Mautner Project has adapted Susan G. Komen's recommendation called "Breast Self-Awareness" for better breast health, the steps to which can be found here and on Komen's website. It is a four step method:

1. Know your risk

The first step to better breast health is knowing your risk and talking about it.
Get started now by filling out a self-breast risk assessment sheet and bring it in with you the next time you see your regular health provider. Next, talk to your family to learn about your family health history. Sometimes it can be hard for LGBT folks to talk to our families, but knowing about our family health histories can help us to determine appropriate screening recommendations and other very important health decisions for the future. If you feel safe enough to talk to your family, please do so for your health! And finally, talk to your doctor about your personal risk of breast cancer and come prepared with your self-breast risk assessment sheet and a summary of the history of cancer in your family.

In summary:
- Talk to your family to learn about your family health history.
- Talk to your doctor about your personal risk of breast cancer


2. Get screened

Regular screening is critical to breast health. One mammogram or clinical breast exam is not enough. Celebrate your life by going every year! Many people go during their birthday month.

Definition: Mammography - A mammogram is a special type of x-ray designed to find abnormalities (a mass or growth that might be cancerous) in your breasts. However, not all abnormalities are found during a mammogram and not all abnormalities found are cancerous. You may have heard from others that having a mammogram hurts – but having breast cancer hurts more. A mammogram does involve gently squishing your breasts between two plates for just a few seconds. These few seconds of discomfort are well worth it – they could save your life!

Definition: Clinical Breast Exam (CBE) - Your health care provider will do a clinical breast examination every three years for women in their 20's and 30's, and annually for women 40 and older. During this examination your provider will feel and look at your breasts and surrounding chest area. They will also examine your underarm and the area around your neck to see if there are any lumps that might be connected to a problem in your breast. If your doctor does not feel under your arms or around your neck you should ask them to examine those areas.

In summary:
- Ask your doctor which screening tests are right for you and for more information about whether you are at a higher risk
- Have a mammogram every year starting at age 40 if you are at average risk
- Have a clinical breast exam at least every 3 years starting at age 20, and every year starting at age 40

If you cannot afford a clinical breast exam or mammogram because you do not have enough insurance, have no insurance, or have limited fiscal resources, there are many places that offer free or low cost screening options. For more information about free and/or low-cost mammograms and CBEs in the DC Metropolitan area, please visit our Tools for Caring webpage. To find free and/or low-cost mammograms outside of DC, give us a call at Mautner Project or send an email to info@mautnerproject.org.


3. Know what is normal for you

Many people get very intimidated when doing a breast self exam (BSE), but this important monthly self-examination can provide you with important information about your body. Doing BSEs regularly will make you more familiar with what your breasts look and feel like, which will help you to identify any changes. All breasts are lumpy - don't do a BSE looking for lumps! Do your BSE to look for changes. So touch yourself! Here's how:

Step 1: Look for changes
In front of the mirror:
- Hold your arms at your side
- Hold your arms over your head
- Press your hands on your hips and tighten your chest muscles
- Bend forward with your hands on your hips

Step 2: Feel for changes
Lying down:
- Lie down on your back with a pillow under your right shoulder
- Use the pads of the three middle fingers on your left hand to check your right breast
- Press using light, medium and firm pressure in a circle without lifting your fingers off the skin
- Follow an up and down pattern
- Feel for changes in your breast, above and below your collarbone and in your armpit
- Repeat on your left breast using your right hand

Step 2 can be repeated while bathing or showering using soapy hands.

See your health care provider right away if you notice any of these breast changes:
- Lump, hard knot or thickening inside the breast
- Changes in a lump
- Swelling, warmth, redness or darkening of the breast
- Change in the size or shape of the breast
- Dimpling or puckering of the skin
- Itchy, scaly sore or rash on the nipple
- Pull in of your nipple or other parts
- Nipple discharge that starts suddenly
- New pain in one spot that does not go away


4. Make healthy lifestyle choices

Going in for regular screening is only half the battle. Part of your breast cancer risk has to do with your long-term exposure to female hormones (estrogen and progesterone). So making healthy lifestyle choices like maintaining a healthy weight (the more of you there is, the more exposure to female hormones you will experience), for women who plan on becoming pregnant choosing to breast feed your child(ren), and limiting your postmenopausal hormone use (such as hormone replacement therapy or HRT) help reduce your risk of breast cancer. You should also limit your alcohol intake, as the link between alcohol and breast cancer has become increasingly clear in recent years - research has has shown that consuming only two drinks a day increases your risk of breast cancer by more than 20% compared with women who don't drink at all.

In summary:
- Maintain a healthy weight
- Add exercise into your routine (if you live in the DC metro area and would like some support, please visit our M.O.V.E. webpage)
- Limit alcohol intake
- Limit postmenopausal hormone use
- Breastfeed, if you can

If you would like more information on breast health and breast cancer, visit our breast cancer webpage or send us an email at info@mautnerproject.org.

References:

Susan G. Komen for the Cure Breast Self Awareness / Breast Self Exam shower card. Retreived on July 3, 2011 from http://ww5.komen.org/uploadedFiles/Content_Binaries/ENGLISH%20-%20Final1.pdf.