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Breast Self-exam

Breast self-examination involves checking your breasts for lumps or changes. Any new lump or change in appearance should be evaluated by a health professional. Most breast problems or changes are not due to cancer. Breast self-examinations should not replace regular clinical breast examinations (CBE) by a health professional, and mammograms if you are older than age 40. Women with breast implants need to talk with their health professional about performing breast self-examinations.

The best time to examine your breasts is usually one week after your menstrual period begins, when your breast tissue is least likely to be swollen or tender. If your menstrual cycle is irregular, or has stopped due to menopause or a hysterectomy, choose a day of the month that is easy for you to remember. Women who are pregnant or nursing should continue to examine their breasts each month. Breast-feeding mothers should examine their breasts after feeding or pumping, making the examination easier and more comfortable.

To perform breast self-examination, remove clothing above the waist and lie down so your breast tissue spreads into a thin, even layer over your chest, making it easier to feel.

Diagram for breast self-examUsing the padded surface (not the finger tips) of the three middle fingers of your left hand, examine your right breast by moving your fingers slowly in small quarter-sized circles. Three different levels of pressure should be used in feeling all of your breast tissue: light pressure to feel the tissue close to the skin surface, medium to feel the deeper level of tissue, and firm pressure to feel the tissue close to your breastbone and ribs. A firm ridge in the lower curve of each breast is normal. Use each pressure level to examine your breast tissue before moving on to the next area.

Examine your entire breast using a lengthwise strip pattern moving from your collarbone to your bra line and from your armpit to your breastbone. Begin at the armpit and move downward toward the bottom of the bra line. Move one finger-width toward the middle and work up to the collarbone. Repeat this pattern until you have covered the entire breast. Then, repeat this procedure for your left breast, using your right hand. The American Cancer Society prefers this method of breast self-examination because it is the best method for finding breast lumps.

You can also use a spiral pattern for your breast examination. As in the strip pattern examination, you should use three different levels of pressure to examine all the breast tissue and avoid lifting your fingers away from the skin as you feel for lumps, unusual thicknesses or changes of any kind.

Most breast tissue has some lumps and/or thick tissue. When in doubt about something you feel, check your other breast. If you find a similar area on the other breast, both breasts are probably normal. Pay particular attention to any lump that feels much harder than the rest of the breast tissue.

The important thing is to learn what is normal for you. If you find anything that concerns you, schedule a visit with your health professional. Understand that most changes you find are not breast cancer, but should be checked. Such changes may include:

  • any new lump, which may or may not be painful to the touch;
  • unusual, thick areas;
  • sticky or bloody discharge from your nipples;
  • changes in the skin of your breasts or nipples, such as puckering or dimpling;
  • unusual increase in the size of a breast; and,
  • If one breast is unusually lower than the other.

In addition, you may also check your breasts while in the shower. Your soapy fingers will slide easily across the breast and may increase your chances of detecting a change. While standing in a shower, place one arm over your head and lightly soap your breast on that side. Using the padded surface of your fingers (not the fingertips), gently move your hand over your breast in the strip pattern described previously while feeling carefully for lumps or thickened areas.

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