The American Cancer Society recommends a monthly breast self-exam for women
age 20 and older. It’s important to continue breast self-exams (BSEs) throughout your life, even during pregnancy, after menopause, or following any type of breast surgery or implants.
Why should I examine my breasts?
A woman knows best how her breasts normally look and feel and is therefore able to detect changes early. The majority of lumps that can be felt are found by women themselves. This exam takes only a few minutes each month, and can help save your life by finding breast cancer early, when it is most curable.
Guide to Self-Breast Examination
When is the best time for me to examine my breasts?
Breast self-exams should be performed once a month, 5-7 days after your menstrual period ends. This allows a woman to examine her breasts when they are least tender or swollen. If you have reached menopause, have had a hysterectomy or are pregnant, choose a day that is easy to remember and do a self-exam on that day monthly thereafter. If you are taking birth control pills, perform the exam the first day of your new packet.
What should I do if I find a lump or other change in my breast?
Call your personal physician for an evaluation and medical opinion. Remember: Most breast lumps are harmless, but all need medical evaluation. Have your self-exam technique checked by your physician at the time of your regular check-up. If your doctor does not examine your breasts during a routine physical, ask for this to be done. Also, ask your physician to point out areas that may require special attention during your monthly self-exam. Although breast cancer cannot be prevented, survival is better when it is detected early and properly treated. Let monthly breast self-exams become a habit.
When do I need a mammogram?
Many women have regular pap smears and checkups yet are unaware they may need a mammogram. According to the American Cancer Society, women age 40 and older should get an annual screening mammogram even if they appear to show no breast symptoms. This is a general guideline. Your doctor may advise a different schedule depending on your personal or family health history.
Most women who get breast cancer have no risk factors except age. As a woman gets older, her risk increases. Women who may have an increased risk:
- Have a sister, mother or daughter who has had breast cancer.
- Have had previous breast cancer.
- Have never had children or have their first child after age 30.
- Began menstruating at an early age or went through menopause late.
While lying down
- To examine the right breast, place your right arm over your head (this distributes breast tissue evenly). Place a folded towel or pillow beneath the shoulder.
- With your left hand, use the flat part of your fingers to press gently but firmly in small circular motions around entire breast and inward toward the nipple.
Many women feel a firm ridge of tissue underneath their breasts. This is usually normal and commonly feels the same on both sides. Some women have naturally lumpy breasts and should record the areas of thickening.
Examine the area between the breast and armpit, as well as the armpit itself.
Depress your nipple. Normally the area behind the nipple feels hollow and soft. This area should feel similar in both breasts.
Repeat this procedure on your left breast, using your right hand.
In the tub or shower
- Continue to use the same circular motions. The soap and water will allow your hands to glide more smoothly over your skin. Check for lumps or unusual thickenings.
- With the right arm raised, use the flat pads of your fingers from your left hand and reach up high and deep. Feel the area between the breast and the armpit, as well as the armpit itself.
- Repeat on opposite side.
- Check the area above and below your collarbone for thickness, lumps and swelling.
In front of mirror
- In good light, turn side to side in these positions:
1. Relax arms at sides.
2. Place hands on hips and press down on hip bones.
3. Clasp hands behind head with elbows pulled back.
4. Place hands on waist and bend forward so breasts hang.
- In each position, look for:
- Nipple change (inverted, flattened, crusty appearance)
- Nipple discharge
- Puckering or dimpling
- Change in breast shape, contour or size
- Scaling, redness, rash, sores or unusual texture
- Anything that is unusual or causes you concern.
For the mastectomy patient
Continue monthly self-exams for the remaining breast. Look in the mirror for redness, scaliness or rash. Pay particular attention to the scar line. Feel between each rib and over the breast bone for thickness, lumps and swelling. Remember to feel under both arms and above and below collarbones.