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Paige Swales, CNM, on Breast Self-Awareness: Knowing Your Own Normal

Despite breast cancer being the most curable when caught early, the warning signs are not the same for all women. Our bodies are unique, and so is what’s normal for our breasts.

Given this, experts now recommend that women focus on breast self-awareness as opposed to self-breast exams. “The difference is that we now ask you to become familiar with how your breasts normally look and feel. This helps you to notice any changes,” said certified nurse midwife Paige Swales, CNM of Foothills Community Midwives, during a free online health lecture on spotting the signs of breast cancer.

Breast Self-Awareness: Knowing Your Own Normal

Swales said we now ask patients to become familiar with what’s their “normal” and notice any changes in:

  • breast size
  • shape
  • texture such as lump(s)
  • skin features (dimples, swelling or rash)
  • nipples (discharge other than breast milk, including blood)
  • area under your arms

She said to contact your provider if you notice any one of those changes. Swales warns that your provider may want to see you right away if you have:

  • Any change in the size or the shape of the breast
  • Pain in any area of the breast
  • Nipple discharge other than breast milk (including blood)
  • A new lump in the breast or underarm


VIDEO: Watch the online lecture on "Spotting the All the Signs of Breast Cancer"

Breast Self-Awareness Includes Understanding Your Risk

“One-in-eight women will be diagnosed with breast cancer at some point in their lives and it’s the most commonly diagnosed cancer in women in the United States after skin cancer. It’s important to know your risks and discuss these with your provider,” said Swales.

When assessing your risks consider:

  • Your personal and family history of breast and female cancers.
  • As you age your risk increases.
  • Being a female increases your risk.

Additional factors that increase your risk for breast cancer include:

  • Having dense breasts
  • Having inherited genetic mutations
  • Having had a breast disease that’s not a cancer
  • Having higher estrogen levels, high bone density and/or hormone replacement therapy
  • Being black or of Ashkenazi Jewish descent
  • Not having had children or having your first child after 35
  • Not having breast fed
  • Being overweight
  • Consuming alcohol in excess
  • Having had your first period earlier than age 12
  • Leading a sedentary lifestyle

While some factors are out of your control, Swales said there are strategies to reduce your risk of getting breast cancer, which include:

  • Maintaining a healthy weight
  • Exercising regularly
  • Limiting alcohol consumption
  • Carefully choosing hormone replacement
  • Breastfeeding (if you can)


Swales also stressed that getting screened is another important element of breast self-awareness noting, “Breast cancer screenings provide early detection that enables us to more easily treat and cure this disease.”

Talk with your provider about which screening tests are right for you if you are at higher risk. Have a mammogram every year starting at age 40 if you are at average risk.

Clinical breast exams are physical examinations included in annual well-woman visits. Swales recommends having a clinical breast exam at least every 3 years starting at age 20, and every year starting at age 40.

Perform an Online Assessment

The National Cancer’s Institute has an online assessment you can use to determine your risk of breast cancer. It can be found at:

To make an appointment with Paige Swales, CNM, call Foothills Community Midwives at (303) 415-4045.

Click here to view the PowerPoint slides from the online lecture on "Spotting All the Signs of Breast Cancer."