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The 5 Steps Of A Breast Self Exam

Examining your breasts is an important way to find a breast cancer early, when it's most likely to be cured. Not every cancer can be found this way, but it is a critical step you can and should take for yourself. No woman wants to do a breast self exam (or "BSE"), and for many the experience is frustrating—you may feel things but not know what they mean. However, the more you examine your breasts, the more you will learn about them and the easier it will become for you to tell if something unusual has occurred. BSE is an essential part of taking care of yourself and reducing your risk of breast cancer.

Try to get in the habit of doing a breast self-examination once a month to familiarize yourself with how your breasts normally look and feel. Examine yourself several days after your period ends, when your breasts are least likely to be swollen and tender. If you are no longer having periods, choose a day that's easy to remember, such as the first or last day of the month.

Don't panic if you think you feel a lump. Most women have some lumps or lumpy areas in their breasts all the time. Eight out of ten breast lumps that are removed are benign, non-cancerous.

Breasts tend to have different "neighborhoods." The upper, outer area—near your armpit—tends to have the most prominent lumps and bumps. The lower half of your breast can feel like a sandy or pebbly beach. The area under the nipple can feel like a collection of large grains. Another part might feel like a lumpy bowl of oatmeal.

What's important is that you get to know the look and feel of YOUR breasts' various neighborhoods. Does something stand out as different from the rest (like a rock on a sandy beach)? Has anything changed? Bring to the attention of your doctor any changes in your breasts that:

last over a full month's cycle

OR

seem to get worse or more obvious over time

Knowing how your breasts usually look and feel may also help you avoid needless biopsies—a procedure in which the doctor takes a small sample of breast tissue and examines it under a microscope.

A journal can help

Some women find it helpful to keep a record of their breast self-exam on paper. This can be like a small map of your breasts, with notes about where you feel lumps or irregularities. Especially in the beginning, this may help you remember, from month to month, what is "normal" for your breasts. It is not unusual for lumps to appear at certain times of the month, but then disappear, as your body changes with the menstrual cycle. Only changes that last beyond one full cycle, or seem to get bigger or more prominent in some way, need your doctor's attention.

Breast physical exam

Some women wonder why they need to have their doctors examine their breasts when they're doing regular self-exams on their own. While it's true that most lumps are found by women themselves, a breast exam by a doctor helps find lumps that women may miss. Sometimes, the abnormality in a breast can be so difficult to feel that only someone with experience would recognize it. Lumps, thickening, asymmetry—changes in your breasts that you may not notice or think are "normal"—may be picked up on by people who examine many breasts regularly.

Studies show that regular breast self-exams, combined with an annual exam by a doctor, improves the chances of detecting cancer early.

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The Five Steps of a Breast Self Exam

Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.

Here's what you should look for:

breasts that are their usual size, shape, and color
breasts that are evenly shaped without visible distortion or swelling

If you see any of the following changes, bring them to your doctor's attention:

dimpling, puckering, or bulging of the skin
a nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
redness, soreness, rash, or swelling

Step 2: Now, raise your arms and look for the same changes.

Step 3: While you're at the mirror, gently squeeze each nipple between your finger and thumb and check for nipple discharge (this could be a milky or yellow fluid or blood).

Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few fingers of your hand, keeping the fingers flat and together.

Cover the entire breast from top to bottom, side to side—from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. Be sure to feel all the breast tissue: just beneath your skin with a soft touch and down deeper with a firmer touch. Begin examining each area with a very soft touch, and then increase pressure so that you can feel the deeper tissue, down to your ribcage.

Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in Step 4.