Your Guide to Breast Self-Examination

Monthly breast self-examination (BSE) is a crucial practice that can help you stay ahead of breast cancer. While many women are familiar with breast self-examinations, some might still question if they are doing it correctly. Several women ask about how to check breast cancer at home.

A breast self-examination involves a woman examining her breasts with her hands periodically at home in a systematic, stepwise fashion.

This helps women become familiar with the look and feel of their breasts and immediately notice when something is not normal. It also helps detect breast lumps that may or may not be cancerous.

Why should you do a Breast Self-Exam?

Many are not aware of the importance of breast self-exams. Performing self-breast examination helps one in many ways. Most importantly, self-breast examination makes early detection of breast cancer possible.

The following are a few reasons why you should consider breast self-exams every month:

Early Detection of Breast Cancer

Like any other cancer, it is important to detect breast cancer in the early stages for appropriate management. Self-breast examination allows you to look for abnormalities that indicate breast cancer, which prompts you to see a doctor for additional examination. These signs and symptoms can be caused by benign breast conditions as well. Nonetheless, it is important to pay attention to the different signs of breast cancer and immediately consult with the doctor to rule out the underlying serious condition.

Increased Awareness

Regular breast examinations help you become more aware of how your breasts look and feel. This helps detect changes, such as lumps, thickening of the skin, and other irregularities.

Non-Invasive

Breast cancer examination at home is a non-invasive, cost-free method. It is simple, can be easily incorporated into the routine, does not require special equipment, and does not require a visit to the doctor.

Improve Survival

Like other cancers, the early detection of breast cancer improves overall survival. Further, managing breast cancer in its early stages requires less aggressive treatment.

Improve the Quality of Life

Breast self-examination improves the overall quality of life by reducing the anxiety and stress of developing breast cancer, especially in women with high risk for breast cancer. However, it is important to note that women at high risk for breast cancer should follow the routine mammography screening schedule as recommended by their gynecologists, in addition to breast self-examination.

How Often Should You Do a Breast Self-Exam?

Five Breast Self-Examination Steps to Consider

To make breast self-examination easy for you, we have broken down the entire procedure into five steps, and they are listed here. Please follow these breast self-exam steps every month.

Examine Your Breasts in a Mirror with Hands-on Hips

Women should relax their arms on their hips and look at their breasts in the mirror. They should note the size, shape, and color of their breasts and examine them for any dimpling of the skin, swelling, or changes in the nipples.

Raise Arms and Examine Your Breasts

Women should raise their arms above their heads and look for the same changes. This position allows women to view the lower and upper parts of the breasts more clearly.

Look for Signs of Breast Fluid

Women should also observe any discharge from their nipples and any sign of fluid on their clothes. In the case of abnormal discharge from the nipples, note the color, consistency, amount, and smell of the discharge.

Feel for Breast Lumps While Lying Down

This step involves the breast physical examination. Women should lie down on their backs in a comfortable position. This position helps to spread the breast tissue evenly. Use of the left hand to examine the right breast and vice-versa is advisable. They must then move their fingers in small circular motions to feel the breast tissue's surface, middle, and deeper layers. Later, they should gently squeeze the nipples to observe any discharge. A breast examination will be followed by an examination of the armpits and the upper chest for any lumps or unusual changes.

Feel Your Breasts for Lumps While Standing or Sitting

Performing a breast cancer self-exam while standing or sitting is an effective way to check for changes or abnormalities in the breast tissue. This position is particularly useful for examining the upper parts of the breasts and the areas near the armpits.

Breast Self Exam: General Tips to Consider

Use the Pads of Your Fingers

It is recommended to use the pads of the fingers during breast self-examination. The finger pads provide an even and sensitive surface for detecting any lumps or changes in the breast tissue.

Use Different Pressure Levels

It is important to apply different pressure levels, i.e., light, medium, and firm, with the fingers to ensure that all the layers of the breast tissues are thoroughly checked. While light pressure is effective in evaluating the breast tissues near the skin, firm pressure is useful for examining the tissues near the chest and the ribs during a self-check for breast cancer.

Follow a Pattern

It is important to follow a specific pattern during a BSE to ensure that all areas of the breast tissues are thoroughly checked. The most common patterns for BSE are circular, vertical strips, and wedges. Regardless of the pattern used, the nipple and armpit areas should be checked thoroughly.

Results

1. What kind of lumps are normal to feel in your breasts?

It is important to note that not all breast lumps are cancerous. Breasts have a nodular or lumpy texture, which can vary based on age, hormonal changes, and individual anatomy. Lumps may occur due to fibrocystic changes, fibroadenoma, lobular carcinoma in situ, fat necrosis and lipomas, and cysts. The doctor should comprehensively evaluate any type of lump. It is important to know what abnormalities indicate the presence of breast cancer.

2. How often should one do a breast self-exam?

Women are advised to perform breast self-examination at least once every month, preferably a few days after their menstrual period. It is important to follow the recommended breast self-examination procedure during the examination to optimize the results.

