Understanding how to perform a breast self-exam (BSE) is an important way to stay aware of your breast health. While it is not a substitute for professional screenings like mammograms, a BSE allows you to familiarize yourself with the typical look and feel of your breasts, so you can quickly detect any changes. Regular self-exams can help women identify potential signs of breast cancer, such as lumps, swelling, or unusual discharge, prompting earlier medical evaluation and intervention.
Starting in your early 20s, it’s a good idea to perform a breast self-exam once a month. The best time for pre-menopausal women to do this is just after their menstrual cycle, when breasts are least likely to be tender or swollen. For post-menopausal women, pick a consistent day each month to perform the exam.
Below is a step-by-step guide on how to perform a thorough breast self-exam.
Why Perform a Breast Self-Exam?
Performing a BSE has many benefits, even though it’s not a definitive screening method for breast cancer. By regularly checking your breasts, you can:
- Familiarize yourself with the normal size, shape, and texture of your breasts.
- Notice changes such as lumps, dimpling, discharge, or skin changes.
- Raise awareness of your breast health, enabling you to inform your doctor of any abnormalities sooner rather than later.
Keep in mind that while breast changes can be concerning, not all changes are cancerous. Breasts naturally evolve over time due to factors like hormonal shifts, aging, and weight changes. However, any significant or persistent change should be evaluated by a healthcare professional.
Step-by-Step Guide to a Breast Self-Exam
Step 1: Lie Down for the Exam
Start your breast self-exam by lying down. This position helps spread the breast tissue evenly across your chest, making it easier to examine. Place your right arm behind your head to expose your right breast for examination.
Step 2: Use the Pads of Your Fingers
Use the pads of the three middle fingers on your left hand to examine your right breast. Using your fingertips provides the sensitivity needed to detect unusual lumps or changes. Make small, overlapping, circular motions about the size of a dime to feel the tissue beneath the skin.
Step 3: Apply Different Levels of Pressure
To ensure you are examining all layers of breast tissue, apply three different levels of pressure:
- Light pressure: Feels the tissue closest to the skin.
- Medium pressure: Reaches the middle layers of breast tissue.
- Firm pressure: Allows you to feel the tissue nearest to the chest and ribs.
When pressing firmly, you may notice a firm ridge at the lower curve of each breast—this is normal. However, if you notice any other unusual lumps or hard areas, contact your doctor for further evaluation. If you are unsure about the correct amount of pressure to apply, speak with your healthcare provider for guidance.
Step 4: Follow a Pattern for a Thorough Exam
To ensure that you cover the entire breast, use an up-and-down pattern. Start at an imaginary line that runs from your underarm straight down to the side of your breast, then work your way across the breast to the middle of the chest, near your breastbone.
Continue this pattern until you’ve examined the entire breast, extending down to the ribs and up to the collarbone. This systematic approach helps ensure that no area is overlooked.
Step 5: Repeat on the Left Breast
After completing the examination of your right breast, switch sides. Place your left arm behind your head and use the pads of your right hand to repeat the same steps for your left breast.
Step 6: Visual Examination in Front of a Mirror
Stand in front of a mirror with your hands pressing firmly down on your hips. This posture tightens the chest muscles and allows you to observe your breasts more clearly. Look for any changes in:
- Size
- Shape
- Contour
- Skin texture (dimpling, redness, or scaliness)
- Nipple appearance
These visual signs can be important indicators of underlying issues.
Step 7: Check Your Underarms
Lastly, examine your underarms while standing or sitting. Raise your arms slightly—not all the way overhead, as this tightens the tissue and makes it harder to feel—then use the pads of your fingers to check for lumps or swelling in the underarm area.
When to Schedule a Mammogram
While breast self-exams are important for monitoring changes, they do not replace the need for professional screenings like mammograms. Starting at age 40, women should begin getting mammograms every 1 to 2 years. If you have an elevated risk for breast cancer due to family history or other factors, talk to your doctor about when to start mammogram screenings and how often they should be done.
Limitations of Breast Self-Exams
It’s essential to recognize the limitations of breast self-exams. While they can help you notice changes, BSEs are not foolproof and can miss certain abnormalities. In addition, many lumps detected during self-exams turn out to be non-cancerous. This is why it’s important to follow up on any concerns with a doctor, who may recommend additional imaging or diagnostic tests if needed.
Regular mammograms and clinical breast exams conducted by healthcare professionals are essential for detecting breast cancer early. However, knowing your body through monthly breast self-exams can still be a useful tool in maintaining breast health.
Conclusion: Take Charge of Your Breast Health
By performing regular breast self-exams, you empower yourself with the knowledge of what’s normal for your body. Early detection plays a critical role in treating breast cancer successfully, and being proactive about your breast health is a step in the right direction.
While a breast self-exam can’t replace mammograms, it’s a valuable tool for catching changes early. Make breast self-exams part of your monthly routine, and be sure to consult your doctor if you notice anything unusual.