In October, much attention is paid to breast cancer awareness, but what about breast awareness as a whole? To get the bigger picture, we talked with Maia Sullivan, DO, with University of Michigan Health-West; Jamie Caughran, MD, FACS with Trinity Health Grand Rapids; Natasha Peoples, NP-C, MSCP, with Corewell’s Women’s Health & Wellness Center; and Lilly Stallmer, PA, with The Cancer & Hematology Centers.
How do I complete an at-home self-breast exam and how frequently should I do so?
“Patients should complete their exam standing up either in the shower or looking in the mirror,” Stallmer said. “I recommend starting in the armpit and slowly moving three fingers down and up in a ‘lawn mower’ type path from the outside to the inside of your breast. You are looking for a lump or hard spot that does not feel like the breast tissue around it, and if the area is fixed or not able to move smoothly between your fingers. If you ever notice anything concerning, you should contact a provider for further assessment.”
She added, “Perform this exam at least once per month, but not around the menstrual cycle (if not postmenopausal), as breast changes during this time can cause the breasts to feel more ‘lumpy.’”
What does it mean to have dense breasts and how do I know if mine are?
“You cannot tell what your breast density is by performing a manual breast exam,” Caughran said. “The ratio of fat to gland is what determines how dense or white a breast appears on a mammogram. However, learning to know your normal breast tissue texture is important so you can detect changes in your body.”
“It doesn’t really matter the size of your breasts; you can have a lot of tissue or little tissue, so there’s not necessarily a correlation with density and larger breasts,” Sullivan added.
Are mammograms safe? What alternative screening options are available?
“I reassure patients that mammograms are safe and remain the most effective, evidence-based tool for early detection of breast cancer,” Peoples said. “The amount of radiation exposure is very low and considered safe for routine screening. For some patients—such as those with dense breast tissue or higher risk—additional screenings, like ultrasound or MRI, may be recommended. These are typically supplemental and not replacements for mammography.”
Should I be concerned if I have breast pain or find a lump?
“Breast pain is very common and is usually not cancer—it’s often related to hormones, especially around the menstrual cycle,” Peoples said. “Most breast lumps are also benign (like cysts or fibrocystic changes). Even though most findings are not cancer, every new lump or persistent symptom should be checked to be safe.”
Besides lumps, what are some other abnormalities I should watch for in my breasts?
“While a lump is one of the most well-known concerning findings in breast cancer, other symptoms could be skin thickening, skin dimpling, nipple inversion, nipple discharge, and a feature that is called peau d’orange or if the skin of your breast begins to look like the outside of an orange peel,” Stallmer, said. “Breast cancer is not typically painful, but if you feel tenderness or pain in a certain area, it can be a good idea to be evaluated, as well, just to be safe.”
What should I know if I’m considering getting breast implants?
“You still need to continue to have mammograms,” Sullivan said. “It’s just important that the radiology tech knows that you have implants, so they can use a specialized technique to make sure that they’re getting good imaging of the actual breast tissue itself. A breast or plastic surgeon may recommend imaging, like an MRI or an ultrasound, in addition to the routine mammograms, but that’s case specific.”
Peoples added, “They are not lifetime devices—many people will need additional surgery over time. Patients should have a detailed discussion with their surgeon and review the FDA ‘patient decision checklist’ before proceeding.”
How can I expect my breasts to change as they age?
Breasts actually tend to become less dense over time, and there’s more fatty tissue as we get older,” Sullivan said.
“Breast changes are a normal part of aging, especially around menopause,” Peoples added. “These include less firmness and fullness, smaller size or change in cup size, sagging, changes in nipple appearance, and more lumps. While most of these are normal, you should still report any new or unusual changes to your provider.”
Allison Kay Bannister has been a West Michigan resident since 1987 and a professional writer since 2002. A GVSU alumna, she launched her own freelance writing business in 2017. Allison is a cookie connoisseur, word nerd, aspiring gardener, and metastatic breast cancer thriver who loves traveling in Michigan and beyond, and enjoys art, world cuisine, wine, music, and making homemade preserves.
This article originally appeared in the Fall ’26 issue of West Michigan Woman.