Breast Self-Exam

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Breast cancer is one of the most common cancers in women. Thanks to modern treatments, many women diagnosed with breast cancer will go on to live full lives.

The key to successful treatment, however, lies in early detection, and for that, every woman needs to follow the recommended breast screening guidelines, which includes a monthly breast self-examination (BSE). Nine out of 10 breast lumps are found by women themselves.

Eight out of every 10 breast lumps are not cancerous, but that does not lessen the need to do breast self-examinations monthly. The BSE will help to determine what is normal for your breasts, and help you recognize a change.

Breast Self-Examination (BSE)

Breast Self- Examination (BSE) can be a valuable tool in diagnosing breast cancer at an early stage. It is important to remember that everyone’s breasts are different and that changes can be related to aging, menstrual cycle, pregnancy, menopause or hormone use. Normal breast tissue feels lumpy and uneven. It is normal for a woman’s breast tissue to become swollen and tender right before or during her menstrual period. Nine out of 10 breast masses are detected through BSE. Eight out of every 10 breast masses are not cancerous, but that does not lessen the importance of performing BSE monthly. Regular BSE will help to identify changes that require further evaluation and possible treatment.

Breast Self-Examination Changes to Report:

  • Lumps, hard knots or thickening in the breast or underarm area
  • Unusual swelling, warmth, redness or darkening that does not go away
  • Change in the size or shape of your breast
  • Dimpling or puckering of the skin
  • An itch, scaly sore or rash on the nipple
  • Pulling in of the nipple or other parts of the breast
  • Nipple discharge that starts suddenly or is bloody
  • Pain that is localized in one area and that does not vary with your monthly cycle

While breast cancer does not typically cause pain, you should see your primary healthcare provider for breast pain or any other finding that does not go away.

Every woman is at risk for breast cancer, regardless of age, family history or current health. In fact, the majority of women who are diagnosed with the disease have none of the commonly known risk factors.

Mammography screening done at regular intervals, together with clinical breast exams, and monthly breast self-examination, are the three techniques that provide the best means of early detection of breast cancer.

We invite you to become better acquainted with the Center for Breast Health. For more information about maintaining breast health, call us at 563-421-7625 or toll-free, 1-800-215-1444. We'd be happy to help.

Basic BSE

To view the Spanish version of the BSE, please visit Susan G. Komen Race for the Cure or you can print the BSE Spanish shower card.

1. First, you should know how your breasts normally look. A small visual change may be an important early sign of a problem. Stand undressed from the waist up in front of a mirror with your arms relaxed by your sides. Compare your breasts while turning from side to side. Look for any change in breast size, shape, skin texture or color, including redness, dimpling, puckering or retraction of the skin. Notice any nipple changes, such as scaliness, a pulling to one side or a change in direction. Tightening the chest muscles beneath the breasts can emphasize changes. Therefore, it is important to assume different positions.

2. Place your hands on your waist and press inward, then turn from side to side to note any changes.

Steps 1 & 2

3. Place your hands behind your head and press forward. Once again, turn from side to side and look for changes. Large breasted women will need to take two fingers of the opposite hand to lift and look.

4. Place your hands on your waist, and bow towards the mirror, letting the breasts fall forward. Note any change in breast shape.

Steps 3 & 4

5. Nipple discharge also can be a sign of a breast problem. Gently squeeze the breast tissue surrounding the nipple between the thumb and middle finger and check for nipple discharge.

Step 5

6. While taking a bath or shower, feel above and below the collar bone for any enlarged lymph nodes.

Step 6

7. From the collar bone, rub down firmly to the nipple of one breast, feeling for any lumps, thickening, or changes from previous examinations.

8. Next, support the breast with one hand while the other hand and fingers slide across top of breast feeling for lumps.

Steps 7 & 8

9. Check for lymph nodes or lumps under your arm while relaxing your arm at your side. Reach across with your other hand to feel the area. Note any changes from previous examinations. Repeat on the other side.

Step 9

10. Next, lie down to complete the exam. Place a pillow under your left shoulder. Put your left hand behind your head and reach across with your right hand to your left breast, holding your fingers together and flat. With firm, even pressure, move your hand in a wide circle around the breast, letting the breast tissue slide under the pads of your fingertips.

Step 10

11. Move your hand in increasingly smaller circles until the entire breast is covered.

Step 11

12. Place your fingers flat on the nipple and depress, feeling beneath for any changes. Now, reverse your hands and the pillow to repeat the exam on the right breast.

Step 12

Finding a lump or change in your breasts does not mean you have cancer. Only your doctor can be sure. Report any change promptly.

Menstruating women should do BSE one week after their menstrual period begins when breasts are less lumpy and tender. Pregnant women should check their breasts on the same day each month. Breastfeeding mothers should check their breasts on the same day each month after emptying their breasts. Women who take hormone replacement therapy should do BSE on the same day every month.

Recommended Breast Screening Guidelines

For women between puberty-40:

  • Monthly breast self-examination
  • Breast examination by a trained health professional at least every three years
  • First mammogram by age 40

For women 40 years and older:

  • Monthly breast self-examinations
  • Annual breast examination by a trained health professional
  • Annual screening mammogram

Screening recommendations are for women who have no symptoms of breast cancer. Women identified as being high-risk for breast cancer should ask their physician for specific guidelines.

Adapted from the Department of Professional Education for Prevention and Early Detection. The University of Texas M.D. Anderson Cancer Center Houston, Texas

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