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Our comprehensive guide to taking care of your breasts

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What can we do to reduce our risk of breast cancer, the most common cancer among Canadian women, affecting approximately 1 in 9 women? We asked Dr. Melinda Wu, a family physician at Women’s College Hospital, a few questions to help you take care of your breasts and improve your overall health.

Do I need a mammogram?

Canadian women of average risk should have a mammogram every two years, between the ages of 50 and 74. Talk to your doctor about your risk factors and make a decision for screening based on what those are. If you’re considered high risk – because of a strong family history or the presence of BRCA1 or 2 gene mutations, for example – you and your doctor can discuss the possibility of an early or more intense screening program. If you have a breast concern, such as a breast mass, nipple changes or skin changes, you may have a mammogram as part of your investigations.

What’s your advice for my first mammogram? I’m nervous!

Having a mammogram is uncomfortable, but should not be terribly painful. Your breasts may be more sensitive right before or during your period. If you have particularly sensitive breasts, you may want to take Advil or Tylenol beforehand, if you don’t have any contraindications. On the day of your mammogram, don’t wear deodorant or fragrance.

How can I be proactive about reducing my risk?

Sex, age and genetics – the most significant risk factors for breast cancer – are, of course, out of your control, but living a healthy lifestyle is something you can do to mitigate some of the other breast cancer risk factors.

  1. Manage your weight. Being overweight or obese is a risk factor for developing breast cancer, so maintaining a healthy weight is an important way to reduce your risk, especially after menopause. Focus on fitting in physical activity and eating a healthy diet low in saturated fats and high in vegetables and whole grains.
  2. Move more, sit less. Women who are more active have less breast cancer than those who are less active. Aim for at least 150 minutes of physical activity per week. And it doesn’t have to be a dedicated 30 minutes, five days a week, at the gym – you can do short 10-minute bursts, say walking or climbing the stairs, a few times a day.
  3. Limit or abstain from alcohol. If you are consuming more than four to five drinks per week, your risk starts to climb. Drinking in moderation can help lower your risk.
  4. Quit smoking. Smoking is linked to an increase in breast cancer risk, so bottom line, try to quit or don’t start.
  5. Supplement with vitamin D. There’s some evidence pointing to a link between breast cancer risk and vitamin D deficiency. As Canadians, we tend to be lower in vitamin D – produced by the sun – so consider supplementing with vitamin D and adding vitamin D rich foods, such as salmon, eggs and mushrooms, to your diet.

 Should I be worried about sore breasts?

Breast tenderness is common around menstruation and, generally, not cause for concern. Pain in the breast area can also be caused by the muscles in the chest and around the breast. If the problem persists, you should check with your doctor to rule out other potential medical concerns. 

I keep hearing about breast density. What does that mean and how does it affect risk?

Breast density isn’t based on how your breasts feel, and it’s not related to size or firmness. It’s something we see on a mammogram that tells us there’s more glandular tissue, which can sometimes make it difficult to see other things like masses or tumors. Breast density is divided into four categories – A, B, C and D. There is a higher risk associated with category D, especially after age 40. If your mammogram report says you have dense breast tissue, talk to your health-care provider about what this means for you.

Are nipples indicative of breast health? What should I look out for?

Nipples reflect breast health when we notice a change. There are a few things that warrant an investigation: If your nipple starts to pull in or look different – the skin appears more red or thicker, for example – or if there’s a bloody discharge. 

Should I get screened for BRCA1 and BRCA2 mutations even though none of my family members (that I know of) have had breast cancer?

There are two reasons to get screened for these genetic mutations: strong family history and being diagnosed with breast cancer at a young age. That said, you could have a family history of genetic mutation you may not know about. This can happen if your relative with BRCA1 or 2 mutation didn’t end up developing breast cancer in their lifetime; you don’t have a clear family history because relatives perhaps died young; you may be adopted; or any number of individual reasons. It’s good to talk to your doctor about the family history you know about, to see if genetic testing may be something you might do.

Will my antiperspirant give me breast cancer?

There’s a lot of literature on this and there is no clear evidence that deodorants containing aluminum or parabens cause breast cancer.

Is wearing a poorly fitting bra bad for my breasts?

There's no reason to think that bras are related to the health of your breasts in terms of breast cancer risk. That said, a poorly fitting bra can cause pain and discomfort. Over our lifetime, women gain and lose weight, we may have babies and go through menopause – all while wearing the same bra size! If you have any breast, back or neck pain, you should consider getting professionally fitted for a bra to ensure that your breasts are properly and comfortably supported.

Dr. Melinda Wu, family physician and general practitioner in oncology at the Breast Centre, Women's College Hospital
This information is provided by Women's College Hospital and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: October 1, 2020.
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