Your Guide to Breast Health

Taking care of your health doesn’t always mean significant changes. Often, it’s the small things that make the biggest difference. When it comes to breast health, knowing how your breasts look and feel gives you a powerful tool: the ability to notice when something changes. That awareness, paired with the right screening schedule, helps detect problems early, when there are more treatment options and better outcomes. Whether you’re approaching your first mammogram or you’ve been getting screened for years, this guide is here to simplify the process and help you feel more in control of your breast health.

How Breasts Change Over Time

Breasts are made up of glandular tissue, ducts, fat and connective tissue—and they naturally change over time. Hormones during puberty trigger development, while pregnancy may cause rapid growth, darkened nipples and stretch marks. Breastfeeding further alters shape and fullness. After menopause, declining estrogen leads to less dense, more fatty tissue. Breasts may shrink, sag or feel softer, and the areola can fade or nipples appear smaller.

Most of these changes are entirely expected. But any new lump, swelling or skin change—especially if it’s one-sided or doesn’t go away—should be checked. Knowing what’s normal for your stage of life helps you decide when to call your provider and when to breathe easy.

Have Breast Self-Awareness

You don’t need a complicated checklist to be breast aware. While showering or getting dressed, take note of the skin, shape and texture of each breast. Knowing your baseline makes it easier to detect an unusual change, such as a new lump, nipple discharge, skin dimpling, swelling, a nipple that begins to pull inward or persistent redness and heat. If you notice a change, don’t wait for your next screening. Make an appointment now. When in doubt, we would rather see you and reassure you.

Clinical Breast Exams

Clinical breast exams, a physical examination of your breasts by a trained healthcare professional, are sometimes included in your routine visits. While not a replacement for mammograms, these exams may be recommended every one to three years starting in your 20s and 30s, and yearly for those over 40, depending on your provider’s assessment and your personal risk factors.

Screening Basics for Average Risk

If you’re considered at average risk for breast cancer, it means you don’t have a personal history of the disease, a known genetic mutation (such as BRCA1 or BRCA2) or a strong family history of breast or ovarian cancer. Most people fall into this category.

Screening helps detect cancer early, before it causes symptoms, when there are more treatment options. For individuals at average risk, the American Cancer Society recommends that people aged 40 start screening with annual mammograms. Those aged 55 and above can continue yearly screenings or switch to every other year, provided they’re in good health.

If You Might Be at Higher Risk

Some people face a higher risk of developing breast cancer. The American Cancer Society recommends that women at high risk get both a mammogram and a breast MRI every year, typically starting at age 30. This includes individuals who:

• Have a lifetime risk of breast cancer of 20%–25% or higher
• Have a known BRCA1 or BRCA2 gene mutation
• Have a first-degree relative (parent, sibling or child) with a BRCA mutation and have not had genetic testing themselves
• Had radiation therapy to the chest before aged 30
• Have Li-Fraumeni, Cowden or Bannayan-Riley-Ruvalcaba syndrome, or have a first-degree relative with one of these syndromes

MRI should be used in addition to, not instead of, mammography. While MRI is more sensitive, it can still miss cancers that mammograms catch.

If you’re aged 25 or older and haven’t had a formal breast cancer risk assessment—especially if breast or ovarian cancer runs in your family—it’s worth having the conversation. A simple risk evaluation could change your screening schedule and help ensure you're using the right tools to stay on top of your breast health.

Dense Breasts and What Your Letter Means

Breast density describes how much fibroglandular tissue you have compared with fat on a mammogram. Dense tissue is common and normal, especially in younger people. It also matters because it can slightly increase the risk and make mammograms more difficult to interpret. All U.S. mammography facilities must tell you in your results whether your breasts are “dense” or “not dense,” and your clinician must receive a density assessment in the report. If your letter says your breasts are dense, talk with your healthcare provider about whether supplemental imaging, such as ultrasound or MRI, makes sense for you, based on your overall risk.

A Word From an Expert

“Early detection doesn’t just save lives—it expands choices. When we find breast cancer sooner, we can often use oncoplastic and reconstructive techniques that remove the cancer while preserving or restoring the natural breast shape. My goal is to partner with each patient so their treatment plan fits their body and their life, from the first mammogram to the finish line of recovery.”

