Women may have a tendency to neglect this because they lack a menstrual period marker as a reminder. Women over 40 are in a higher risk group for breast cancer than younger women; thus, it is especially important that they continue breast self-examination. In addition, be certain to assess for fetal heart sounds and fetal move- ment at prenatal visits because hydatidiform mole has a higher than usual incidence in the woman over 40 (see Chapter 15)