As you begin to experience the symptoms of menopause, it's a good time to take stock of your body-especially taking care of your breasts, as during the menopausal transition and after it is important to take breast health seriously. We explain some important distinctions between fact and fiction to help you understand how your breasts respond to aging.
If you don't wear a bra your breasts will eventually sag.
False. This is a common miscon-ception. But in fact, even if you had diligently worn a bra 24/7, your breasts would inevitably sag after menopause. The mammary glands in your breasts usually shrink after menopause. For some women, fat replaces the glands that once filled out the breast. Because fat tissue has no structure, it sags. Other than a surgical breast lift or strength-training exercises, such as push-ups, which strengthen the pectoral muscles in the chest, nothing's going to reduce that sagging.
Lumpy, sensitive breasts are normal in perimenopause.
True. Breast pain is very common during perimenopause. In fact, uncomfortable breast pain is sometimes an early sign that menopause is approaching. Don't fret, though, it won't go on forever. The tenderness and lumpiness should subside after menopause. Fluctuating hormones are likely to blame, though sagging breasts may contribute. They are thought to create discomfort as fat pulls the breasts downward. To alleviate that discomfort, sleep in a light cotton or sports bra.
Estrogen fuels breast cell growth, so breast cancer risk declines after menopause.
False. Breast cancer rates rise with age, despite the drop in estrogen levels. The good news is that postmenopausal breast cancers tend to grow more slowly than those in younger women, making them less dangerous. No matter what your age, early detection is the key. It is important to continue screening through regular clinical breast exams and mammograms or other tests. You and your healthcare provider also should discuss the option of breast self-exams. While research has not established its value in early detection of cancer, they may help you become more familiar with your breasts and therefore better able to notice any problems and seek further screening.
There's a new drug available that can help reduce the risk of breast cancer.
True. In 2007, the U.S. Food and Drug Administration approved Raloxifene, marketed as Evista(r), to reduce the risk of certain breast cancers in postmenopausal women. It's not suitable for everyone, though, and it doesn't treat existing breast cancer or lower the risk of recurrence. If you have a history of clotting disorders or are at risk of having a stroke, you'll need to assess the risk-benefit ratio with your healthcare provider.
Feeling tense during a mammogram makes it more uncomfortable.
True. Anxiety can lead to greater discomfort, so try using some relaxation techniques before your appointment. Deep breathing exercises and meditation can go a long way in reducing pre-appointment jitters. The more relaxed you feel going into the mammogram, the less uncomfortable the procedure will be. Remember, any discomfort is over very quickly.
Mammograms work better on postmenopausal women.
False. Not necessarily. In fact, breast density is more a factor than age. It is difficult to detect cancer in women with dense breasts at any age, because glands, ligaments, and other non-fat tissues appear white on a mammogram, as do cancer cells. Fat, on the other hand, looks black, making tumors easier to spot. About half of postmenopausal women experience a reduction in the density of their breasts significant enough to improve a mammogram reading. Using hormone therapy can increase breast density, adding to the challenge of detecting tumors.
A mammogram is the only way to detect cancer.
False. If you are a breast cancer survivor, have dense breasts, have a strong family history of cancer, or have the BRCA1 and BRCA2 cancer genes, consider having a breast ultrasound or breast MRI in addition to your mammogram. If you're at high risk for developing breast cancer, some experts recommend a breast MRI every three years. Using a facility dedicated to breast health is another good option. Studies find that radiologists who specialize in reading mammograms catch twice as many cancers as those who don't. If you find a breast lump, it needs follow-up with a surgeon, even if the mammogram is negative.
Self-Exam Tips
Even though breast self-exam has not been proven to improve breast cancer outcomes, women can and do find their own cancerous lumps. The more often you examine your breasts, the more you'll learn about them, which may make it easier to detect when something unusual has occurred. However, don't use regular self-exams as an excuse to skip your mammogram or clinical breast exam. Mammograms and other diagnostic tools, such as ultrasound and MRI, often catch cancer earlier than breast self-exams. Breastcancer.org has the following advice:
If you're still menstruating, do a breast self-exam (BSE) a few days after your period ends; your breasts will be less lumpy and less tender at this time.
If you're postmenopausal, check your breasts on the first or last day of the month.
Different areas of the breasts often feel quite distinct. For example, the upper, outer quarter (close to your armpit) tends to be lumpy and bumpy, while the lower half may feel like a sandy or pebbly beach. Another area might feel like a lumpy bowl of oatmeal. The important thing is to get to know what is normal for you. If you do feel an unusual lump, don't panic. Book an appointment with your healthcare provider to get it checked out.
And finally, remember that eight out of 10 lumps that are removed will turn out to be noncancerous.
Importance of Early Detection
Finding breast cancer early means that you have more treatment options, and your chances of survival are better. Survival is less likely if the cancer has already spread outside the breast when it is diagnosed. As an example, about nine out of 10 women whose cancer is diagnosed before it has spread outside the breast will be alive five years later. However, if the cancer has spread to other parts of the body outside the breast and lymph nodes at diagnosis, only about two out of 10 women will be alive five years later. This means that you should be getting regular clinical breast exams and mammograms or other breast imaging at the interval recommended by your healthcare provider.
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