The NHS page on how to check your breasts or chest includes a video demonstrating the technique — what to look for in a mirror and how to feel the breast tissue. It is a useful visual educational resource, available at nhs.uk.3
Knowing what is normal for your own body — and recognising when something changes — is the approach now described in UK clinical guidance in place of scheduled self-examination routines.
Section 1
Breast awareness is a term used in clinical practice to describe familiarity with how your own body normally looks and feels — and being alert to anything that is new or different. It is the approach now described in UK clinical guidance as preferable to the previously promoted practice of formal monthly breast self-examination (BSE) — in which people were taught to follow a specific prescribed checking routine at a set time each month.2
The distinction matters. Formal BSE involved learning a technique and performing it to a schedule. Breast awareness is less prescriptive: it describes an ongoing, general familiarity with how your own breast tissue normally looks and feels — across different times of the month and different stages of life — so that anything genuinely new or different becomes noticeable against that background of personal normality.
Breast cancer can develop in anyone with breast tissue. It is far more common in women — around 59,000 diagnoses in the UK each year1 — but around 420 men are also diagnosed in the UK each year.1 The principles of breast awareness apply to everyone.
Section 2
Breast cancer outcomes are strongly linked to stage at diagnosis. The earlier a change is identified and investigated, the wider the range of available treatment options and the better the outcomes, on average. This is the clinical rationale behind breast awareness — not to create anxiety, but to build a reliable sense of personal normality so that genuinely new changes can be noticed promptly.
It is important to understand that the vast majority of breast changes are not cancer. Many are the result of normal hormonal fluctuations across the menstrual cycle, benign (non-cancerous) cysts, or fibroadenomas (non-cancerous lumps made of glandular and fibrous tissue). The purpose of breast awareness is not to generate alarm at every change, but to create familiarity — so that changes that are genuinely new, different, or persistent stand out clearly against a background of individual normality.
Section 3
There is no single standard for what breast tissue looks or feels like. Normal varies considerably between individuals, and changes over time within the same person in response to hormones, age, pregnancy, breastfeeding, and other factors. Getting to know what is normal for you — rather than comparing to an external standard — is the clinically relevant goal.
Cyclical changes. Many people notice that breast tissue changes across the menstrual cycle — becoming more tender, fuller, or lumpier in the days before a period, and settling again once a period begins. This cyclical tenderness and lumpiness is caused by normal hormonal fluctuation (changes in oestrogen — the main female sex hormone — and progesterone) and is a recognised physiological (body function) response.
Asymmetry. It is clinically normal for one breast to be a slightly different size or shape from the other. Most people are not perfectly symmetrical, and a mild persistent difference between the two sides is not, in itself, a sign of a problem — unless that difference is new or has changed.
Nodularity. Breast tissue can feel dense, grainy, or nodular (lumpy), particularly in younger people and in the upper-outer area of the breast towards the armpit. This reflects breast composition — denser tissue contains a higher proportion of glandular (milk-producing) and fibrous tissue relative to fat — and is not itself a cause for concern.
Changes at menopause and with age. After the menopause — when the ovaries stop producing oestrogen — breast tissue often changes in composition, becoming less dense and sometimes feeling softer or less firm. This is a normal part of ageing. The menopause is the natural end of menstrual periods, typically occurring between the ages of 45 and 55.
Nipple variation. Nipples vary considerably. Some are inverted (pointing inward), some are flat, some are prominent. Nipple inversion (see Key Terms: Nipple Inversion) or other characteristics that have been present since early adulthood are not clinically significant in themselves. What becomes clinically meaningful is a change in a previously established appearance.
The key clinical principle is this: because normal varies so much between individuals, the most useful benchmark is your own established normal — not any external standard or comparison with other people.
