Breast Self-Exam


It has been some time now since I have discussed any medical issue and so I will continue the discussion on preventive medicine.


Breast cancer is the most common cancer among women after skin cancer. The most effective way to fight breast cancer is to detect it early. Although the most effective tools to detect breast cancer are mammography and clinical breast exam by your health professional, the breast self-exam may also be an effective tool to find cancer early. In fact, women who perform regular breast self-exam find 90% of all breast masses.


While 80% of all breast lumps are not cancerous, you can help catch potentially serious changes early by regularly performing a self-exam. This is so due to the fact that if breast cancer is detected in its early stages then your chances of surviving the disease are greatly increased.


The best time to examine your breasts is monthly about three to five days after your menstrual period ends.If you have stopped menstruating, perform the exam on the same day of each month, such as the first day of the month. With each exam, you will become more familiar with the contours and feel of your breasts and will be more alert to changes.


To do a breast self-exam is simple and you can follow the steps below:


In the mirror


1.       Stand undressed from the waist up in front of a mirror in a well-lit room. Look at your breasts. Don't be alarmed if they do not look equal in size or shape. Most women's breasts aren't. With your arms relaxed by your sides, look for any changes in size, shape, texture or skin. Look for skin puckering, dimpling, sores or discoloration. Inspect your nipples and look for any sores, peeling or change in the direction of the nipples.


2.       Next, place your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. Turn from side to side so you can inspect the outer part of your breasts.


3.       Then bend forward toward the mirror. Roll your shoulders and elbows forward to tighten your chest muscles. Your breasts will fall forward. Look for any changes in the shape or contour of your breasts.


4.       Now, clasp your hands behind your head and press your hands forward. Again, turn from side to side to inspect your breasts' outer portions. Remember to inspect the border underneath your breasts. You may need to lift your breasts with your hand to see this area.


5.       Check your nipples for discharge (fluid). Place your thumb and forefinger on the tissue surrounding the nipple and pull outward toward the end of the nipple. Look for any discharge. Repeat on your other breast.


In the shower

6.       Now it's time to feel for changes. It is helpful to have your hands slippery with soap and water. Check for any lumps or thickening in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat on the other side.

7.       Check both sides for lumps or thickenings above and below your collarbone.

8.       With hands soapy, support the breast with one hand while using the other hand to feel the tissue. Use the flat part of your fingers to press gently into the breast. Follow an up-and-down pattern along the breast, moving from bra line to collarbone. Continue the pattern until you have covered the entire breast. Repeat on the other side.

Lying down

9.       Next, lie down and place a small pillow or folded towel under your right shoulder. Put your right hand behind your head. Place your left hand on the upper portion of your right breast with fingers together and flat. Body lotion may help to make this part of the exam easier.


10.   Think of your breast as a face on a clock. Start at 12 o'clock and move toward 1 o'clock in small circular motions. Continue around the entire circle until you reach 12 o'clock again. Keep your fingers flat and in constant contact with your breast. When the circle is complete, move in one inch toward the nipple and complete another circle around the clock. Continue in this pattern until you've felt the entire breast. Make sure to feel the upper outer areas that extend into your armpit.


11.   Place your fingers flat and directly on top of your nipple. Feel beneath the nipple for any changes. Gently press your nipple inward. It should move easily.


Repeat steps 9, 10 and 11 on your other breast.


After doing the breast exam, if you notice any changes that persist after your menstrual cycle or any other changes that you may be concerned about then you should visit your doctor. Some conditions that warrant a visit to the doctor include:

                     An area that is distinctly different from any other area on either breast

         Lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle

                     A change in the size, shape or contour of the breast

                     A mass or lump, which may feel as small as a pea

                     A marble-like area under the skin

         A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly or inflamed)

                     Bloody or clear fluid discharge from the nipples

                     Redness of the skin on the breast or nipple.


The self-exam of the breast is quite simple and can be done within five minutes and so this exam done routinely can protect you from the problem of breast cancer.

In the next session I will discuss breast cancer.


Excerpts taken from The Cleveland Clinic