How to Perform a Breast Self-Examination
What is a breast self-examination (BSE)?
Breast self-examination is a procedure performed by an individual to
physically and visually examine herself for any changes in the breasts
and underarm areas of the body. It has not shown that BSE alone can accurately
determine the presence of breast cancer. Therefore, BSE should not be
used in place of, but in addition to, clinical breast examination and
mammography.
When should BSE be done?
By doing BSE regularly, you get to know how your breasts normally feel
so that you are more apt to detect any change.
Women should begin practicing breast self-examination by age 20 and continue
the practice throughout their lives - even during pregnancy and after
menopause.
Breast self-examination (BSE) should be performed every month. Become
familiar with how your breasts usually look and feel so that you may notice
any change from what is normal for you.
- If you still menstruate, the best time to do BSE is several days,
or about a week, after your period ends. These are the days when your
breasts are least likely to be tender or swollen.
- If you no longer menstruate, pick a certain day - such as the first
day of each month - to remind yourself to do BSE.
- If you are taking hormones, talk with your physician about when to
do BSE.
Changes to be aware of:
Check with your physician if you find any change in your breast(s) that
causes you concern. Changes in your breasts may include:
- development of a lump
- a discharge other than breast milk
- swelling of the breast
- skin irritation or dimpling
- nipple abnormalities (such as pain, redness, scaliness, turning inward)
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How to do BSE:
1.
Stand in front of a mirror that is large enough for you to see your breasts
clearly. Check each breast for anything unusual. Check the skin for puckering,
dimpling, or scaliness. Look for a discharge from the nipples.
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2.
Watching closely in the mirror, clasp your hands behind your head and
press your hands forward.
3.
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Next, press your hands firmly on your hips and bend slightly toward the
mirror as you pull your shoulders and elbows forward.
Do steps 2 and 3 to check for any change in the shape or contour of your
breasts. As you do these steps, you should feel your chest muscles tighten.
4.
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Gently squeeze each nipple and look for a discharge.
5.
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Raise one arm. Use the pads of the fingers of your other hand to check
the breast and the surrounding area firmly, carefully, and thoroughly.
Some women like to use lotion or powder to help their fingers glide easily
over the skin. Feel for any unusual lump or mass under the skin. Feel
the tissue by pressing your fingers in small, overlapping areas about
the size of a dime. To be sure you cover your whole breast, take your
time and follow a definite pattern: lines, circles, or wedges.
Some research suggests that many women do BSE more thoroughly when they
use a pattern of up-and-down lines or strips. Other women feel more comfortable
with another pattern. The important thing is to cover the whole breast
and to pay special attention to the area between the breast and the underarm,
including the underarm itself. Check the area above the breast, up to
the collarbone and all the way over to your shoulder.
Lines: Start in the underarm area and move your fingers downward
little by little until they are below the breast. Then move your fingers
slightly toward the middle and slowly move back up. Go up and down until
you cover the whole area.
Circles: Beginning at the outer edge of your breast, move your
fingers slowly around the whole breast in a circle. Move around the
breast in smaller and smaller circles, gradually working toward the
nipple. Don't forget to check the underarm and upper chest areas, too.
Wedges: Starting at the outer edge of the breast, move your
fingers toward the nipple and back to the edge. Check your whole breast,
covering one small wedge-shaped section at a time. Be sure to check
the underarm area and the upper chest.
6.
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It is important to repeat step 5 while you are lying down. Lie flat on
your back, with one arm over your head and a pillow or folded towel under
the shoulder. This position flattens the breast and makes it easier to
check. Check each breast and the area around it very carefully using one
of the patterns described above.
7.
Some women repeat step 5 in the shower. Your fingers will glide easily
over soapy skin, so you can concentrate on feeling for changes underneath.
What do you do if you find a lump?
One of the most frightening moments for a woman is if she feels something
different or unusual while performing breast self-examination. One of
the most important reasons to perform regular breast self-examination
is so that you know what is normal for your breasts. If you find a lump,
it is important not to panic.
If you discover a lump in one breast or feel something "different" in
the tissue, examine the same spot in the opposite breast. Usually, if
the same area in the opposite breast feels the same there is little need
for worry. However, if they feel different, or you feel a definite lump,
there may be valid reason for concern and it is important to contact your
physician right away. Sometimes, the lumpiness may be due to menstrual
changes, however, if you have nipple discharge or skin changes such as
dimpling or puckering, your physician may want to see you right away.
It is natural to be frightened when discovering a lump, but do not let
the prospect of cancer delay you from taking action. Remember that 80
percent of all breast lumps are benign (non-cancerous).
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