Breast cancer has taken up a large part of my life. As my book, Staying Alive: A Family Memoir reveals, my mother and two aunts all suffered from the disease, all diagnosed when mothers and relatively young women - and - as cases can be linked to genetics, so did I. Unlike my mother and her sisters, I was fortunate enough to benefit from significant advances in treatment. In the 90s I underwent a preventive bilateral mastectomy, in which early stage cancer was discovered. By taking this action I had effectively saved my life.
Given that nearly 900 women in the UK are diagnosed with breast cancer every single week, I know that I am not alone in this experience. Indeed, it is likely that every woman knows or will know someone that has experienced breast cancer, a disease that all women know and hear about through high profile campaigns (e.g. Breast Cancer Awareness Month launching today).
Yet despite this prevalent public attention, a report commissioned by Avon Cosmetics Limited - the Avon Breast Promise Report - has shown that over one-third of the women rarely or never check their breasts. This is despite women claiming to know how to do it - perhaps mysterious until you delve into the psychology of breast self-checking.
Breast checking campaigns stress its importance as a way to avoid risk: if you spot something abnormal early you are more likely to catch the disease at a point when it may be treatable, even curable (as I did). But young women, unless they have a family history like mine (and in terms of percentage of breast cancer, that's only about 8% of cases) the risk to them is minimal.
The incidence of breast cancer statistically rises as you age. Younger women quite rightly do not see breast checking for risk reasons as particularly relevant to them. Indeed, fear as a motivator for habit change, unless the risk is clearly personal, can be problematic: people can be too scared, especially if they aren't exactly clear what to look for as they check, and may prefer to avoid checking for fear of what they might find. So the task for anyone trying to persuade women to develop the habit of breast checking, for women who don't see themselves at risk (the younger groups, especially) is to find a different motivator: something positive.
Moreover, we know that habit change begun early signals habits that are likely to stick. The younger you develop the habit of breast checking, then, the better. Children don't care about rotting teeth - they aren't likely to develop them if they don't brush teeth until they get older. Again, the risk doesn't apply to them. Yet parents mostly get their children into teeth brushing habits, and do so when they are young. They emphasise other things: the clean feeling, the praise that is given for actually sticking to the routine each day and night.
Similarly, breast checking can be tied to a positive reward, and the Avon research showed that those rewards can be getting to know your body and feeling you are looking after your breasts as part of a regime, like exercise and grooming as, like these, an investment in good health and future good health. Tying breast checking in this way to a positive reward, positive feelings of looking after yourself as an 'investment' can start young.
Because the earlier a habit forms the easier it is to stick doesn't mean that habits developed later are that much harder to set in. Habits become easier to form if they 'make sense' in terms of a person's life. The Avon Breast Promise Report shows that 55% of women admitted that they would be more likely to check their breasts if they looked at the process as part of their general health and beauty regime. In addition to those women who would be motivated by the 'positives' are those who 'personalise' the risk of breast cancer - for instance, if a relative background develops it. About 10% of women would develop breast checking habits as a preventative measure against breast cancer.
Another key thing about helping habits to form is that they need consistency and repetition. This can be difficult to do if you don't get help in both of these--encouragement and assistance from people who matter to you.
As part of the Avon Breast Promise campaign, I have devised a five-step guide to help drive behaviour change and get women into the habit of breast-checking.
1. Promise to Teach - Create a legacy by teaching your daughter to know and love her breasts, by promising to look and check.
2. Promise to Repeat - Aim to repeat your breast checks every month.
3. Promise to Remind - Remember to check by setting an automatic alert on your mobile, iPad, computer or calendar.
4. Promise to Sync - Add a breast check to part of an existing health, fitness, or beauty routine.
5. Promise to Share - Letting friends and family know about your promise will help you keep it.