From killer symptoms to best fitting bras - top GP's ultimate boob guide

BREASTS get a lot of attention – from discussions around how they look and feeding babies to seeing too much of them.

Many of us will remember being taught a little at school about the changes our bodies will likely go through during puberty.

But very few were taught how to examine our breasts or chest area, or what to do if we have symptoms of breast cancer.

Roughly 55,000 women and 370 men are diagnosed in the UK every year, according to Breast Cancer Now.

But it is not just lumps and bumps that should be on people’s radar.

Knowledge is power, so here is my ultimate guide to boobs, to help see you through every decade of life.BREASTS actually begin to develop very early on in pregnancy, while you are still in the womb, at about four to six weeks after conception.

The Y chromosome in males kicks into action at about seven to nine weeks of pregnancy and the testes begin to develop, but by this point the nipples are already in place.The increase in size related to contraception is not permanent and either returns to normal in a few months or after stopping.

Hormonal contraception can also cause breast tenderness which generally settles down.

If you do get pregnant, your breasts develop in readiness.

The hormone changes in pregnancy change the size of the breasts, can lead to tenderness and heaviness and increased sensitivity.

The nipples can get darker and larger, and you may notice prominent blue veins.

Colostrum can be produced and leak from the nipples during pregnancy and can even be collected in advance.

After delivery, the levels of oestrogen and progesterone fall relatively rapidly while levels of another hormone, prolactin, rises, leading to the production of milk.

This is solely hormone-driven until the baby’s suckling and removal of milk and hormones are involved.

At that point, the more milk used for feeding or pumping, the more milk produced.

There is a lot of pressure put on people to breastfeed.

It is true there are health benefits to breastfeeding, both to the baby which continues later on into childhood, and for yourself.

Breastfed babies have stronger immune systems with fewer coughs and colds, have lower rates of allergies, and breastfeeding lowers the risk of breast cancer.

But it is also important to say breastfeeding is not always easy.

The pressure and stress around feeding can contribute to mental health issues.

We need to support people to be able to breastfeed if they choose, but also respect that it can be difficult to do.

In my opinion, the phrase “breast is best” is outdated and not useful.

Instead, as we are fortunate enough nowadays to have access to formula and can sterilise water, “fed is best”, however it is done.

10-19 years

THE first major changes to the breasts occur at puberty, which tends to start from around eight years old.

Hormones released by the brain cause the ovaries to produce oestrogen and progesterone, and the breasts begin to change and grow.

This can lead to tenderness, aching, itching and tingling sensations, and the breasts can feel swollen and sore.

They may develop at different speeds, which means some asymmetry is normal.

Time and rate of breast development does not influence size, so if someone develops earlier or later than you, it doesn’t mean they will have smaller or bigger breasts at the end of puberty.

Each month the breasts respond to the hormones of the menstrual cycle, and start to get ready for pregnancy and the possibility of breastfeeding, even if conception does not happen.

In the first half of the menstrual cycle leading up to ovulation, rising levels of oestrogen stimulate the growth of milk ducts in the breast.

In the second half of the cycle, after ovulation, higher levels of progesterone stimulate the formation of milk glands, in readiness for conception and beyond.

Around seven out of ten women will have breast pain at some point, which is often related to the menstrual cycle.

You may notice your breasts are more lumpy, tender and painful in the lead up to your period, and then smaller and softer afterwards.

If you have cyclical breast pain, wearing a supportive bra and rubbing in a non-steroidal anti-inflammatory gel can be useful, or see your doctor as other treatments are available.

20s and 30s

CONTRACEPTION that contains hormones such as the combined oral contraceptive pill, or progesterone-only contraception, can affect the breasts.

Starting hormonal contraception you may notice your breasts look and feel larger, which is due to the effect of the hormones on the breast and fluid retention.

40s and 50s

DURING perimenopause, a person’s periods can become irregular.

This means your breasts are irregularly exposed to the hormones of the menstrual cycle and so might become tender or sore.

In menopause, falling levels of oestrogen and progesterone affect the entire body, including the breasts.

