Avon's Breast Promise: The Second Generation

01/10/2013 13:20 BST | Updated 30/11/2013 10:12 GMT

In 2012, I worked on a pioneering report with Avon UK exploring the psychology of breast checking and why over one-third of the women rarely or never check their breasts. The report revealed younger women, understandably, do not see breast checking as particularly relevant to them because they are at statistically lower risk. 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.

This year we continued our research, and investigated whether encouraging mother-daughter conversations on regular breast checking would develop positive breast awareness habits at a younger age. By adopting a regular breast checking habit at a younger age it is more likely the habit will stick for life, women will be much more aware of their bodies and any changes later in life will be detected at an earlier stage.

Breast cancer is the most common cancer in the UK, with around 135 women diagnosed every day. With one in three women in the UK not checking their breasts, creating a habit at a younger age could increase breast awareness across the life course and improve the rate of early detection.

Avon Breast Promise - the Next Generation asked 2,000 women, supplemented by focus group research, who would be best placed to teach young women about breast awareness and what role a mother could play in passing on positive breast checking habits to her daughters.

This quantitative research found that both mothers and daughters are very aware of health; however neither group is in a regular breast checking habit. From this we speculated that there is a real opportunity to equip mothers with knowledge - because if they do not have it, and don't feel confident, themselves, about breast checking, they cannot help their daughters to do so. Moreover, security in knowing about how to check correctly, when, and why, is likely to breed more ease in talking about breast awareness to their daughters. Indeed, over a third of mothers (31 per cent) surveyed had not spoken with their daughters about breast awareness, even though 40 per cent of mothers believe they are best placed to teach their daughters about breast awareness.

Further qualitative research also found that both mothers and daughters felt that mothers could be sources of information for daughters. Furthermore, the focus groups amplified this finding: while daughters would actually welcome conversations about breast checking with their mothers, and while mothers would like to be able to have these conversations with their daughters, both groups needed to be sure that, on the one hand, turning to mothers would yield correct information about breast checking, and, on the other, that mothers, themselves, needed to gain correct information and feel secure about it, before being able to have such conversations.

This is important, because opening up the conversation between mothers and daughters is likely to instil regular breast checking habits in daughters from a younger age, and we know that the earlier good health habits are developed the more entrenched they become as normal behaviour.

During the focus groups, both mothers and daughters highlighted that their understanding of breast checking was closely associated with looking for cancer and the prospect of death. For many, this immediate link to breast checking is a barrier to initiating discussions. Over half of mothers who stated they had not had a conversation about breast awareness with their daughters, chose not to because of fear, or lack of knowledge. However, the same groups showed that daughters are keen to learn about breast checking: they glean their information from media (the coverage, for instance, of celebrities' experiences of breast cancer is where many of the daughters were getting their information).

They wondered why information about breast checking is not as much part of normal conversations as related topics are, such as information about safe sex or reproductive health, or general health knowledge. And they felt that if that were so- that is, that discussions about breast health and checking were made more 'normal' they would find it easy to ask their mothers about how to do it. For their part, the mothers in the focus groups felt that they wanted to help their daughters but needed to be clear they had the right facts. The groups showed that, in fact, they did not: many did not know the correct way to breast check, and most misunderstood the genetic risk from breast cancer, thinking that most breast cancers were genetic, when in fact, only about 8 percent are genetically linked.

The research provides a very clear indication that both mums and their daughters wish to discuss breast awareness issues, including how to breast check. Most mothers see it as their duty to broach the subject with their daughters and to talk openly about it. While a significant proportion of the younger women in the focus groups related to their breasts purely in aesthetics, to their credit, they showed they are breast aware. They also indicated they are willing to, and do, take awareness campaigns seriously. However misinformation exists and they don't feel they can speak openly with their mothers about it. Our research found that mothers don't feel they have the correct information and thus a vicious cycle of silence ensues between both groups.

There is the need to claim our breasts back for ourselves - the current culture and media influences means that breasts are seen as sexual objects, as the daughters in the focus group indicated. When discussing breasts, daughters expressed concerns around how their breasts look, some even talked about breast enlargement, but there was little concern over breast health, per se, even if there was a keenness to learn more about how to preserve health through accurate checking. To mark Breast Cancer Awareness Month (BCAM) the research results will be presented to breast cancer charities and the Department of Health in October, 2013, highlighting how a mother can be the primary informer in shaping her daughter's awareness of breast health.

In response to the research, Avon UK has devised a piece of educational guidance, with the support of Breakthrough, for mothers to use to talk to their daughters about how to form healthy breast habits: