Even after all these years, you probably don’t know as much about your breasts—or keeping them healthy—as you think you do. We’ve got the experts’ advice on what’s normal, what’s not, and why you should be paying more attention to your bust.

It's true that some 83 percent of breast cancer cases occur in women over 50, but about 17 percent of new diagnoses still belong to women in their 40s. “We want women to start thinking about their breast health by their 30s,” says Dr. Colin Mar, Vancouver-based medical director of the B.C. Cancer Breast Screening Program. That way you’re armed with the important information you need to discuss your breast cancer risk with your doctor and decide when is the best time to start screening for the disease.

The time to start thinking about your breast health is now. Read on for five surprising facts you probably didn’t know about your boobs.

1. It's totally normal to Google "Are my nipples normal?"

Chances are, whatever you're noticing, from bumps to hairs to differences in shape, it’s all completely natural. “Honestly, anything goes,” says Dr. Susan Peddle, a radiologist at The Ottawa Hospital Breast Health Centre. “Across the board, whatever you own is normal.” Both nipples and areolas (the circle of darker skin around your nipple) can come in different sizes, textures and colours, ranging from light pink to dark brownish-black.

What’s not normal is a change in the appearance of your nipples. It’s not uncommon to have inverted nipples (by some estimates as many as 10 to 20 percent of women have nips that could be considered “innies”), but if one nipple becomes inverted, that can be cause for concern because it may flag the growth of a tumour that’s altering the shape of the breast. A bit of white, yellow or green nipple discharge, even when you’re not breastfeeding, can be normal, but it can also be a sign of a problem within the ducts of the breast. If you get small, occasional leaks from both boobs after they’ve been compressed (in a tight sports bra, for example), that’s not cause for concern. But, if the discharge is clear or bloody, or only occurring on one side, see your doctor. You should also book a checkup if you have a rash around the nipple that doesn’t go away, since this can be a sign of Paget’s Disease (a rare form of cancer).

2. It's not your imagination, your boobs are probably shrinking

Our breasts change in shape and size over time. They’re likely to swell during pregnancy and breastfeeding, but after babies, there’s really nowhere for them to go but down and out, says Dr. Peddle. “Nobody talks about gravity, but it’s not your breasts’ best friend.” Hormonal changes during menopause typically contribute to a loss of collagen and tissue elasticity, causing breasts to deflate. And any dramatic weight changes, especially in a repeated cycle of gains and losses, can make breast tissue even more slack.

3. You've likely never given a thought to your breast density, but it's super important

Large or petite, perky or droopy, round-ish or flat-ish, breasts come in all shapes and sizes—and also densities. According to Dense Breasts Canada (a non-profit organization run by health-care professionals and breast cancer survivors), about 43 percent of women over 40 have dense breasts. 

“When it comes to breast health and breast cancer risk, this density is really important,” says Dr. Mar. That’s because dense breasts put you at higher risk of developing breast cancer, and the density can make it harder for radiologists to spot cancer during a mammogram (an X-ray of the breasts to look for cancer).

Dense breasts can be big or small, and you can’t tell how dense they are by feeling them yourself. The only way to tell is with a mammogram. Described using letters A, B, C or D in some provinces, there are four categories of breast density—with C and D being the most dense. (And in some provinces and territories, women with more than 75 percent density are notified automatically).

4. You're not the only one with achy boobs

"So many women come in with breast pain and they’re afraid it’s cancer,” says Dr. Peddle. “I do a lot of reassuring patients about pain because 9 times out of 10 it’s not a problem with the breasts,” she says.

An intermittent, achy feeling in the upper breast area is most often referred pain coming from the neck, shoulders or chest muscles, says Dr. Peddle. “Particularly in recent months, with COVID-19, and many women working at home in non-ergonomic conditions where their posture is not good, I’m hearing even more about chest pain.”

5. You may need to ask for a mammogram—especially if you're in your 40s

The national guidelines set by the Canadian Task Force on Preventive Health Care recommend that most women have mammograms every two to three years, starting at age 50. “But these guidelines have been widely criticized for being out of date,” says Dr. Peddle. And emerging research does seem to support a more proactive approach for younger women. One key study, published in the May 2020 issue of the medical journal Cancer, followed more than half a million women in Sweden and found those who received regular mammograms were 41 percent less likely to die of breast cancer within 10 years of their diagnosis.

So what if you’re 40-something and think you’re at higher risk for breast cancer, due to a strong family history, for example? The Canadian Cancer Society suggests women in their 40s talk to their doctor to weigh the pros (including the fact that early detection may mean less treatment and easier recovery) and cons (which include the risk of a false-positive result). Dr. Peddle strongly advises all women over age 40 to consider yearly mammograms: “One out of six breast cancers are diagnosed in women in their 40s,” she says. “I try my best every day to help women advocate for their own breast health because we know that if we screen regularly we save lives—that’s the bottom line.”