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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.
Once a month, just after completing a menstrual flow, a woman examines her breasts. This can be done in the shower, but at least part of the exam should be done while standing in front of a mirror.
Inspect the breasts for:
- Skin changes
- Visible bumps
- Nipple crusting
When raising her arms up, both breasts should rise evenly on the chest wall.
While raising her arms, she should watch closely for any skin dimpling or nipple retraction.
With her arm raised, she should feel for lumps with the opposite hand.
Most breast tissue is somewhat nodular. She is feeling for a “marble in a bag of rice.”
She should move her hand in small circles while compressing the breast tissue.
Then she should move to another area and perform the same small circular examination.
Many people find it easiest to move in a clockwise fashion to avoid missing any areas of the breast.
The same circular motion should be used to exam the armpit and the “tail” of the breast that extends up into the armpit.
In the armpit, she is feeling for any breast lumps or lymph nodes. Enlarged lymph nodes are about the size of a pencil eraser, but longer and thinner.
She should try to express nipple discharge by stripping the ducts towards the nipple.
Normally, there will be one or two drops of clear, milky or green-tinged secretions.