October is the month to paint the streets pink for a really good reason – it’s Breast Cancer Awareness month!


Breast cancer is by far the most common cancer affecting women all around the world, and even those without a family history are not immune so here are some guidelines to guide you with your own breast care. The recommendations for breast screening differ around the world and so this topic is actually not very simple, so this serves to briefly highlight some of the more commonly practiced recommendations.


  • Know your own boobs! As bizarre as that sounds, the subtle changes that might indicate a problem, may only be possible if you are able to notice the slightest change. Monthly self-examination of your own breasts from the age of 20 is recommended to get you familiar with your breasts so that you are able to notice the subtlest of changes. If you have any concerns, get them checked out by a medical doctor!

CANSA has recommended three steps in self-examination.

  1. In the Mirror
    • In the mirror check for any changes in your breasts. This may include any colour or texture changes of the skin, any areas that are dimpled, any nipple discharge or size differences.
    • Inspect in four ways: arms at your side, arms overhead, hands on your hips and bending forward

2. Lying down

    • Use the flat part of your fingers and move in circular motions to cover the entire area of the breast. This areas is from under your arms on the side to the midline and up to the clavicle (the bone from the top of your chest to your shoulder)
    • repeat this on both sides

3. In the bath

    • With your right arm raised check your right breast with a soapy left hand with the method above.
    • Repeat on the left side


  • It is recommended that women over the age of 40 have 6 monthly clinical breast examinations by a qualified medical person. Synch these with your regular gynae checks and times when you visit your GP. Women between the ages of 20 and 39 should get clinical breast examinations done every 2-3 years.
  • It is generally recommended that women between the ages of 40 and 54 should have an annual mammogram. After 55 and generally until the age of 70, this can become less frequent to every two years (CANSA). Because breasts can me more tender at different times of the month, it might be more comfortable to have a mammogram done two weeks after your period when your breast are less sensitive. Minimize your caffeine intake one week before your mammogram as it can make your breasts more sensitive. There are risks involved in having a mammogram, such as the exposure to XRAYs. It is also possible to get a false-positive test result, which can understandably cause potential anxiety.
  • Please tell your doctor if you have any family history of breast or any other cancer as some women will be at a higher risk of breast cancer, and so the guidelines above will look a little different for this group as more caution is necessary. If imaging of the breast is needed from a younger age an ultrasound and not a mammogram may be more suitable. This is because breast tissue is generally more dense in a younger woman.
  • What about screening if you have breast implants? There should be no need to do anything differently to what is recommended for your age group and risk profile.


This is a huge topic with varied advice as mentioned. If you have any concerns or questions, do not hesitate to ask. Careful screening and early identification can significantly improve the outcome for women who get breast cancer. If you are concerned – ask!

Written by Dr Bianca Birdsey