Breast Self Exam

Traditionally, women have been strongly encouraged to perform monthly breast self-exams beginning at age 20. These exams were intended to look for breast lumps or changes that might signal breast cancer. Most studies have shown that women who routinely perform breast self-exams do not have a lower risk of dying from breast cancer. However, many physicians still strongly recommend the practice given the feeling of self-control that many women gain from addressing their own breast health. If you would like to perform breast self-exams, learn how to do them correctly and perform them monthly.

Before you begin a breast self-exam, you should be aware that every woman's breasts are different. The key to the success of the self-exam is knowing the shape and texture of your own breasts so you can recognize any changes or abnormalities that might occur. Remember, when you are doing your breast self-exam, you are looking for masses within the soft tissue of your breasts or changes in their appearance.

Since your breast size, sensitivity and even texture can vary throughout the month, it is important to do the self-exam at the same time each month. Women who are menstruating should do their breast self-exam at the end of their menstrual cycle. Women who take estrogen should conduct their exams on a non-hormone day. Women who do not have periods, and those taking estrogen every day, should conduct their exam during the first week of the month.

View the step-by-step illustration below:

Step 1. - Lie down and place your right arm behind your head. The exam is done while lying down, not standing up. This is because when lying down the breast tissue spreads evenly over the chest wall and it is as thin as possible, making it much easier to feel all of the breast tissue.
Step 2. - Use the finger pads of the three middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue.


Step 3. - Use three different levels of pressure to feel all of the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. A firm ridge in the lower curve of each breast is normal. If you're not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving to the next spot.


Step 4. - Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle).
Step 5. - There is some evidence to suggest that the up and down pattern (sometimes called the vertical pattern) is the most effective pattern for covering the entire breast without missing any breast tissue.

Step 6. -
Repeat the exam on your left breast using the finger pads of the right hand.


Step 7. - While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, dimpling, redness or scaliness of the nipple or breast skin. (The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.)


Step 8. - Examine each underarm while sitting up or standing with your arm only slightly raised so you can easily feel this area. Raising your arm straight up tightens the tissue in this area and makes it difficult to examine.

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