Section 4
The following changes are clinically recognised as warranting assessment — not because they are always significant, but because they are the kinds of changes that benefit from clinical investigation to establish what they are. The majority will have a benign explanation. Some will require further investigation.2 3
The general clinical principle: changes that are new, persistent (lasting more than a few weeks), and clearly different from what has previously been individually normal are the ones clinically recognised as warranting assessment. Temporary changes that follow the pattern of the menstrual cycle and resolve predictably fall into a different category.
Section 5
Breast awareness and the NHS Breast Screening Programme are complementary, not alternatives. They detect different things, in different ways, at different points in time.
Mammography reveals changes in the internal structure of breast tissue that are not yet detectable by touch. This is its clinical value — identifying early-stage cancers before they cause noticeable symptoms. Breast awareness complements this by describing attention to changes that become noticeable — lumps, skin changes, nipple changes — in between screening appointments, or in people outside the routine screening age range.
For people with a significant family history of breast cancer — for example, a first-degree relative (parent, sibling, or child) diagnosed at a young age, or several relatives affected — there is a clinical pathway through a GP referral to a familial cancer service, where individual risk is assessed and a personalised surveillance (monitoring) plan may be offered. This is a separate service from the routine population screening programme.2
Section 6
The shift from scheduled monthly breast self-examination to breast awareness is grounded in evidence from large-scale randomised trials and systematic reviews, which informed the current NICE clinical guidance.2
Large randomised controlled trials covering hundreds of thousands of women found no reduction in breast cancer mortality from formal scheduled breast self-examination compared with no BSE routine. Systematic reviews of this evidence reached consistent conclusions.4 NICE NG101 (updated April 2025) does not recommend formal breast self-examination. The clinical approach described in NICE guidance is breast awareness — knowing what is individually normal and noticing change — which does not involve a prescribed technique or schedule.
It is important to understand what this evidence shows and what it does not show. The absence of mortality benefit from formal BSE as a prescribed routine does not mean that noticing changes is without clinical value. Earlier detection of breast cancer is associated with better outcomes — the evidence indicates that the benefit comes from ongoing awareness itself, not from adherence to a specific scheduled technique.
Some NHS resources — including the NHS breast checking page — suggest checking once a month as a practical way to build familiarity. This is a reasonable practical approach, and the NHS page includes a genuinely useful video demonstrating how to look and feel for changes.3
NICE NG101 takes a slightly different position: it does not recommend any fixed schedule, because the evidence does not show that monthly checking outperforms less prescribed awareness. The clinical emphasis in NICE guidance is on familiarity — knowing your own normal — rather than on calendar adherence.
For the purpose of this article, both the video technique and the awareness approach are clinically valuable. If a monthly habit helps build that familiarity, that is a reasonable individual choice. What the evidence does not support is the idea that missing a monthly check is a clinical failure, or that checking more frequently than that adds meaningful additional benefit.
The NHS page on how to check your breasts or chest includes a video demonstrating the technique — what to look for in a mirror and how to feel the breast tissue. It is a useful visual educational resource, available at nhs.uk.3
helf.school has a separate article — Breast Cancer (Article 27, Cancer Series) — covering what breast cancer is, how it develops, how it is diagnosed, and what the clinical trial evidence shows about treatment. It is available in the conditions library.
Breast awareness is not about following a routine or performing a prescribed technique at a set time. It describes something simpler and more durable: familiarity with your own body — how your breast tissue normally looks and feels at different points in the menstrual cycle and across different stages of life — so that something genuinely new or different becomes noticeable against that personal baseline.
Most breast changes have a benign explanation. Many are part of normal hormonal fluctuation, or the natural changes of ageing. The changes clinically recognised as warranting assessment are those that are new, persistent, and different from what has previously been individually normal.
The NHS Breast Screening Programme and breast awareness serve different but complementary roles. Screening detects changes too small to feel; awareness detects changes that become noticeable to the individual. Both have a place in the broader picture of early detection.
Anything personally relevant is a conversation for you to have with your GP or healthcare professional.