3. When to Contact Your Doctor?

The women should not ignore any of the symptoms of breast cancer or any other serious underlying disease detected during breast self-examination. It is important to seek care from a breast surgical oncology service provider in case women experience new or persistent lumps, nipple discharge, altered skin of the breasts, and pain in the breasts. Women, especially those who are at high risk, should consult the doctor to discuss the measures to reduce breast cancer risk.

Conclusion

Regular breast self-examination is a vital, non-invasive tool for early breast cancer detection, raising awareness of breast health, and improving overall quality of life. Conduct these exams monthly to familiarize yourself with your breasts and promptly detect any abnormalities. Always consult your doctor if you notice any unusual changes.

Frequently Asked Questions

1. When should women begin breast self-examination?

Beginning at age 20, women should perform self-breast exams every month for the rest of their lives.

2. Can I self-examine my breasts during my periods?

The ideal time to perform your monthly breast self-examination is one week after your monthly period ends.

Some women experience tenderness in their breasts during their periods, and self-breast exams during this time can cause discomfort. Therefore, you should examine your breasts sometime after your period ends.

3. Can I self-examine my breasts during my pregnancy?

Some reports suggest that breast self-examinations may not be effective during pregnancy as the size of milk ducts tends to change rapidly, especially during the last trimester.

Nevertheless, it is safe to get familiar with your breasts during your pregnancy so you can alert your doctor if you come across something that is unusual and needs medical attention.

For more information on self-examining your breasts during pregnancy, please talk to your gynecologist or primary physician.

4. Should I visit a hospital for my breast self-examination?

No, you need not visit a hospital for your breast self-examination.

5. Is breast self-examination necessary after mastectomy and breast reconstruction surgery?

Yes, the other breast that was not affected by cancer will still need screening. Also, if autologous tissue is used for breast reconstruction, screening will become necessary for the reconstructed breast.

For more information on better screening guidance after breast reconstruction surgery, it is important to talk to a breast cancer specialist.

6. Do I need mammography if I am self-examining my breasts every month?

Breast self-examination is a tool that can help women find out if any changes may point toward various benign and malignant breast problems. However, mammography, on the other hand, provides you with detailed information about your breast health.

Mammography can detect different anomalies, namely cysts, calcifications, and tumors, and can play a significant role in helping you make informed health decisions. Therefore, breast self-examination should not be considered as a substitute for mammography.

7. If my breasts appear to be different in size during my self-exam, is that a sign of breast cancer?

It is normal for women to have uneven breasts or nipples. However, if the breasts vary in size by over 20%, it may indicate the risk of breast cancer. You should immediately consult your primary care physician or gynecologist for a proper evaluation.

8. What should I do if I find a lump or any other abnormalities during my breast self-exam?

Do not panic. In most cases, lumps found in the breasts and armpits are non-cancerous. However, consult a breast cancer specialist and report your observations. You may have to take further tests, like mammography and ultrasound, for a conclusive diagnosis.

9. How long does a breast exam take?

Breast self-examination typically takes about 10 to 15 minutes to complete. During this time, the patient should properly follow the breast examination steps to thoroughly inspect and feel each part of the breast tissue, including the underarm area, using different positions and pressure levels to ensure a detailed check.

10. What are the problems with doing a breast check self-exam?

Some of the potential problems with breast self-examination are false positive and false positive results, technique variability, overconfidence, anxiety, and stress. Further, the evidence is mixed for the effectiveness of breast self-examination in the detection of breast cancer.

11. Is a self-breast exam better than a mammogram?

A self-breast exam is not better than a mammogram; they complement each other. Mammograms are more accurate for early detection of breast cancer and can find tumors that cannot be felt. Self-exams help you become familiar with your breasts and notice changes between mammograms. Both are crucial for comprehensive breast health.

References

Self Breast Examination: https://www.ncbi.nlm.nih.gov/books/NBK565846/

Breast Self-Exam: https://www.breastcancer.org/screening-testing/breast-self-exam-bse

Breast Self-Exam: National Breast Cancer Foundation: https://www.nationalbreastcancer.org/breast-self-exam/

Breast Cancer / Self Breast Examination: https://screening.iarc.fr/breastselfexamination.php

A Guide to Checking Your Boobs (Breasts): https://www.nhslanarkshire.scot.nhs.uk/services/adult-learning-disability-service/womens-health/breast-self-exam/

Dr. Tanay Shah is a seasoned surgical oncology consultant practicing at HCG Cancer Centre, Ahmedabad, a comprehensive cancer hospital in Ahmedabad. Dr. Tanay Shah specializes in the surgical management of breast, head and neck, gynecological, and GI oncological cancers. He is highly skilled in endoscopy including upper gastrointestinal tract endoscopy, colonoscopy, fiberoptic laryngoscopy, and bronchoscopy. His expertise has been recognized by his peers and he has participated in many oncology conferences and CMEs, which have significantly helped him hone his skills as a surgical oncologist.

To book an appointment with Dr. Tanay Shah, click here.