The Importance of Breast Self-Exams
- LeaAnn Bonnema, a 56-year-old hairdresser living in Hawarden, Iowa, was diagnosed with estrogen-based breast cancer at 45 years old after finding a lump on her left side while lifting weights.
- Now 56, Bonnema is celebrating 10 years cancer-free and is spreading awareness for the disease.
- It’s important to be aware of how your breasts normally look and feel, a major factor when it comes to breast cancer detection. Doing regular self-exams is one way to familiarize yourself with how your breasts normally feel so that you will be able to identify anything out of the ordinary like a lump or hard mass.
Now 56, the hairdresser, who celebrated 10 years cancer-free this past summer, is spreading awareness for the disease and urging others to maintain a support system amid a cancer battle.
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That phone call, during the summer of 2012, revealed Bonnema’s biopsy was positive for cancer and that she’d have to follow up with the doctor.
"You know how that always is, the next checkup, it is bigger, there was more cancer, and so I did have to do chemo and radiation after my surgery," Bonnema, who hoped all she would need was surgery and some radiation, told NWestIowa. "When I found out I had to have chemo, that changed a little."
Once again, Bonnema received another important phone call while in her saloninforming her she would need chemotherapy.
Bonnema admitted she and her husband “played down” the diagnosis for their children. She explained, “At the time (my daughter) Laney was only in fifth grade. So she would ask, 'Is this bad?' And you know we would say no, it's fine, that is just, you don't think about anything else and thankfully that is the way it did turn out, just fine."
The worried mom later found an oncologist in Avera, Sioux Falls, where she began chemotherapy treatments on March 19, 2012. Bonnema completed her chemo on May 19 of this year before doing 32 treatments of radiation five days a week.

Now, Bonnema hopes to inspire others to get routine mammograms starting at age 40, take things one day at a time, and maintain a good support system.
"You can't let yourself go into thinking of anything else, thinking ahead into next week, nothing but one day at a time, it is all you can take when you are going through something like this," she advised. "You can't think about next week, anything, just today. You never know what is going to hit you in life, so just take it the best you can and one day at a time."
Bonnema, who lost her hair after her third chemo treatment and maintained a positive attitude as she rarely wore a wig, kept her business running during her cancer battle to keep her routine normal, thanks to the help of her fellow stylists.
Coming from a family of 10 children has also allowed Bonnema to have a large support system as she underwent treatment, something she hopes others with cancer have to make the fight easier.
Breast Cancer in Women Younger than 45
Breast cancer is the second most common cancer among women in the United States, according to the U.S. Centers for Disease Control and Prevention.
The CDC also reports that breast cancer mostly occurs among older women, but it's possible for women under the age of 45 to be diagnosed with this type of cancer. In fact, about 9% of all new breast cancer cases in the U.S. are found in women younger than 45.
But in some ways, a diagnosis for a younger woman can often be even more devastating, Dr. Ann Partridge, an oncologist at Dana-Farber Cancer Institute in Boston, told SurvivorNet in a previous interview.
Getting To Know Your Breasts With Self-Exams
This is because the cancer is likely to be a more aggressive form of the disease and also at an advanced stage, as screening for younger women is not standard.
It's important to know it is possible for young women to get breast cancer, so listening to your body when something doesn't feel right is vitally important.
How To Perform Self-Exams
Getting to know how your breasts look and feel may be one of the best ways to recognize when something is not quite right. "When we think about breast cancer prevention and awareness, the first step is that women need to feel comfortable with their breast and know what their breasts feel like normally," says Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center and an advisor to SurvivorNet. Here's how, according to the National Breast Cancer Foundation:
- While standing straight in front of a mirror, place your hands on your hips and look at your breasts for any swelling, bulging, changes in shape of breast or nipple (inverted), redness, rashes, or any fluid leaking. Then do the same with your arms in the air.
- Next, while lying down, use your right hand to examine your left breast and vice versa, while using your first three fingers to apply pressure. Ensure you cover the entire breast area, from your collarbone to below your ribcage and from your armpit to your cleavage area. Do the same self-exam standing or sitting up. Be sure to use light to medium pressure for the middle breast area and firmer pressure when feeling deep breast tissue.
Once you get the hang of it, Dr. Comen recommends you do it once a month after your period. However, it should be emphasized that breast self-examination is NOT a replacement for mammography.
Symptoms of Breast Cancer
Being aware of how your breasts normally look and feel is an important factor when it comes to breast cancer detection. Doing regular self-exams is one way to familiarize yourself with how your breasts normally feel so that you will be able to identify anything out of the ordinary like a lump or hard mass.
Below are some other symptoms to look out for:
- New lump in the breast or underarm (armpit)
- Any change in the size or shape of the breast
- Swelling on all or part of the breast
- Skin dimpling or peeling
- Breast or nipple pain
- Nipple turning inward
- Redness or scaliness of breast or nipple skin
- Nipple discharge (not associated with breastfeeding)
Of course, these symptoms can be due to things other than cancer. For example, a lot of women experience breast tenderness during certain times in their menstrual cycles. If you're worried talk to your doctor about it. They may want to perform an exam, or even schedule a mammogram just to be safe.
The Importance of Breast Cancer Screening
Screening for breast cancer is typically done via mammogram, which looks for lumps in the breast tissue and signs of cancer. The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms.
For screening purposes, a woman is considered to be at average risk if she doesn't have a personal history of breast cancer, a strong family history of breast cancer, a genetic mutation known to increase risk of breast cancer such as a BRCA gene mutation or a medical history including chest radiation therapy before the age of 30.
Beyond genetics, family history and experience with radiation therapy, experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
In a previous interview with SurvivorNet, Dr. Connie Lehman, chief of the Breast Imaging Division at Massachusetts General Hospital, said people who hadn't reached menopause yet should prioritize getting a mammogram every year.
When Should I Get a Mammogram?
"We know that cancers grow more rapidly in our younger patients, and having that annual mammogram can be lifesaving," Dr. Lehman said. "After menopause, it may be perfectly acceptable to reduce that frequency to every two years. But what I'm most concerned about is the women who haven't been in for a mammogram for two, three or four years, those women that have never had a mammogram. We all agree regular screening mammography saves lives."
Contributing: Survivornet Staff
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