Breast Cancer Awareness Month: A Guide to Early Detection and Screening

Breast cancer is a health condition that occurs when cells in the breast tissue multiply uncontrollably. When caught in its early stages, the treatment success rate exceeds 90 percent. With a very high chance of complete recovery upon early diagnosis, this disease can be effectively managed through regular screenings. Especially during October, Breast Cancer Awareness Month, it is vital to know your own body and keep up with your routine medical check-ups.

• Breast cancer is one of the most common types of cancer in women, but it is highly treatable with early detection.
• Starting from age 20, every woman should perform a breast self-exam once a month.
• Having an annual mammogram after the age of 40 is the gold standard screening method.
• About 85 percent of breast cancer cases have no family history; therefore, assuming "it doesn't run in my family, so I won't get it" is a dangerous misconception.
• A palpable lump in the breast, skin dimpling, a puckered "orange peel" texture, or nipple discharge are the most frequently encountered symptoms.

What is Breast Cancer?

Breast cancer begins when the cells forming the milk ducts or glands in the breast undergo genetic changes and multiply out of control. Over time, these abnormal cells clump together to form masses known as tumors. While it is the most common cancer among women, it affects not only older individuals but also young women.

The most significant feature of the disease is that it typically causes no discomfort in its initial stages. As the cells slowly multiply, a person might continue their daily life feeling completely healthy. However, thanks to medical advancements and sophisticated imaging technologies, it is possible to halt this silent progression before it even forms a lump. In cases detected early, breast-conserving surgeries—where only the tumorous area is removed without needing to remove the entire breast—are successfully performed. Although the word "cancer" is alarming, overcoming this disease is largely in your hands with accurate information and timely action.

What Are the Risk Factors for Breast Cancer?

Knowing the factors that play a role in the development of the disease is a critical step in determining prevention strategies. Breast cancer risk factors are divided into two categories: non-modifiable genetic traits and environmental factors that can be controlled through lifestyle changes.

Being female and advancing in age are the most fundamental non-modifiable risk factors. As we get older, the likelihood of cellular mutation increases. Having a history of breast or ovarian cancer in first-degree relatives (mother, sister, aunt) elevates the risk, particularly concerning gene mutations like BRCA1 and BRCA2. However, the vast majority of patients have no family history at all. Starting menstruation at an early age (before 12) and entering menopause late increases the risk by exposing the body to estrogen for a longer period.

Modifiable factors include obesity, a sedentary lifestyle, excessive alcohol consumption, and smoking. Weight gained, particularly after menopause, poses a direct threat as it increases the amount of estrogen produced in fat tissue. For more detailed information on this topic, you can read our article titled Breast Cancer Risk Factors: Uncontrollable and Modifiable.

What Are the Symptoms of Breast Cancer?

In the early stages of the disease, there are usually no obvious complaints. However, as the tumor begins to grow, the body sends out certain signals. Although breast cancer symptoms vary from person to person, the most common finding is a palpable, usually painless, and firm lump in the breast or underarm. Unlike cysts that appear and disappear with the menstrual cycle, these lumps are persistent and may grow over time.

Changes in the skin tissue of the breast also offer important clues. Swelling in a part of the breast, skin thickening, redness, or a dimpled appearance known as "orange peel" skin should be taken seriously. Structural changes such as an inward turning nipple, asymmetry, crusting, or flaking may occur. Furthermore, any discharge from the nipple outside of breastfeeding—especially if it is bloody or clear—must be evaluated by a specialist. To notice such changes in your body, you need to be well-acquainted with the natural shape and feel of your breasts.

How to Perform a Breast Self-Exam?

Being aware of your own body is the first and most powerful step in protecting your breast health. It is recommended that every woman from the age of 20 perform a breast self-exam once a month. The best time for this is between the 5th and 7th days after the end of your menstrual period; during this time, the influence of hormones decreases, leaving the breast tissue at its softest and least tender. Women who have gone through menopause should pick a fixed day each month to perform this exam.

Visual Inspection in Front of a Mirror

• Stand in front of a mirror, bare-chested. Let your arms hang loosely by your sides and inspect the size, shape, and color of your breasts.
• Place your hands on your hips, flex your chest muscles, and lean your shoulders slightly forward. Look for any asymmetry, skin pulling, or dimpling.
• Raise your arms above your head and repeat the same visual inspection. Check to see if the nipples are inverted or have changed direction.

Manual Examination in the Shower

• The shower is an ideal setting for an exam because water and soap allow your fingers to glide easily over your skin.
• To examine your right breast, raise your right arm behind your head. Use the flat inner surface of the middle three fingers of your left hand.
• Move your fingers in small circular motions, applying light, medium, and firm pressure to cover the entire breast. Do not skip any area, from the collarbone down to the bra line, and from the armpit to the breastbone.
• Repeat the same process for your left breast using your right hand.

Examination Lying Down

• Lie flat on your back. To examine your right breast, place a small pillow or a folded towel under your right shoulder. Put your right arm behind your head.
• This position allows the breast tissue to spread evenly and thinly over the chest wall, making it easier to feel deep-seated lumps.
• Using the middle three fingers of your left hand, carefully check your breast and armpit in circular motions, just as you did in the shower.
• Perform the procedure with the same diligence for the other side.

