Breast self exam
Self-examination of the breast; BSE
Many women feel that doing a breast self exam is an important part of their health care. It helps them learn how their breasts normally feel, so that if they find a lump they will know whether it is something to discuss with their health care provider.
However, there is controversy about recommending breast self exams. There is no evidence that doing breast self exams saves lives from breast cancer, so if you are not comfortable checking your breasts, don't be concerned.
What is most important is to have routine screening mammograms if your health care provider recommends them. Even getting a yearly exam is controversial, but many women and their health care providers feel that this is still an important part of breast cancer screening.
Talk to your health care provider about whether or not you should do breast self exams. If you do decide to perform breast self exams, be sure to do the exam about 3 - 5 days after your period starts, when your breasts are not as tender or lumpy. If you have gone through menopause, do your exam on the same day every month.
First, lie on your back. Place your right hand behind your head. With the middle fingers of your left hand, gently yet firmly press down using small motions to examine the entire right breast. Then, while sitting or standing, examine your armpit, because breast tissue extends to that area. Gently squeeze the nipple, checking for discharge. Repeat the process on the left breast.
Use one of the patterns shown in the diagram to make sure that you are covering all of the breast tissue. Most women have some lumps, so don't be concerned about figuring out what a lump or abnormal area is. Your goal is to find anything new or different and then see your health care provider for an evaluation.
Although some women find it easiest to do the exam in the shower, when the skin is soft and wet, you are more likely to examine all of the breast tissue if you are lying down.
Next, stand in front of a mirror with your arms by your side. Look at your breasts directly and in the mirror for changes in skin texture (such as dimpling, puckering, indentations, or skin that looks like an orange peel), shape, contour, or the nipple turning inward. Do the same with your arms raised above your head.
Discuss any changes you find right away with your health care provider.
Smith RA, Cokkinides V, Brawley OW. Cancer screening in the United States, 2008: A review of current American Cancer Society guidelines and cancer screening issues. CA Cancer J Clin. 2008;58:161-179.
Debra G. Wechter, MD, FACS, General surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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