Breast Cancer Basics: Breast Self Examinations

While the use of screening mammograms save lives, there is controversy on recommending self-breast examinations (SBE). What is not controversial is the importance of being aware of what your breasts look and feel like, and to report any concerning changes to your healthcare provider right away. I recommend doing your SBE as the best way to find these changes as soon as possible. This is even more important these days, since imaging is not being routinely offered.

Pros of SBE:

SBE is a free tool that you can use on a regular basis and at any age as part of your routine breast cancer screening strategy.
  • Studies have previously reported that 50% of cases of breast cancer in women 50 years and older and 70% of cases of breast cancer in women younger than 50 years are detected by women themselves.
  • One study found that 43% of breast cancer survivors surveyed stated that they detected their own cancers on self-exam.
  • In another study of low-income breast cancer patients, investigators reported that 64% of the women self-detected their breast cancer.

Cons of SBE:

  • Two large studies compared women who did SBE to those who did not, and they found that there was no difference in breast cancer survival and a higher rate of false positive results (which led to many more biopsies with no cancer found).

The Most Common Warning Signs of Breast Cancer:

  • A change in the look or feel of the breast OR
  • A change in the look or feel of the nipple OR
  • Nipple discharge
In most cases, these warning signs changes are NOT cancer. However, to know for sure you need to inform your healthcare provider if you have any of these.

When Should You Do Your SBE?

Starting at 20 years of age is the most commonly recommended age to begin SBE’s. It’s recommenced to do your SBE once a month. Examine yourself a 3-5 days after your period ends, when your breast are least likely to be swollen and tender. After menopause, pick an easy day to remember, such as the first or last day of each month.

How Do You Do A SBE?

Here are two video demonstrations I recommend:
From: Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
Here’s what you should look for:
  • Breasts that are their usual size, shape, and color
  • Breasts that are evenly shaped without visible distortion or swelling
If you see any of the following changes, bring them to your doctor’s attention:
  • Dimpling, puckering, or bulging of the skin
  • A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
  • Redness, soreness, rash, or swelling
Step 2: Now, raise your arms and look for the same changes.
Step 3: While you’re at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).
Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.
Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage. Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.