Screening Methods (Mammography, Ultrasound) and Early Detection

As valuable as self-exams are, they cannot replace modern medical imaging methods in the early detection process of breast cancer. Regular screening programs allow us to detect millimetric cancer cells that are far too small to be felt by hand.

Mammography is an imaging method that uses low-dose X-rays and is considered the gold standard for breast cancer screening. The answer to "when to get a mammogram" generally starts at age 40, and it is recommended to be repeated once a year. For women with a family history of breast cancer, these screenings might be pushed forward to their 30s depending on their risk profile. Mammograms save lives by catching tumors years before they can be felt. For more guidance on which screenings are needed at what age, you can refer to our article Age-Based Screening and Examination Calendar: A Roadmap for Your Breast Health.

Ultrasonography is generally used as the primary screening method for young women under 40 who have dense breast tissue. After age 40, it serves as a complementary tool alongside mammography to examine suspicious areas in more detail. It involves no radiation and works with sound waves. For high-risk patients or genetic mutation carriers, Breast MRI (Magnetic Resonance Imaging) steps in to provide the most detailed cellular mapping.

Diagnosis and Treatment Processes

When a suspicious finding is detected during imaging, a biopsy is performed to establish a definitive diagnosis. A small tissue sample taken from the suspicious lump via fine or core needle biopsy is examined under a microscope in a pathology laboratory. This analysis determines whether the cells are benign or malignant, and if it is cancer, its specific type and stage.

Breast cancer treatment is completely personalized based on the patient's age, overall health, tumor stage, and genetic characteristics. Surgical intervention is usually the first step. In current medical approaches, breast-conserving surgeries—where only the tumorous tissue is removed rather than the entire breast—are preferred. Following or preceding surgery, treatments such as chemotherapy, radiotherapy, hormone therapy, and targeted smart drugs are used to destroy cancer cells and prevent recurrence.

Complications and Risk Groups

When breast cancer is left untreated or detected late, cancer cells can spread to other parts of the body through the lymphatic system or bloodstream. The most common organs for metastasis are the bones, lungs, liver, and brain. This situation makes treatment much more complex and lowers the success rate.

In terms of risk groups, individuals carrying gene mutations like BRCA1, BRCA2, or PALB2, those who received radiation therapy to the chest area at a young age, and those with multiple cases of breast cancer in their family are placed in the high-risk category. It is essential for individuals in this group to be monitored at much earlier ages and at more frequent intervals than standard screening schedules, ideally while receiving specialized genetic counseling.

When to See a Doctor?

When you notice anything unusual regarding your breast health, you should see a specialist without panicking, but also without delay. If you experience any of the following symptoms, you should consult a General Surgery specialist immediately:

• If you notice a new, hard, and immobile lump in your breast or armpit,
• If you observe sudden redness, thickening, dimpling, or sores on the skin of your breast,
• If there is spontaneous nipple discharge, particularly if it is bloody or clear like water,
• If you develop a sudden nipple inversion, crusting, or deformity,
• If you notice a recent and distinct asymmetry in size or shape between your breasts.

Many of these symptoms can also be caused by benign cysts or infections. However, a physician's examination and medical imaging are essential to make a definitive distinction.

The Breast Health Journey at BHT CLINIC

Early detection in the fight against breast cancer requires a well-equipped infrastructure and an experienced team of specialists. At the General Surgery department of BHT CLINIC İstanbul Tema Hastanesi, all the screening, diagnosis, and treatment processes you need for your breast health are carried out in accordance with international quality standards. While detailed screenings are performed with our advanced mammography, ultrasonography, and MRI devices, a multidisciplinary council will create the most appropriate treatment plan for you in the event of a diagnosis.

To stop postponing your health and to schedule your regular check-ups, you can call our 24/7 call center at 0850 811 34 00 or easily complete the process through our online appointment page.

Frequently Asked Questions

Does breast cancer cause pain?

Breast cancer usually presents as a painless lump in its early stages. Pain is more commonly associated with benign conditions like fibrocystic breast changes, cysts, or infections. However, in rare cases, pain may be felt if the tumor presses against nerves.

Do mammograms hurt?

During a mammogram, the breast tissue is compressed between two plates for a few seconds to obtain a high-quality image and minimize the radiation dose. While this procedure can cause a feeling of pressure and mild discomfort, it does not cause severe pain. Having the procedure done the week after your menstrual period ends can help reduce sensitivity.

Can men get breast cancer?

Yes, because men also have breast tissue, they can develop breast cancer. Approximately 1 percent of all breast cancer cases occur in men. If symptoms such as a hard lump in the breast, nipple inversion, or discharge are observed in men, a doctor should be consulted immediately.

Do fibrocystic breasts turn into cancer?

Fibrocystic changes are a benign condition seen in a large portion of women, characterized by cysts and increased connective tissue in the breast due to hormonal fluctuations. A fibrocystic structure alone does not turn into cancer or increase the risk of breast cancer. However, because it increases breast density, it can make examinations more difficult, requiring regular medical monitoring.

Is the radiation received during a mammogram dangerous?

Mammography machines use a very low dose of X-rays. The amount of radiation received during a scan is equivalent to the natural background radiation we are exposed to from environmental factors over a few months in daily life. The life-saving benefit of catching breast cancer early far outweighs this extremely low radiation risk.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.