7800 Wolf Trail Cove, Germantown, TN 38138 • (901) 682-9222 • Open Weekdays 8:00 - 5:00
THE BREAST CANCER SELF-EXAM: STEP BY STEP
It takes only about 15 minutes to perform a thorough BSE. Proper technique is essential to ensure that you examine the entire breast. It's a good idea to ask a doctor or nurse to instruct you, and to have illustrations to guide you.
First, What Are We Looking For
- A painless lump in the breast or armpit.
- Unexplained pain in the breast with no lump.
- Unusual thickening of the breast skin.
- Swelling, redness or distortion of the breast skin.
- Puckering or dimpling in the skin of the nipples or breast.
- A sore or ulcer on the breast skin that does not heal.
- Sticky or bloody nipple discharge.
- Scaling, crusting or erosion of the nipple.
- Inversion or retraction of the nipple.
- An increase in size of one breast.
- One breast has suddenly shifted postition/height.
The key to this exam is to spot changes in your breasts. Many women naturally have beasts that are different sizes or heights or a tendancy toward developing harmless lumps. Look for changes that persist after your menstral cycle or any changes that concern you.
1. In front of the mirror.
Standing undressed in front of a mirror, look at your breasts with your arms at your sides; check each breast for anything unusual, such as puckering, dimpling, or scaliness.
Remember to look beneath each breast, using your hands to lift the breasts if necessary. Clasp your hands behind your head and press them forward. You should feel your chest muscles tightening, allowing you to see the contours of your breasts. Turn from side to side so you can see the outer surfaces.
Next, inspect your breasts while pressing your hands firmly on your hips and bending forward slightly, pulling your shoulders and elbows forward as well. Standing erect again, raise one arm, and use the pads of the three middle fingers of the opposite hand to feel the breast. You can use lotion or powder to help your fingers glide easily over the skin, or you can do the raised-arm part of the exam in the shower with soapy skin.
2. Lying down.
Lie down with a pillow under your left shoulder, and put your left hand behind your head. Feel your left breast with the pads of the three middle fingers of your right hand. Start at the outer edge and work inward toward the nipple. Then squeeze your nipple gently to look for discharge. Do the same thing to your right breast with a pillow under your right shoulder. Be sure to include the area up to your collarbone and out to your armpit.
Using a "search pattern" can help you perform BSE more thoroughly.
To use the "line" technique, start under the arm and move your fingers downward slowly until they are below the breast. Then move your fingers slightly toward the middle, and slowly move back up. Continue going up and down until you cover the whole breast.
To use the "wedge" pattern, start at the outer edge of the breast, and move your fingers toward the nipple and back to the edge. Check the entire breast by covering one small wedge at a time.
You can also use a "circle" pattern by beginning at the outer edge of your breast and moving your fingers slowly around the whole breast in a circle. Keep feeling the breast in smaller circles, gradually working toward the nipple. Whichever pattern you prefer, remember to apply it up to the collar bone and out to the armpit.
When Should I perform a BSE?
You should perform a BSE every month beginning at age 20; this will make it easier for you to distinguish changes throughout life. Because breast tissue changes in response to fluctuations in estrogen and progesterone, you should schedule BSE 3 to 5 days after your menstrual period. If you don't have periods or if they're unpredictable, check your breasts on the same day of every month, perhaps on the first, fifteenth, or another day that's easy to remember.
What if I find a lump or other abnormality when I perform a BSE?
If you find a new lump or other change, make an appointment with your doctor immediately: More than 80% of breast lumps found during BSE are not cancerous, but speedy diagnosis is essential. The doctor will probably take a detailed medical history and perform a thorough manual breast exam. If there is nipple discharge, a sample will be inspected for cancer cells, and a biopsy may be obtained for tissue sampling. Breast mammography and/or ultrasonography may be ordered. Most breast lumps are due to noncancerous (benign) conditions that either need no therapy or can be treated easily. These disorders rarely increase your risk of breast cancer.
Is BSE really an effective way to detect cancer?
Yes. In fact, women who perform regular BSE find 90% of all breast lumps. Good technique is crucial: research shows that women who perform BSE correctly (inspecting the breasts visually and palpating with the pads of their middle three fingers) are less likely to die of breast cancer or have metastasis (cancer spread) to other parts of the body. Furthermore, women who report performing BSE thoroughly are about 35% less likely to develop advanced breast cancer.
There is nothing you can do that will absolutely prevent breast cancer. However, monthly BSE and annual mammography and check-ups by your doctor can both lower your risk and promote early detection. Combining these measures with a healthy diet and regular exercise will also reduce your risk, and increase your peace of mind.
Date Published: 2002-10-30
7800 Wolf Trail Cove, Germantown, TN 38138
Phone: (901) 682-9222; Fax: (901) 682-9505