How to Do a Breast Self Exam

Understanding Your Breast and Breast Self-Examination

Why BSE?

No one knows your breasts better than you. By conducting breast self-examination every month, you will become so familiar with your breasts that you should be able to detect the slightest change. If you feel a change, any change, you should report it to your physician as soon as possible. Don’t wait for your annual exam. Always remember that breast self-examination, mammography and an examination by your physician, in combination, all make the difference in greatly increasing your chances of finding a lump while it’s still small and more easily treated.

Breast Self-Examination

Studies show areas of occurrence to approximate:

• Fifty percent occur in the upper outer quadrant.
• Fifteen percent develop in the upper inner quadrant.
• Six percent develop in the lower inner quadrant.
• Eleven percent develop in the lower outer quadrant.
• Eighteen percent develop in and around the nipple.

It is important to examine all areas thoroughly.

Perimeter

The perimeter of the area to be examined should include all the breast tissue and chest area. This area is shown by a dotted line on the diagram.

You should examine from the middle of the armpit across the lower border of the collar bone to mid-chest, lower border of the bra-line. (A ridge of firm tissue in the lower curve of each breast is normal.)

Using the Fingerpads to Examine Your Breasts

Always use your right hand to examine your left breast and vice versa. Use your three middle fingers, keeping the thumb extended and always feel with the sensitive “palmer pads” (see diagram) on the flat inner surface of your fingers using a rubbing motion.

Types of Pressure

A. Superficial pressure of the fingers will detect any tiny mobile lumps right under the skin.
B. Deep pressure of the fingers must be used to reach the mid-level tissues and to firmly probe all the way to the ribs.

Completely feel all of the breast and chest area especially up under the armpit, across the collarbone area and down the front of the sternum to the bra-line area.

Breast Self-Exam-When? How Often?

When doing BSE, choose a quiet time when you will not be interrupted. Your monthly BSE should be carried out when your breasts are least tender and your hormones are at their lowest level.

If you have regular menstrual cycles, you should examine your breasts seven to 10 days from the start of your period. If you don’t have menstrual periods, BSE should be done on the same day every month, preferably the first day of the month. If you have irregular periods, consult your physician to determine an appropriate time for BSE. Click here for a personal calendar worksheet.

To ensure a thorough self-examination, the following four-step sequence should be followed in order. Each step is described-the shower examination, visual inspection, examination while lying down and examination of the nipple.

Step one: BSE Shower Information

You should start breast self-examination by examining yourself in the shower. Many lumps are easily felt when breasts and fingers are wet and slippery with soap lather. With your fingers flat, touch every part of each breast and chest area and feel gently for a lump, hard knot or thickening by using light pressure.

Step Two: Visual Inspection

It is important to become familiar with the normal appearance of your breast. Note any changes in the breast from its usual appearance, particularly a change in one breast without a similar change in the other.

Step Three: Lying Down

Place a pillow under your shoulder blade to elevate, distribute and flatten your breast across your chest area.

Palpation (examination by touching) is performed lying down. Place your left hand behind your head and palpate your breast with your right hand. Repeat procedure on the other side.

Step Four: Nipple

Finally, gently squeeze the nipple to look for any unusual discharge, particularly a pinkish or reddish discoloration. Should you detect any unusual discharge at the nipple, contact your personal physician immediately.

Manual Methods of BSE

Use the same pattern to feel every part of the breast tissue. Choose one easiest for you. Whichever method you choose, remember that the goal is to become familiar with your breasts in order to detect any changes from month to month.

This diagram shows three patterns preferred by doctors and most women: the circular or clock method, the vertical strip and the wedge.

After you have completely examined your right breast, then examine your left breast using the same method. Compare what you have felt in one breast with the other.

What You Should Do if You Find a Lump in Your Breast

If you notice a lump in one breast, examine the opposite breast in the same area. If both breasts feel the same, it’s a good sign that what you are feeling is a normal part of your breast tissue. If it is not similar, note the location and make an appointment to be examined by your physician.

Take Charge of Your Life

Breast Health Services of Lehigh Valley Hospital and Health Network offers comprehensive, state-of-the-art services for the prevention, diagnosis and treatment of breast cancer. We are located throughout the Lehigh Valley. Take the next step toward breast health.

Call 877-722-HOPE (4673) or 610-402-CARE for more information or to schedule an appointment.

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