Women should begin doing self breast exams beginning in their 20s. Performing these breast examinations at home becomes a habit that may one day save her life. Women should know how their breasts normally look, feel and react and should report any new changes to their primary care physician or gynecologist as soon as they have been found. Many breast changes that a woman may find are not necessarily linked to breast cancer but may be an indication of another underlying medical condition. (1)
However, women can only notice changes if they have a good awareness of how their breasts normally look and feel each and every month. Doing a breast self exam is a step-by-step approach to becoming aware and intentionally looking for any changes. The best time to do a self-examination is when the breasts are not tender or swollen because of hormonal changes which go on each month. This means that the week following her menstrual period will be a time when breasts will be the least sensitive and the least tender.
Women who have breast implants should also do self examinations each month. Once the breast has healed from any implants the woman should have the surgeon help her define where the edges of the implants are so that she is aware of what she is feeling. Women who are pregnant or breast-feeding should also examine their breasts regularly.
Breast examinations are very easy and require only about 15 minutes every month in order to protect your health and your future. Begin by standing in front of a mirror which allows you to see both breasts at the same time. Stand with your hands on your hips and check the appearance of the breast. Do the same thing with your arms over your head. You are looking at the size, shape and symmetry. Note if there are any changes in the skin color, texture, or nipples. Pay attention to any dimples, bumps or retraction in the nipple area and look into the armpit area to see if you notice any swelling along the lymph nodes. (2)
The next step is to manually palpate the breast tissue to determine if you notice any changes in density or any lumps. Many women prefer doing this lying down but the procedure can also be done standing up. The American Cancer Society recommends that the breast exam is done while lying down because this allows the tissue to spread evenly over the chest wall and makes it much easier to feel all of the tissue. (3)
Use the finger pads of the middle three fingers on your left hand to feel for lumps on the right breast. You will be moving throughout the breast tissue in an up-and-down pattern starting with an imaginary line from the inside of your under arm to the middle of your chest bone. You will be checking the entire breast tissue going up and down until you feel only rib or the collarbone.
Use overlapping circular motions of the finger pads to feel the tissue but your hand will be moving in a straight line from collarbone toward your waist and back again. Use light pressure to feel the tissue that’s closest to the skin and then make the pressure slightly harder to feel a little deeper and then the firm pressure to feel the tissue that’s closest to the chest and ribs. Use each of these levels of pressure to feel the breast tissue in the spot your hand before moving on to the next spot.
Breast self examinations were once taught to be completed in a circular pattern from the nipple outward toward the tail of the breast tissue which resides under the armpit. However, there is been some evidence to suggest that using this up-and-down pattern is more effective for covering the entire tissue without missing any spots.
When using your right hand to examine your left breast put your left arm under your head in order to raise the left chest area. Repeat this examination on both sides.
Until this examination becomes habit it is important to mark your calendar to remind yourself to do your breast self-examination regularly. This is also a good way to evaluate any normal cyclical changes to both your breast tissue and menstrual cycle. When you are doing your breast self-examination try to stay relaxed and breathe as normally as possible. Report any changes or unusual discomfort or pain to your primary care physician or gynecologist.
Remember that your breast self-examination does not take the place of an annual clinical examination by your physician nor does it take the place of a mammogram. Each of these three factors, mammogram, clinical exam and self examination, are required in order to improve the chances that you will find any abnormalities or breast changes early.
(1) Susan G. Komen for the Cure: Breast Self-Exam
(2) Breast Cancer.org: The Five Steps of Breast Self-Exam
(3) American Cancer Society: Can Breast Cancer be Found Early