— Ayesha Punjabi, MD, Plastic and Reconstructive Surgery, Southwest General Medical Group

What To Expect at Your Mammogram

A screening mammogram usually takes about 20 minutes. You’ll stand in front of the machine while each breast is briefly compressed—often uncomfortable but quick. Try to schedule when your breasts are least tender (many people prefer the week after a period). Avoid using deodorant or powders on exam day, as they can appear as white spots on your images, making interpretation more difficult. Many centers utilize 3-D mammography, which captures images in thin slices, providing radiologists with a clearer view. If you’re asked to return for more images or an ultrasound, remember that most callbacks do not end in a cancer diagnosis—they are a standard part of careful screening.

Symptoms and What They Usually Mean

Breast pain is common and rarely signals cancer, especially if it comes and goes with your cycle or changes with movement. A new lump deserves attention, but many lumps turn out to be cysts or fibroadenomas—benign and treatable. Nipple discharge that is milky in a breastfeeding parent is expected; clear or bloody discharge that happens on its own (not from squeezing) should be checked promptly. During breastfeeding, redness, warmth and fever may indicate mastitis and should be treated promptly. If symptoms don’t improve, your provider will investigate further. Any skin dimpling, a new nipple inversion or an “orange peel” appearance is a reason to call your doctor now rather than waiting.

Men Can Get Breast Cancer, Too

Breast health isn’t only a woman’s issue. Men can develop breast cancer, particularly with certain genetic risks such as a family history of breast cancer, having liver disease and receiving radiation or hormone therapy. Any new lump in the male breast, any dimpling, redness or flaky breast skin or nipple discharge should be evaluated.

Everyday Habits That Help

You don’t have to overhaul your entire lifestyle to lower your breast cancer risk. Small choices can add up to meaningful protection over time, and many of these habits benefit your overall health, too.

Move your body most days.
Physical activity helps regulate hormones like estrogen and insulin, which play a role in breast cancer development. You don’t need to hit the gym every day—walking the dog, dancing in your kitchen, biking with a friend or even doing yardwork all count. The goal is to move more and sit less.

Keep alcohol in check.
Alcohol can raise estrogen levels in the body and damage DNA in cells—two reasons why it’s linked to a higher risk of breast cancer. If you choose to drink, limiting intake to no more than one drink per day (and not every day) is a good benchmark.

Maintain a healthy weight.
Excess body fat, especially after menopause, can increase breast cancer risk because fat tissue produces more estrogen. If weight loss feels overwhelming, start with manageable steps, such as adding more fiber-rich foods, drinking more water and focusing on portion sizes.

Prioritize a balanced, whole-food diet.
Fill your plate with a variety of colorful fruits and vegetables, whole grains, lean proteins and healthy fats. High-fiber foods, such as beans, lentils and oats, not only support digestion but also may help reduce estrogen levels.

Don’t smoke—or make a plan to quit.
Smoking is linked to many cancers, including breast cancer, particularly in premenopausal women. If you smoke, quitting is one of the best things you can do for your long-term health, and help is available if you're ready.

Revisit hormone therapy decisions.
If hormone therapy is part of your menopause plan, work with your provider to use the lowest effective dose for the shortest necessary time. Regular check-ins can help weigh the benefits and risks as your body and needs change.

Know the power of breastfeeding.
If you’re pregnant or planning to be, breastfeeding—when possible and desired—can slightly lower your breast cancer risk. It supports healthy hormone regulation and encourages your breast cells to become more resistant to change.

Above all, consistency is more important than perfection. Choose habits that feel doable, make you feel good and fit your life. Breast health is just one part of your overall well-being—and it’s never too late to start caring for both.

Southwest General Resources Close To Home

Care is most helpful when it’s convenient. Southwest General’s Breast Center offers advanced diagnostic imaging and coordinated care, including digital and 3-D mammography, on our Middleburg Heights Main Campus, with 3-D mammography also available at the Strongsville Medical Center. To schedule a mammogram, please call our Scheduling Department at 440-816-8605.