Breast Self Examination
Medical experts don't recommend regular breast self-examinations. Studies show that self-exams don't save women's lives and that they can lead to unneeded tests, such as biopsies. But some experts believe that women should know how their breasts look and feel (breast self-awareness) so any breast changes can be reported to a doctor.
How to Perform a Breast Self-Exam
Breast self-exam (BSE) is one way a woman can track any changes in her breasts, and adult women may choose to perform monthly breast self-examinations. Even though breast self-examination is not recommended as a screening tool for breast cancer (routine mammography is recommended for breast cancer detection), every woman should become familiar with how her breasts feel and look so she can more easily identify changes she feels or sees in her breasts. Any changes in your breasts (nipple discharge, change in size, color, lumps, etc.) should be discussed with your health-care professional as soon as possible (it is important to remember that if you find changes in your breast it does not necessarily mean it is cancer).
If you still have menstrual periods, perform the examination a few days after your period has ended. During this time, your breasts are less tender and less lumpy. If you are not menstruating (such as after menopause), breast self-examination should be performed on the same day each month.
Breast Cancer Symptoms and Signs
If you notice any of the following changes in your breasts, notify your doctor as soon as possible. Possible signs and symptoms of breast cancer include:
Changes in the nipple:
- Change in appearance
- Nipple that is slightly depressed inward (retracted)
- Any discharge
Changes in the appearance of the breast:
- A new lump or lumps in the breast (not all lumps are cancerous)
- Unexplained change in the size or shape of the breast
- Dimpling or puckering on the surface skin of the breast
- Unexplained swelling or shrinking of the breast
- Unexplained pain in one spot that will not resolve
- Redness, warmth, or scaly skin on the breast
- A hard lump, knot, or thickening inside the breast or underarm
- Itchy or scaly skin on the breast
Facing a Mirror
Use the following techniques if you wish to perform breast self-examination. Choose the method that is best for you. Stand before a mirror and compare the breasts for differences in size, nipple inversion (turning in), bulging, or dimpling. Note any skin or nipple changes, such as a hard knot or nipple discharge.
Inspect your breasts in the following four steps:
- With your arms at your sides
- With your arms overhead
- With your hands on hips - press firmly to flex your chest muscles
- Bend forward - inspect your breasts
In these positions, your pectoral muscles are contracted, and a subtle dimpling of the skin may appear if a growing tumor has affected a ligament.
- Place a pillow under your right shoulder
- Put your right hand under your head
- Check the entire breast area with the finger pads of your left hand
- Use small circles and follow an up-and-down pattern
- Use light, medium, and firm pressure over each area of the breast
- Feel the breast with the surfaces of the second, third, and fourth fingers, moving systematically and using small, circular motions from the nipple to the outer margins
- Gently squeeze the nipple for any discharge
- Repeat these steps on your left breast using your right hand.
In the Shower
Breast self-examination can easily be performed while you're in the bath or shower. Some women discover breast masses when their skin is moist.
- Raise your right arm.
- With soapy hands and fingers flat, check your right breast with your left hand.
- Use the same small circles and up-and-down pattern described earlier.
- Repeat on the left breast with your right hand.
If you have breast implants it may be useful to have your surgeon or doctor assist you in identifying the edges of the implants so you can identify any changes you may feel in your breasts.