It is a sad truth that one in eight women in the UK will develop breast cancer at some point in their lifetime. One of the things that gives us hope when we think about this is the established fact that the earlier the diagnosis, the better the chance of beating it.
Most breast cancers are found by women noticing unusual changes in their bodies, taking the initiative and visiting their doctor.
But worryingly, a survey conducted last year by the charity, Breast Cancer Now, revealed that as many as 46% of women do not check their breasts regularly or have never checked themselves for signs and symptoms of the disease. These are women who could be missing vital opportunities to give themselves a fighting chance, should it happen to them.
Providing breast cancer education in schools could mean equipping future generations of women with the knowledge and confidence to do these checks throughout their life. The findings of my latest research, conducted with academics at the University of Portsmouth and University of Chichester, make a compelling case for this.
Breasts are the first outwardly visible sign of puberty, and it'll be no surprise to any woman reading this that breast development is often associated with decreased body satisfaction and low self-esteem. Yet there seems to be a reluctance to discuss concerns about breast health at a young age and currently the school curriculum in the UK offers no compulsory breast education beyond the biological aspects of puberty.
We surveyed over 2000 schoolgirls (aged 11-18) and more than a quarter (26%) reported negative feelings when their breasts developed and 87% reported at least one breast concern.
One of the most commonly reported concerns was breast cancer and how to check themselves for signs of the disease, with 72% of schoolgirls reporting that they wanted to know more about this topic.
These girls were represented in every school type -- single sex schools, single sex schools with boys in sixth form, and mixed schools -- and there was no connection between the desire for increased knowledge and the girls' breast sizes. It is universal.
Interestingly, our survey revealed that girls from black and ethnic minority backgrounds are three times more likely to rate the topic as 'not important' compared to white girls.
This supports previous research in adults, which shows that breast cancer knowledge is worse in black and ethnic minority women and that although the incidence of breast cancer is lower in women from this population, they are more likely to be diagnosed with meta-static cancer and to die from it. Cultural and religious beliefs, embarrassment and considering cancer a 'taboo' subject are all recognised barriers to learning about the disease and participating in health promotion activities in these women.
While developing breast cancer at an early age is extremely rare, research shows that adolescence is a critical time where life-long behaviours are established. Teaching schoolgirls breast awareness may encourage positive breast health behaviours in adulthood, when the risk of breast cancer is greater to them.
And this education could and should extend beyond breast cancer alone - this was just one of the concerns girls reported in our survey. For example, around half said that they avoided sport because of their breasts, with this effect more prevalent among larger breasted girls (≥ D cups).
This reluctance to participate in exercise was linked to breast bounce, breast pain, and embarrassment about their bodies. We know that appropriate breast support can reduce, or even eliminate problems associated with breast movement during sport, however more than half of the girls reported never wearing a sports bra during exercise. With the right education we can alleviate many of these worries.
Schools are fundamental settings for promoting health. Armed with the knowledge of girls' breast concerns, we have developed a range of breast health education resources covering issues including breast awareness and the benefits of appropriate support.
We have successfully piloted some of these resources and out of 100 girls who attended a breast health workshop at school, 90% found it helpful and 84% reported that it should be available to other schools. Based on feedback from the girls surveyed, our recommendation to schools is that sessions are delivered by a female educator, to a girls-only group at around the age of 11 years.
Engaging girls on how to be breast aware from a young age, will help them to recognise what is normal for them and when to seek help.
Ultimately, this could provide the opportunity to increase the likelihood of girls practicing positive breast health behaviours in adulthood in a sustainable and cost-effective way, and lead to better long-term health outcomes for women in future.