diagnostic mammogram.

Priority Two - Know Your Breasts

From the age of 20, the Foundation recommends women become aware of how their breasts look and feel:

Know what is normal for you
Know what changes to look and feel for

Breast changes to see your family doctor about are:

A new lump or thickening, especially if it is only in one breast
A breast pain that is unusual
A change in breast shape or size
A change in the skin of the breast such as:
- Puckering or dimpling
- Reddening or a rash
- Any change in a nipple, such as:
  - A turned-in nipple
  - A discharge that occurs without squeezing
  - Crusting, ulcer or redness

Remember:

You are looking and feeling for any new or unusual change - a change that is different, not normal for you
Discuss any concerns you have about your breasts with your family doctor without delay
Nine out of ten lumps are not cancerous (benign); only one in ten lumps is cancerous

What a lump may feel like

Lumps can feel hard and irregular, or they can feel smooth. A suspicious lump is usually hard and irregular in shape – a bit like a raisin. It may be attached to the surrounding tissue or skin, so it doesn’t move around easily. A non-cancerous lump feels more like a grape (smooth edges and more rounded); however, if you find any unusual lumps get them checked by your family doctor without delay.

Breast self checks

By checking your breasts, you get to know how your normal breasts look and feel. Therefore, you will increase your likelihood of detecting an early breast cancer, if it should develop.

The New Zealand Breast Cancer Foundation recommends women do breast self checks from 20 years of age. Women who carry out breast self checks become aware of what their normal breast looks and feels like, and if breast cancer did develop at some time during their lifetime, hopefully, they will have more of a chance of detecting it. There are examples of many women being ‘breast aware’ and finding their own lumps (either unfortunately before the age for screening mammograms, or unfortunately, when a screening mammogram hasn’t picked it up).

If you wish to check your breasts, good places to do this are:

In front of a mirror
In the shower or bath

In front of a mirror
(a) Place your hands at your sides and look for any changes
(b) Place your hands on your hips and then press your shoulders and elbows forward - look for changes.
(c) Raise your arms and clasp your hands above your head - look for changes

In the shower or bath
With the fingertips of your three middle fingers, use soap to glide over each breast. The way you check your breasts does not matter; there isn’t a right or wrong way (for further information click here to view our Position Statement on Breast Awareness). The main thing is to cover your entire breast tissue, from just below your collarbone to under your breast, and from your mid-chest to your ribs at the side of your chest. Also, with each arm by your side, press your fingers firmly up into each armpit. Breast self checks may make some women feel very anxious, while others will feel reassured; they are - very much - a personal choice.

Lump sizes
The circles below show lump sizes at various stages of detection.

	2 mm This is the size of the smallest cancer found by regular mammography
	14.5 mm Average size of cancer found by regular mammography
	15.6 mm Average size of cancer found by a first mammogram
	22 mm Average size of cancer found by chance

Note: circle sizes for demonstration purposes only. Size of circle on screen may be affected by your computer settings.

Priority Three - Your Family Doctor

The Foundation urges women - at any age - to consult their family doctor, without delay, if they have the slightest concern about their breasts:

Discuss your need for a clinical breast examination:
- The Foundation recommends women have an annual clinical breast examination from 40 years of age, and in-between their two yearly screening mammograms
Discuss your personal risk, particularly if you have:
- A previous personal history of breast or ovarian cancer
- A strong family history of breast or ovarian cancer
- An at-risk lesion, for example, atypical ductal hyperplasia
Discuss your need for a mammogram

Your personal need will be assessed

Summary

Be Breast Aware	20-39 years	40-49 years	50+ years
1. Screening mammogram
2. Do breast self checks
3. Clinical breast examination by your family doctor

The Foundation encourages women to make breast awareness part of their life. Screening mammography, breast self checks and discussing any breast concerns/changes – without delay - with your family doctor all contribute to the likelihood of detecting breast cancer early. Until breast cancer can be prevented and cured, we need to be proactive about the three ‘Priorities in Breast Awareness’.

Priorities in Breast Awareness

Priority One – have a regular screening mammogram

Priority Two - Know Your Breasts

Priority Three - Your Family Doctor

Summary

About Breast Cancer