A breast self-exam that you do for breast awareness helps you understand the normal look and feel of your breasts. If you notice a change in your breasts that seems abnormal or if you notice one breast is different when compared with the other, you can report it to your doctor.
There are many conditions that can cause changes in your breasts, including breast cancer.
Although the breast self-exam technique isn’t always a reliable way to detect breast cancer, a significant number of women report that the first sign of their breast cancer was a new breast lump they discovered on their own. For this reason, doctors recommend being familiar with the normal consistency of your breasts.
Risks
A breast self-exam for breast awareness is a safe way to become familiar with the normal look and feel of your breasts.
However, there are some limitations and risks, including:
- Anxiety caused by finding a lump. Most of the changes or lumps women find in their breasts aren’t cancerous. Still, finding something suspicious in your breast can make you anxious about what it may mean. You may endure several days of worry until you can see your doctor.
- Additional tests and procedures may be necessary to check out lumps or changes. If you discover a suspicious lump, you may end up having imaging test such as a diagnostic mammogram or a breast ultrasound, or a procedure to remove breast tissue for examination (biopsy). If it turns out the lump was noncancerous (benign), you might feel that you’ve undergone an invasive procedure unnecessarily.
- Overestimating the benefits of self-exams. A breast self-exam isn’t a substitute for a breast exam by your doctor (clinical breast exam) or a screening mammogram. Becoming familiar with the normal look and feel of your breasts can supplement breast cancer screening, but can’t replace it.
Discuss the benefits and limitations of being familiar with the consistency of your breasts with your doctor.
How you prepare
To prepare for your breast self-exam for breast awareness:
- Ask your doctor for a demonstration. Before you begin breast self-exams for breast awareness, you may find it helpful to discuss the instructions and technique with your doctor.
- If you menstruate, choose a time in your cycle when your breasts are least tender. Your hormone levels fluctuate each month during your menstrual cycle, which causes changes in breast tissue. Swelling begins to decrease when your period starts. The best time to perform a self-exam for breast awareness is usually the week after your period ends.
What you can expect
Begin with a visual examination of your breasts
Sit or stand shirtless and braless in front of a mirror with your arms at your sides. To inspect your breasts visually, do the following:
- Face forward and look for puckering, dimpling, or changes in size, shape or symmetry.
- Check to see if your nipples are turned in (inverted).
- Inspect your breasts with your hands pressed down on your hips.
- Inspect your breasts with your arms raised overhead and the palms of your hands pressed together.
- Lift your breasts to see if ridges along the bottom are symmetrical.
If you have a vision impairment that makes it difficult for you to visually inspect your breasts, ask a trusted friend or a family member to help you.
Next, use your hands to examine your breasts
Common ways to perform the manual part of the breast exam include:
- Lying down: Choose a bed or other flat surface to lie down on your back. When lying down, breast tissue spreads out, making it thinner and easier to feel.
- In the shower: Lather your fingers and breasts with soap to help your fingers glide more smoothly over your skin.
When examining your breasts, some general tips to keep in mind include:
- Use the pads of your fingers: Use the pads, not the very tips, of your three middle fingers for the exam. If you have difficulty feeling with your finger pads, use another part of your hand that is more sensitive, such as your palm or the backs of your fingers.
- Use different pressure levels: Your goal is to feel different depths of the breast by using different levels of pressure to feel all the breast tissue. Use light pressure to feel the tissue closest to the skin, medium pressure to feel a little deeper, and firm pressure to feel the tissue closest to the chest and ribs. Be sure to use each pressure level before moving on to the next spot. If you’re not sure how hard to press, talk with your doctor or nurse.
- Take your time: Don’t rush. It may take several minutes to carefully examine your breasts.
- Follow a pattern: Use a methodical technique to ensure you examine your entire breast. For instance, imagine the face of a clock over your breast or the slices of a pie. Begin near your collarbone and examine that section, moving your fingers toward your nipple. Then move your fingers to the next section.
If you have a disability that makes it difficult to examine your breasts using this technique, you likely can still conduct a breast self-exam. Ask your doctor to show you ways you can examine your breasts.
Results
What’s normal
Many women find lumps or changes in their breasts, since some of these are normal changes that occur at various points in the menstrual cycles. Finding a change or lump in your breast is not a reason to panic. Breasts often feel different in different places. A firm ridge along the bottom of each breast is normal, for instance. The look and feel of your breasts will change as you age.
When to contact your doctor
Make an appointment with your doctor if you notice:
- A hard lump or knot near your underarm
- Changes in the way your breasts look or feel, including thickening or prominent fullness that is different from the surrounding tissue
- Dimples, puckers, bulges or ridges on the skin of your breast
- A recent change in a nipple to become pushed in (inverted) instead of sticking out
- Redness, warmth, swelling or pain
- Itching, scales, sores or rashes
- Bloody nipple discharge
Your doctor may recommend additional tests and procedures to investigate breast changes, including a clinical breast exam, mammogram and ultrasound.
Breast Cancer Screening Recommendations
The following are the recommended guidelines for breast cancer screening by age and risk factor:
Beginning at 16 to 18:
- Breast self-exam
Breast cancer is one of the few cancers that can sometimes be felt. It is important to become accustomed to how your breasts naturally feel so that you can recognize any abnormalities. Breast tissue can be lumpy, but if you think you feel something abnormal, you should contact your doctor.
20 onward:
- Annual clinical breast exam
This is typically conducted at your yearly gynaecological or physical exam.
40 onward:
- Annual clinical breast exam
- Annual mammogram
There is no recommended age at which you should stop receiving annual mammograms, unless you have less than five years of life expectancy due to old age or other illness.
40 onward, with high-risk factors
- Annual clinical breast exam
- Annual mammogram
- Breast MRI (or breast ultrasound for those who cannot have an MRI)
