How to preform a Breast Self-examination
American Cancer Society
Beginning in their 20s, women should be told about the
benefits and limitations of breast self-exam (BSE). Women should know
how their breasts normally look and feel and report any new breast
changes to a health professional as soon as they are found. Finding a
breast change does not necessarily mean there is a cancer.
A woman can notice changes by being aware of how her breasts
normally look and feel and by feeling her breasts for changes (breast
awareness), or by choosing to use a step-by-step approach (see below)
and using a specific schedule to examine her breasts.
If you choose to do BSE, the information below is a
step-by-step approach for the exam. The best time for a woman to
examine her breasts is when the breasts are not tender or swollen.
Women who examine their breasts should have their technique reviewed
during their periodic health exams by their health care professional.
Women with breast implants can do BSE. It may be helpful to
have the surgeon help identify the edges of the implant so that you
know what you are feeling. There is some thought that the implants push
out the breast tissue and may actually make it easier to examine. Women
who are pregnant or breast-feeding can also choose to examine their
breasts regularly.
It is acceptable for women to choose not to do BSE or to do
BSE once in a while. Women who choose not to do BSE should still
be aware of the normal look and feel of their breasts and report any
changes to their doctor right away.
How to examine your breasts
*Lie down and place your right arm behind your head. The
exam is done while lying down, not standing up. This is because when
lying down the breast tissue spreads evenly over the chest wall and is
as thin as possible, making it much easier to feel all the breast
tissue.
*Use the finger pads of the 3 middle fingers on your left
hand to feel for lumps in the right breast. Use overlapping dime-sized
circular motions of the finger pads to feel the breast tissue.
* Use 3 different levels of pressure to feel all the breast
tissue. Light pressure is needed to feel the tissue closest to the
skin; medium pressure to feel a little deeper; and firm pressure to
feel the tissue closest to the chest and ribs. A firm ridge in the
lower curve of each breast is normal. If you're not sure how hard to
press, talk with your doctor or nurse. Use each pressure level to feel
the breast tissue before moving on to the next spot.
*Move around the breast in an up and down pattern starting
at an imaginary line drawn straight down your side from the underarm
and moving across the breast to the middle of the chest bone (sternum
or breastbone). Be sure to check the entire breast area going down
until you feel only ribs and up to the neck or collar bone (clavicle).*There is some evidence to suggest that the up-and-down
pattern (sometimes called the vertical pattern) is the most effective
pattern for covering the entire breast, without missing any breast
tissue.
*Repeat the exam on your left breast, using the finger pads
of the right hand.
*While standing in front of a mirror with your hands
pressing firmly down on your hips, look at your breasts for any changes
of size, shape, contour, or dimpling, or redness or scaliness of the
nipple or breast skin. (The pressing down on the hips position
contracts the chest wall muscles and enhances any breast changes.)
*Examine each underarm while sitting up or standing and with
your arm only slightly raised so you can easily feel in this area.
Raising your arm straight up tightens the tissue in this area and makes
it harder to examine.
This procedure for doing breast self exam is different than in
previous recommendations. These changes represent an extensive review
of the medical literature and input from an expert advisory group.
There is evidence that this position (lying down), area felt, pattern
of coverage of the breast, and use of different amounts of pressure
increase a woman's ability to find abnormal areas.
Susan G. Komen
