Knowing Your Normal: Dr. Heather Sinner's Guide to Breast Self-Awareness
Between mammograms and clinical exams, there's a simpler, everyday habit that plays an important role in breast health: knowing what's normal for your own body. It doesn't require special training or a perfect routine, just consistent attention.
Dr. Heather Sinner, board-certified breast surgeon and Breast Program Director with CaroMont Breast Surgical Specialists, explains why breast self-awareness still matters, even as formal screening guidelines have evolved, and what to do if you notice a change.
Why Breast Self-Awareness Matters
"Many major medical organizations no longer recommend a rigid, step-by-step self-exam as a stand-alone screening tool," explains Dr. Sinner. "But they do emphasize breast self-awareness, which simply means understanding the usual look and feel of your breasts and speaking up if something seems new or different. You don't need to be an expert. You just need to understand what is normal for you.”
Breast tissue naturally changes over time. Hormones, aging, weight changes, pregnancy and menopause can all affect how it looks and feels, which is why many changes turn out to be harmless. Even so, a meaningful number of people first notice a sign of breast cancer themselves, often a new lump, a skin change or a difference that doesn't go away.
"Formal self-exams alone haven't been shown to reduce mortality from breast cancer, but breast awareness helps people recognize changes earlier and seek care sooner," states Dr. Sinner. "Earlier conversations often mean earlier diagnosis and less intensive treatment. This isn't about replacing mammograms or clinical exams. It's about being an informed, active participant in your own health."
When to Check: Timing and Consistency Matter
According to Dr. Sinner, timing can reduce false alarms caused by normal hormonal changes:
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If you menstruate: the best time to check is three to seven days after your period begins, when hormonal swelling and tenderness are lowest.
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If you're postmenopausal: pick a consistent day each month, such as the first. The exact date matters less than consistently checking your breasts.
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If your cycle is irregular, or you're pregnant or breastfeeding: choose a recurring day each month and stay consistent.
"This takes a few quiet minutes once a month, and that's all it takes," says Dr. Sinner.
How to Check
"You don't need special equipment or a perfect technique," explains Dr. Sinner. "What matters most is covering the whole area and paying attention."
First, look in the mirror. Stand with your arms at your sides, then raise one overhead. Notice the shape of your breasts, their symmetry, the texture of the skin and the position of the nipples. You're watching for new dimpling, redness, puckering or changes in how the nipples sit.
Second, feel with the pads of your fingers. Using the pads, not the tips, of your index, middle and ring fingers together, move in circles, vertical lines or wedge-shaped sections. Apply light, then medium, then deeper pressure, and cover the entire area from the collarbone to under the breast, and from the center of the chest outward.
"Breast tissue isn't limited to what fits in a bra. It extends into the underarm, so that area deserves a quick check too," notes Dr. Sinner. "Your armpits carry a lot of lymph tissue, and changes can show up there before anything is noticeable in the breast itself."
Finally, check in more than one position. For example, in the shower, soap helps fingers glide over the skin. Another position would be to lie down which results in breast tissue spreading more evenly across the chest. These changes of position can make subtle differences in what you are feeling easier to detect.
What's Normal, and What's Worth a Call
"Understanding which changes fall within a normal range helps you stay calm instead of alarmed," says Dr. Sinner.
Common, often normal changes include:
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General lumpiness, especially before your period
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Mild tenderness tied to your cycle
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One breast looking or feeling slightly different from the other
Changes worth taking seriously include:
- A new lump that doesn't go away
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Thickening or firmness you haven't felt before
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Skin changes such as dimpling, redness or scaliness
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A nipple turning inward, or discharge unrelated to breastfeeding
"If something feels different and it persists, that's your cue to call your provider," states Dr. Sinner. "You don't need to wait it out or apologize for asking."
What Happens When You Call Your Provider
"Most breast concerns turn out to be benign, but that determination should come from your care team, not from guesswork," explains Dr. Sinner. "Your provider will start with a discussion and a physical exam. Imaging, such as an ultrasound or mammogram, may be ordered if needed, and a biopsy is never automatic. When one is recommended, reassurance is the most common outcome."
Early conversations often lead to simple answers and less invasive testing, which is exactly why familiarity with your own body matters.
The One Thing to Remember
"Breast self-awareness isn't about mastering a medical skill," says Dr. Sinner. "It's about paying attention, just enough to notice when something changes, and knowing that your care team is here when you do."
Talk to Your Primary Care Provider
If you notice a change that doesn't go away, your primary care provider is the right first call. They can evaluate what you're noticing and coordinate next steps, whether that's imaging, a referral to a breast specialist or simply reassurance.
"Annual screening mammograms remain one of the most important tools we have for catching breast cancer early, often before it can be felt at all," says Dr. Sinner. "Talk to your primary care provider about when to start screening and how often, based on your age, family history and personal risk factors."
Schedule a visit with your primary care provider to discuss any changes you've noticed and to make sure you're up to date on your screening mammograms, should they be recommended for your age and health history. If further care is needed, your primary care provider can connect you to CaroMont Health's network of expert care providers, including specialists like Dr. Sinner, so you have a clear pathway to advanced care close to home. No matter where you are in the process, a coordinated team of dedicated providers is behind you.