Self Breast Exam

Self breast exam comprised one portion of the classic triad of early detection of breast abnormalities, the other two being regular professional breast exams and screening mammography. It has been widely recommended and widely practiced for many years.

Recently, the value of self breast examination has been questioned because:

  • Several large studies have shown that self breast exams are not an effective strategy for improving the outcome for breast cancer patients.
  • Performing self breast exams may be worse than not doing self breast exams since many innocent lumps will be discovered, each requiring medical intervention with potential side-effects, but without changing the prognosis for the few who actually have breast cancer.

We should not be surprised that self breast exams fail to improve breast cancer outcomes since by the time a cancer is large enough to be felt, it is not early detection.

That said, not everyone is in agreement with those conclusions, and so for those who wish to perform self breast examination, this is how to do it.

1. About 10% of women will develop breast cancer over the course of their lifetime.

2. Breast cancer can be found in any age group, but occurs more often in older women.

3. In addition to regular professional breast exams and mammography, many physicians recommend self breast exams.

4. These exams are most reliable shortly after your menstrual flow begins.

5. Start by inspecting your breasts in the mirror.

6. No two breasts are identical. One may be larger or positioned differently on the chest wall.

7. Most nipples are normally everted.

8. If you notice recent onset of nipple inversion, you should bring this to the attention of a physician.

9. Crusting around the nipple can also be a danger sign.

10. You should report any redness to your doctor.

11. Look for any skin discoloration, dimpling or retractions.

12. Then raise and lower your arms looking for the same things.

13. Go slow, take your time, and focus first on one breast and then on the other.

14. Raise one arm and begin feeling for lumps or masses.

15. Most breasts are somewhat nodular, so pretend you are feeling for a marble in a bag of rice.

16. Significant lumps will be about the width of your index finger or perhaps a little larger.

17. Use your left hand to examine your right breast.

18. Use your right hand to examine your left breast.

19. Use this portion of your hand to feel for lumps.

20. Use a circular motion and be complete.

21. Raising your arm above your head makes it easier to feel for lumps.

22. With your arm raised above your head, examine your breast systematically, using circular motions, feeling for lumps or masses.

23. These are the same motions a physician would use to examine your breast.

24. Then squeeze the breasts, stripping the ducts towards the nipple, looking for any significant discharge.

25. A few drops of clear, green-tinged, or milky discharge is considered normal.

26. You are duplicating the maneuvers a physician would use to examine you.

27. This lactating patient produces milk as her discharge.

28. While milk is considered a normal finding, if, instead of whitish discharge, it were reddish or blood-tinged, that would be a danger sign that would need to be reported to your physician.

29. Finally, examine your armpit for any lumps or masses.

30. Breast tissue normally extends into the armpit and any masses or swellings you discover there should be reported to your physician.


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