Breast Self-examination (BSE) is a technique which allows a woman to examine her breast by herself for any physical or visual changes.
A breast self-exam was once thought to be a good screening process for breast cancer. Now, a self-exam is considered to be less effective than other techniques, such as regular mammograms. This has led groups, such as the American Cancer Society to deem breast self-exams optional.
However, breast self-exams help you familiarize yourself with the shape, size, and texture of your breasts. This is important because it can help you determine if what you’re feeling is normal or abnormal. Anytime you feel an abnormality in your breast, tell your healthcare provider.
Breast lumps can be noncancerous (benign) or cancerous (malignant).
Breast cancer can occur at any age, though it is most common in women older than 50 years.
Besides cancer, breast lumps or changes can be caused by fibroadenoma, mastitis, fibrocystic breast disease, intraductal papilloma, mammary fat necrosis, among other conditions.
BSE should be performed at least once a month beginning at age 18.
How do you perform a breast self-exam?
The best time to examine your breasts is usually one week after your menstrual period starts, when your breasts are least likely to be swollen or tender.
A breast self-exam normally doesn't cause any discomfort. If your breasts are tender because your menstrual period is about to begin, you may feel slight discomfort when you press on your breasts.
Examining your breasts at other times in your menstrual cycle may make it hard to compare results of one exam with another.
If your menstrual cycle is irregular, or if you have stopped menstruating due to menopause or the removal of your uterus (hysterectomy), do your examination on a day of the month that's easy to remember.
To do a breast self-exam, remove all your clothes above your waist:
- Stand in front of a mirror with your arms on your hips
- In each area of one breast, look for unusual size, shape, color, distortion, dumpling, inverted nipple, redness, soreness, rash or nipple swelling.
- Raise your arms and look for same changes
- Squeeze each nipple between your thumb and index finger to check for nipple discharge.
1. Lying down spreads your breasts evenly over your chest and makes it easier to feel lumps or changes. Check your entire breast by feeling all of the tissue from the collarbone to the bottom of the bra line and from the armpit to the breastbone.
2. Use the pads of your three middle fingers—not your fingertips. Use the middle fingers of your left hand to check your right breast. Use the middle fingers of your right hand to check your left breast. You can use an up-and-down or a spiral pattern. Move your fingers slowly in small coin-sized circles.
3. Use three different levels of pressure to feel all of your breast tissue. Light pressure is needed to feel the tissue close to the skin surface. Medium pressure is used to feel a little deeper, and firm pressure is used to feel your tissue close to your breastbone and ribs. Avoid lifting your fingers away from the skin as you feel for lumps, unusual thicknesses, or changes of any kind.
4. Squeeze each nipple between your thumb and index finger to check for nipple discharge.
When in doubt about a particular lump, check your other breast. If you find the same kind of lump in the same area on the other breast, both breasts are probably normal.
You may also check them while in the shower. Soapy fingers slide easily across the breast and may make it easier to feel changes. While standing in a shower, place one arm over your head and lightly soap your breast on that side.
Then, using the flat surface of your fingers—not the fingertips—gently move your hand over your breast, feeling carefully for any lumps or thickened areas.
It takes practice to perform a breast self-exam. Having fibrocystic lumps also may make a breast self-exam difficult, because lumps occur throughout the breast.
Ask your doctor for tips that can help you do it correctly.
What are the risks of doing breast self-exams?
The risk of doing breast self-exams is that you may find a breast change that makes you anxious and may lead to unnecessary tests (such as a biopsy).
Also, a change you notice on a breast self-exam may be a kind of cancer that would never cause symptoms or threaten your life. But because no one can tell what kinds of cancer will cause problems, all cancers are treated.
This means that you may end up having treatments (such as surgery, radiation, and chemotherapy) that you don't need.
These treatments can cause harmful side effects.
Because of these risks, many experts don't recommend breast self-exams. Others consider it an option for women.
Talk with your Doctor about breast self-exams.
When should you see a doctor about breast self-exams ?
After you know what your breasts normally look and feel like, any changes should be checked by a Doctor.
Changes may include:
- Any changes in the skin of your breasts or nipples, such as puckering or dimpling.
- An unusual increase in the size of one breast.
- One breast unusually lower than the other.
- Any lump, whether painful or painless.
- Sticky or bloody nipple discharge.
- Unusual thick areas.
Talk to your doctor about having regular mammograms as well as regular breast checkups