Self Breast Examination
PowerPoint
Lecture
Watch a Video
Breast self examination is an important, potentially life-saving
procedure. It should be known and practiced by all women. Because the majority of breast
masses are detected by women themselves, monthly self breast examination, in combination
with regular, annual, professional examinations and periodic mammography offers the best
chance of reducing the risks of advanced breast cancer.
Inspect
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The best time to examine the breasts is immediately following a menstrual period. The
breasts are the smoothest (least lumpy) and easiest to examine at this time. The
completion of a menstrual period is a convenient reminder to examine the breasts.
Begin with a close inspection of the breasts in the mirror.
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Skin Changes
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With your arms at your side, look for any dimpling or unusual skin changes. There
should be no visible bumps or bulges of the breast beyond the normal contour.
The skin should be a uniform color and not have areas of redness suggesting increased
blood flow.
The nipples should have no visible secretions or crusting.
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Raise your Arms
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Watch in the mirror as you raise your arms over your head. The breasts should rise and
there should be no change in shape.
Some breast problems cause a portion of the breast to become adherent to the chest
wall. In such cases, when the arms are raised, the "stuck" portion of the breast
remains in place while the rest of the breast rises. This causes "dimpling" or
"retraction" of the skin over the stuck portion of the breast.
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Feel for Lumps
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With one arm raised begin feeling for lumps or masses with the opposite hand.
Raising the arm is helpful because it stretches the pectoralis major muscle (the large
muscle under the breast) and lifts the breast up, creating a more solid, smooth surface on
which to examine the breast.
All breasts feel a little "lumpy," but remember that you are not feeling for
tiny nodules, but rather for larger lumps. You are feeling for "a marble in a bag of
rice."
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Use the Mid-portion of your Fingers
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Don't use your fingertips...they are too sensitive and you will end up focusing on all
the tiny irregularities and nodules that are present in everyone's breasts.
Don't use the palms of your hand...they are too insensitive and you can miss something
important.
Use the middle portions of your fingers...they have just the right sensitivity for
finding the lumps or masses you are seeking.
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Circular Motion
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Move your hand in small circles while feeling for lumps.
By compressing the breast tissue between your fingers and your chest wall, while moving
your hand in small circles, you will be able to feel the fine nodularity of your breast,
and also detect any changes in that nodular feeling.
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Move to Another area of the Breast
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After examining the first area with circular motions of your hand, move to another area
and again feel for lumps, using a circular motion. Many people find it easiest to progress
in a clock-wise fashion around the breast until the entire breast has been examined.
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Breast Tail
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Remember that the breast is not perfectly round, but has an extension
("tail") that extends up into the armpit. It is important to examine that
portion of the breast too.
Of all breast lumps that are found, more arise in the upper outer quadrant and tail
than any other area.
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Feel for Lumps in the Armpit
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Using the same circular motions, examine the armpit, feeling for any lumps in the
"tail" of the breast or any lymph nodes.
Lymph nodes are normally so small they cannot be felt. If enlarged due to infection or
inflammation, they grow to about the size of a pencil eraser but are long and narrow
rather than round.
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Check for Nipple Discharge
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Using the thumb and fingers, squeeze the breast toward the nipple to try to express any
discharge. This stripping of the milk ducts can be useful in identifying early problems
with the ducts. You should squeeze not only from side to side, but also from top to bottom
and at an angle.
In normal breasts, you can, with effort, usually produce a drop or two of clear, milky,
or slightly green-tinged discharge. Abnormal findings would be a bloody discharge, or so
much discharge that it squirts across the room or consistently stains the inside of your
bra.
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Check the Opposite Side
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Then move to the other breast, performing the same maneuvers. Make sure to remember to
raise your arm over your head to stretch the muscles underneath the breast.
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Annual Professional Examinations
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In addition to your monthly breast self-examinations, an annual professional exam by a
physician or other qualified health professional is important.
At that time, you can ask questions about findings that you didn't consider abnormal
but were nonetheless troubling.
Watch a video showing a professional
breast exam
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Mammograms
Mammography is the final part of routine breast screening.
For women without significant breast disease or a family history of breast cancer ,
mammography is probably useful about every other year from age 40 to age 50. After age 50,
most health providers recommend annual mammograms.
For women with specific risk factors, mammography more often may be recommended.
Check with your own health care provider to find out what would be best for you.
If you find an Abnormality
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Don't panic.
Most (90%) are benign, innocent abnormalities that often will go away by themselves.
Others will need treatment or removal, but with complete resolution of the problem.
For those few that are cancerous, early treatment leads to the best possible outcome,
so make sure to see your health care provider right away.
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Bureau of Medicine and
Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300 |
Operational Obstetrics
& Gynecology - 2nd Edition
The Health Care of Women in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMEDPUB 6300-2C
January 1, 2000 |
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