The glandular tissue involved in milk production shrinks, meaning the breasts become less dense and firm, feeling softer.

Reduced levels of collagen and elastin means the skin is less able to support the breasts, so they will start to look different.

They may look smaller, lower on the chest or flattened.

As you get older, the risk of developing cysts and other growths also increases.

Get any breast changes checked.

50s, 60s and beyond

BREAST screening starts from age 50, and you will be invited every three years until 69.

After 70 you are still eligible to have breast screening every three years, though you won’t automatically be sent an invitation.

Contact your local screening unit directly.

It is estimated the programme prevents 1,300 deaths from breast cancer each year.

Screening involves a mammogram, which is a low dose X-ray.

On the day of your appointment, do not use spray deodorant or talcum powder as these can show up on a mammogram and make it harder to read.

The breasts are positioned between two X-ray plates and images are taken.

There may be some brief discomfort or tight squeezing sensation during the mammogram.

Irrespective of your age or gender, everyone should be examining their chest area once a month.

If you have periods, try to examine after your period as the breasts are least likely to be tender at that point.

If you don’t have periods to remind you, put a reminder on your phone or calendar to “feel on the first”.

Don’t wait for your screening appointment.

If you notice a change, get it checked by your GP.

The perfect-fitting bra

WHETHER or not you wear a bra is entirely up to you, your body, your breasts and your choices.

But if you do wear one, it should be supportive and well-fitting – and most are not.Most babies are born with some breast tissue due to the transfer of hormones from the mother during pregnancy.

In fact, some babies may even produce a milky-coloured fluid from the nipples.

These baby breast buds will tend to go away on their own within a few weeks to months.

Breasts are heavy and move a lot – up to almost 20cm during exercise – and wearing a bra can help with pains in your upper back, neck and chest.

One in five people report their breasts are a barrier to exercise, and this number is higher in adolescent girls aged 11-18.

More breast education can help, especially around wearing a well-fitting sports bra.

There is no standardisation in bra sizing.

A 36C in one bra may not be the same as a 36C in another style, even from the same manufacturer.

And most of us do not understand what the combination of letters and numbers even mean.

If your bra fits well, the underband is snug (you can get one finger underneath it comfortably but not much more) and the band is parallel all the way around, so it does not rise up at the back.

Straps should be adjustable and set up so they neither slip off nor are too tight and dig in.

The breasts should fill the cups so there is not gaping or wrinkling in them, and the breast should not spill over the top.

The centre of the bra between the two cups should sit flat against the chest.

With sports bras, a higher neckline will give more support.

Most of us would take a little walk in a new pair of shoes before buying them to see if they fit. So when you buy a sports bra, do a few jumping jacks in the changing room and see how it feels.

An easy way to remember is to give your breasts some TLC when you self examine – Touch, Look and Check Changes with a doctor.

1. STAND in front of a mirror with your hands by your sides, then above your head and place your hands on your hips and push in on your hips slightly.
2. In each position, look for any changes in breast size or shape, and any new asymmetry, lumps or changes in outline.
3. Look to see if your nipple is pointing in a different direction or has turned inwards (if you have always had inverted nipples, this is normal for you and not of concern).
4. Check if there is any nipple discharge or crusting, any rashes, darker or red patches, or other changes such as the appearance of cellulite or if the skin is like orange peel. Then feel the whole of the chest area as the breast tissue extends up to the collarbone and into the armpit. Use the flat of your fingers to feel for changes such as a lump, thickening or bumpy area.
   It does not matter exactly how you examine your breasts, be it in sections like a quarter at a time, or starting from the nipple and working outwards in circular motions, just that you examine the whole area.
5. If you do notice any changes, please see your GP.

Breast cancer signs and symptoms to watch out for when you examine your boobs each month:

• Change in nipple direction.
• New nipple inversion.
• Change in size, shape or outline of breast.
• New lumps or thickening (Dimpling or puckering.)
• Nipple discharge.
• Rashes, redness, darker patches or nipple crusting.
• Orange-peel like skin, or appearance of cellulite.