The bottom line with a breast self-exam is that all women need to know what their breasts feel like and identify when that changes. Because your breasts change at different times of the month due to the balance of hormones in your body, you should make sure to give yourself the breast self-exam at the same time during every cycle. The recommended timing is three to five days after the end of your menstrual period. When performing the self-exam, remember it’s normal for your breasts to feel lumpy or uneven.

• First, you will need to check the outward appearance of your breasts. This means that you should stand in front of a mirror without wearing a shirt or bra.
• Look at your breasts and nipples for any signs of swelling, discoloration, dimpling, skin tightening, or sores.
• Look at your breasts from all directions by changing positions, with your arms at your side, in front of you, and behind your head. You should also check for nipple discharge at this time by rubbing the area around your nipple and pulling out toward the nipple.
• The next part of the exam is recommended for in the shower, because it’s best to use slippery and wet hands.
• Check your underarms for any thickening or lumps by placing your left hand on your hip and using your right hand to feel under your left arm.
• Repeat on the other side. Next, you should check for lumps and thickening above your collarbone.
• You should then check your breasts. Support the breast with one hand, and use your other hand to press gently into your breast, covering the entire breast, to feel for any lumps or thickening.
• Remember to check both breasts.
• The third part of the self-exam should be performed lying down.
• You should place a small pillow or a folded towel under your right shoulder and pull your right arm up and under your head. This position will allow your breast tissue to distribute more evenly.
• It’s recommended that you think of your breast as a clock and move from 12 o’clock all the way around and back to 12 o’clock with small circular motions of your hand. You should trace one outer clock, and one clock closer to your nipple.
• You should also squeeze your nipples to make sure there is no abnormal discharge.

You can obtain a breast self-exam card from your provider for more detailed information and guidelines on the breast self-exam. For more information on the breast self-exam, visit The American Cancer Society.

What’s not normal?
It’s difficult to know what is normal in breast tissue, and what isn’t. Because your breasts are changing throughout the month, you need to pay careful attention to your breast tissue to find abnormal lumps and thickening. You should notify your provider and make an appointment if:

• You find a lump or thickening in your breast or underarm that remains the same throughout the menstrual cycle
• Your breast changes in size or shape
• You notice a mass or a lump, which can be as small as a pea
• You feel something that resembles a marble under your skin
• A distinct area on your breast is unlike any other area on your breast
• The skin on your breast or the nipple changes and becomes dimpled, tightened, scaly or inflamed
• You have a clear or bloody discharge from your nipples
• Your skin or nipple has redness