Self-breast exam is a technique, a step by step approach for individual examination of the breast. It allows you to check for any physical and visual changes of the breast. It involves looking at and feeling your breasts for lumps and skin thickening. Often used as an early detection tool for breast cancer, breast self exam should be used by both men and women. It should however not be used as a sole screening method for breast cancer. Here are guidelines on how to do a self breast exam.
Self Breast Examination
Self breast exam seemed promising when it was first introduced. However, clinical trials have found no difference in women who did a routine self breast exam and those who did not. Experts do not recommend this as a screening tool for breast cancer. It may give more false results leading to early biopsies which turn benign.
Best Time to Do a Breast Self Exam
What is the best time to do a self breast exam? Breast exam should be performed by both men and women from the age of 18 at least once every month. Choose a specific day each month preferably at the end of your monthly period. If pregnant or not menstruating, do your breast exam same day every month. It is advisable to keep a journal of your BSE’s to track and keep record of any changes.
According to The Breast Cancer Charities of America, 1 in 8 women will be diagnosed with cancer. When detected early, breast cancer has a 98% survival rate. It is very important for you to know what is normal. Get to know what your breasts normally look and feel like. This will help you detect any changes. Any unusual changes should be reported to your doctor. Your doctor will discuss with you the benefits and limitations of a self breast exam.
Unusual symptoms to check for include:
- Change in size or shape of the breast. One breast may be normally larger. However, sudden changes should not occur.
- Dimpling or puckering of breast skin. The skin may have pitting marks that make it look like an orange
- A lump or thickening in, near the breast or in the underarm area.
- Nipple discharge that occurs without squeezing the nipple, only in one breast, if clear or bloody
- Nipple retraction
- Scaly, itchy, red, warm breast skin
- Unexplained swelling or shrinking of the skin
- Noticeable increase in size and number of veins compared to the other breast
Note that lumps are rarely a sign of breast cancer. If you find a lump or any changes, do not panic. Consult your doctor for an evaluation. If you’ve had a benign lump in the past, do not assume that a new lump will also be benign.
Other than breast cancer, breast lumps can be caused by:
- Mammary fat necrosis- lumps formed by injured or dead fat tissue
- Fibrocystic breast disease- painful, lumpy breasts caused by hormonal changes
- Adenofibroma- benign tumor of the breast tissue
- Intraductal papilloma- small, benign tumor of the milk ducts
How to Do a Self-Breast Exam
Even though considered a less effective screening tool, a BSE helps you to familiarize yourself with the size, shape and texture of your breasts. This will help you determine what is normal or abnormal. Here is how to a self-breast exam
While Lying Down
This is the best position to perform a BSE. The best tissue spreads out evenly on the chest wall.
- Place a small pillow or folded cloth under your right shoulder
- Place your right arm behind your head
- Using your left hand, move the pads of your fingers gently in circular motions. Keep your fingers flat and constant in a clockwise directions. Once you complete a full circle, move in toward the nipple and complete another circle.
- Do this until you cover the entire breast and the nipple. When gently pressed inwards, the nipple should move easily.
- Squeeze the nipple to check for any discharge
- Do not forget the upper outer areas of your breast towards the armpit
- Repeat the steps above for your left breast
In Front of the Mirror
This will help you note any changes in shape, size and contour of the skin on either breasts.
- Place arms at your sides
- Raise both arms above your head, bending forward
- Place hands firmly on your hips and hunch over to flex your chest muscles
- Check for any nipple discharge; be it clear, milky, yellow or bloody
In the Shower
The fact that your hands are wet and slippery makes this procedure easy and fast.
- Place your left hand on your hip
- With your right hand, reach for your underarm area and feel for any lumps and thickening
- Check for the same below and above the collarbone
- Use the flat part of your index, middle and ring finger follow and up and down pattern from the bra line to the collarbone.
- Continue until the entire breast is covered. Repeat the procedure for the other breast
Almost half of cancerous lumps are found in the upper outer quadrant. Also known as the tail of the breast, it is advisable to examine this area closely.
Incidence of cancerous lumps in each area of the breast are as follows:
- 41% in the upper outer quadrant
- 14% in the upper inner quadrant
- 5% in the lower inner quadrant
- 6% in the lower outer quadrant
- 34% in the area behind the nipple
Self Breast Exam Recommendations
Always remember that self breast examination should not be used as a sole screening tool for breast cancer. Mammography can detect lumps before they can be felt in a BSE. A combination of both mammography, BSE and regular medical care is recommended for early detection of any abnormalities. If you find a lump, DO NOT panic. 8 out 10 lumps are not cancerous.
- Once every month, set aside 15 minutes to conduct a thorough breast examination
- Do a mammography screening every other year if above 50 years. Consider a thermography screening on alternate years. If positive, schedule a mammogram.
- When there’s need to perform a mammogram, schedule it within the first 14 days of your menstrual cycle.
- If you have breast implants, have a doctor help you to identify the edges of your implants so that any changes in contour can be easily noted.
Sources and References
How to Do a Breast Self Exam: Maurer Foundation
Breast Self Exam: National Breast Cancer Foundation, Inc
The 5 Steps of a Breast Self Exam: Breastcancer.org
Understanding Breast Cancer: The Breast Cancer Charities of America