Self Breast Exam

by M. Punukollu M.D

Breast cancer is the most common cancer among women. The best time to treat breast cancer is when it is detected at its earliest stages.

Currently the causes for breast cancer are not known and the best protection is to detect it as early as possible.

How can I detect breast cancer?

Regular mammograms. Annual mammograms begin at age 40 years.

See your doctor for regular breast exams. At least every three years from age 20 to 39 and every year beginning at age 40.

Practice monthly self-breast exam.

It is important to get an idea of what your breasts feel like normally as this will enable you to be more aware of changes if they develop. You are the best authority on your own breasts. Doing self breast exam every month helps you become that authority.
It's a good idea to ask you health care provider to learn about doing self-breast exam and explain to you what you are feeling in the breast tissue so you are aware of what's normal. That way you can learn more about the difference in feel between normal breast tissue and lumps that may be of concern.
If you are still menstruating, it is best to wait at least two to three days after your period ends to do the self-breast exam when your breasts are less likely to be swollen and tender.

How do I perform a breast exam?

Visual Inspection

Stand in front of a mirror with your upper body unclothed and pressing both hands behind your head.
Look for changes in the shape and size of your breasts.
Check for dimples of the skin or "pulling in" of the nipples.
Check for scaling or a rash on your beasts and nipples.
Next, place your hands on your hips and press firmly inward, tightening your chest muscles, while looking at your breasts for any change in their usual appearance. Perform leaning slightly forward and again while standing upright.

How should I feel my breasts?

In fact, there are three different methods that can be used, all equally effective. It is important that you choose the method that you are most comfortable with and use the same method each month.

Circular method

Use the hand opposite the breast you are examining, beginning at the outermost top of your breast.
Press the flat portions of the second, third and fourth fingertips into your breast.
Move in small circles slowly around your breast, working toward the nipple.
Press gently to feel tissues under the skin and more firmly to feel deep tissues.
Cover all areas of the breast.
Repeat for the opposite breast.

"Wheel Spokes" Method

Imagine your breast is divided into sections, like spokes dividing a wheel.
Begin at the outermost top of the breast.
Press the flat portions of the fingertips into your left breast, moving first toward the nipple, then away from the nipple.
When you complete that section, slide your fingers slightly to the next area and repeat the process, gradually moving around your entire breast.
Repeat for your opposite breast.

Grid Method

Begin at the innermost portion of the breast, near the breastbone.
With the flat portions of the fingertips, move down your breast, pressing firmly and gently.
Slide your fingers slightly and move up your breast, then down, and so forth until the entire breast area has been examined.
Repeat for the opposite breast.

Lying down

Masses in the lower part of the breast may be more easily felt lying down.

To examine your left breast, lie flat on your back with a pillow or folded towel under your left shoulder.
Raise your left arm over your head.
Use the flat portions of the second, third and fourth fingertips of your right hand to examine your left breast with one of the above methods.
Press gently to feel tissues under the skin and then more firmly for deep tissues.
Repeat for the right breast.

Standing up

Masses in the upper part of the breast are easier to detect while standing upright.

Place your left hand behind your head, and with the flat portions of the second, third and fourth fingertips of the right hand, examine your entire left breast by one of the methods described.
Repeat for your right breast.

Nipple area

Gently squeeze your left nipple between your right index finger and thumb and look for any discharge.
Repeat for right nipple.

Additional areas

Check the area between the upper outer breast and your armpit, as well as the armpit itself.
Check the area just above your collarbones for enlarged lymph nodes.

When should I see my health care provider?

If you detect a lump or change in the breast.
Nipple discharge.
"Pulling in" of the nipple.
Change in texture, color or dimpling of the skin.

80% of all lumps found are normal breast tissue, benign (non-cancerous) masses. However, if you notice a change in your breast tissue, don't wait. See your health care provider immediately, even if you have had a negative mammogram in the past.

If you would like more information regarding breast cancer, or if you are concerned about breast cancer and would like to talk to a survivor, call the American Cancer Society toll free at 1-800-ACS-2345 or visit the web site at www.cancer.org.

Breast Health page

WATCH THIS slide show: called Stirrups and Stories - personal stories and thoughts about women's gyn exams

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