October means there’s pink everywhere, bringing awareness to one of the most common cancers. It doesn’t take much to be affected by this widespread illness– most of us have had a relative with breast cancer or know someone who does. My mother was diagnosed over 10 years ago with breast cancer (she’s all good now), I have friends with mothers who have been diagnosed, and even friends themselves. While this diagnosis brings with it astonishment on my behalf at how incredibly strong and resilient these women are, I think we’d all rather not realize it that way. I’ve put together some facts on breast cancer below—know your risks, know the signs, and be proactive in your health care.

Risk Factors

Increased age, sex (female), history of a benign breast disorder (such as fibroadenomas), a family history of breast cancer, younger age onset of menses or a later onset of menopause (aka a longer period of time in which you are exposed to hormones), no pregnancies or first child after age 30, no breastfeeding, increased alcohol intake, obesity, genetic risk (BRCA 1, BRCA 2).

Breast exams

While it is no longer recommended to teach the self breast exam to patients, many providers still encourage patients to do this regularly. Breasts naturally feel nodular and lumpy, causing concern in some patients where concern isn’t warranted. But it’s useful to know your own—when you know what normal feels like, you’ll know when something doesn’t feel normal. If something doesn’t feel normal, make sure and ask your provider to check it out. Yearly mammograms are recommended to start at age 40, but based on your individual risk may need to be initiated sooner. Make sure and discuss with your provider your own risk and when it is recommended that you begin breast cancer screening.

Breast Pain

While breast pain isn’t typically a cause for concern for providers, it can absolutely cause some alarm for patients. If you are experiencing breast pain, ask yourself some questions. Is there a mass associated with this pain? Is it bilateral or unilateral? Is it cyclical (only occurring during a certain period of the month, every month)? Have I been sized for a bra recently? How much caffeine am I consuming? Typically, breast pain is caused by a few things: hormones (causing cyclical pain, like breast tenderness near your period), incorrect bra size, or too much caffeine.

Typically (and I bold this, because this does not mean always!) benign breast lesions, such as hormonal fibrous tissue or cystic changes or fibroademoas (benign breast mass), tend to be firm, sore or tender to touch, moveable, and may fluctuate in size throughout the month. Cancerous lesions typically (again, not always) tend to feel firm, irregular with poorly defined borders, and are immobile in the surrounding tissue; there may also be associated skin changes on the breast, such as skin dimpling. However, any mass or skin changes on the breast should be brought up to your provider. It’s not always easy for us to distinguish between cancerous and noncancerous lesions through an exam alone, so it’s even harder for patients to make that call. If something feels unusual, it is important that you tell your provider about it at your next visit.