Leading breast cancer surgeon Associate Professor Sanjay Warrier is warning women of the importance of paying extra attention to their breasts once they turn 40.
Associate Professor Warrier is one of the world’s leading breast health and breast cancer surgeons who has built a highly respected practice in Sydney. The practice spans three locations with its main surgical centre located at the Chris O’Brien Lifehouse in Camperdown, and the other sites at BMA House, Macquarie Street, Sydney and Bondi Junction Medical, Oxford Street, Bondi Junction.
In addition to Associate Professor Warrier’s breast health and surgical work, he also dedicates considerable time to research exploring and developing advancements in breast cancer detection and treatments to improve outcomes for patients. He also developed the world’s first Master of Breast Surgery degree which is delivered through the University of Sydney.
He has guided many women through their breast journeys and is encouraging women to be more attentive to this often overlooked stage of breast health from the age of 40.
“This time of ‘perimenopause’, ie ‘the change before the change’, is a really significant time that is not often talked about, sandwiched as it is between youth and menopause. It’s actually a really important time to start noticing changes in your breast health, and start important conversations with those around you,” he said.
“The first change you might notice is breast sensitivity. Due to increased surges of estrogen, breasts can become tender and you may notice them a lot more than you did before.
“Your bra may start to feel a bit tighter than it used to. The shorter cycles, increased estrogen and inflammation can lead to swelling. This is more common in overweight women, as stored fat can increase estrogen in your bloodstream.”
So what about sagging? Associate Professor Warrier emphasises women not to worry as this is all part of the normal process of ageing.
“As you age, you lose collagen, your skin becomes less elastic and your tendons lose strength. Your Cooper’s Ligaments: bands of tough, fibrous, flexible connective tissue that shape and support your breasts, begin to sag. There’s nothing we can do about these specifically, but lifestyle factors can make a lot of small differences,” he added.
Your 40s is also the time when your breast cancer risk begins to rise.
“As your breasts age they can change shape, get lumpier and even denser. This can lead to feeling more lumps but also more difficulty in finding the troublesome ones. That’s why getting regular check-ups and screens to make sure anything concerning is caught early is a really good idea,” Associate Professor Warrier explained.
“Unfortunately, fear of embarrassment or anxiety about the screening procedure are common deterrents for women from having a breast screen.
“Although it may be a little uncomfortable, the few minutes of discomfort far outweigh the alternative.”
Associate Professor Warrier emphasises that there are many things we can do for our breast health in our 40s.
“Exercises like push-ups, wearing a more supportive bra, knowing your family health history and focusing on maintaining a healthy weight will go a long way to ensuring you have healthy breasts going into your 40s, 50s and 60s,” he said.
“Getting regular breast exams and noticing what changes aren’t normal are also crucial, and should become a regular part of your healthful routine.
“‘Utilising my easy to follow ‘three-step’ process, LOOK, LIFT, FEEL, which is a simple breast examination you can undertake yourself at home in front of the mirror, is the ideal way to check the health of your breasts on a regular basis. It is not meant to replace regular check-ups, but rather supplement them in between check-ups and annual scans. If you find anything concerning, you can make an appointment with your GP who will then determine the next best steps.
“The two biggest factors are non-modifiable; being female and increasing age. However, there are modifiable factors. Lifestyle plays a part. Beer, wine and spirits can increase the levels of oestrogen and other hormones in the body associated with breast cancer development. Smoking can increase your risk of breast cancer. However, regular exercise not only helps to keep your weight in check but can also lower oestrogen levels and boost your immune system.
“If you’re a little embarrassed to talk about your breasts with your friends, now is a great time to start opening up the topic as everyone is probably feeling as anxious as you. It can be a really great feeling to realise that while everyone is different, you’re actually totally normal.

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