As part of their routine health care, women of all ages should be familiar with their bodies. Being aware of breast changes is especially important because many breast cancers are found by women themselves. To promote breast self-awareness, many advocacy groups encourage breast self-exams (BSE) on a routine basis.
So, how do you properly perform a BSE and what should you look for? It is
suggested that the exam be performed at the same time every month because of
the hormonal fluctuations that can affect breast tissue. Premenopausal women
should perform their exam toward the end of their menstrual period and postmenopausal women should be consistent with the time of the month they choose.
How to perform a breast self-exam
- In the shower. Use the pads of your fingers to move around your entire breast in a circular pattern, moving from the outside to the center. Make sure to check the entire breast and armpit area.
- In front of a mirror. Visually inspect your breasts in front of a mirror. Place your arms at your sides and then raise them high overhead, because this will show you different angles. Also, place your palms on your hips and press firmly to flex your chest muscles.
- Lying down. When lying down, the breast tissue spreads out evenly along the chest wall. With a pillow under your right shoulder and your right arm behind your head, use your left hand to move the pads of your fingers around your right breast just as you did in the shower. Repeat these steps for your left breast.
Symptoms and signs to look for
- Lumps. Look for lumps or unusual thickness. Most lumps are pea-size. It is important to remember that all lumps should be investigated by a health care professional, but not all lumps are cancerous.
- Nipple changes. Look for tenderness, changes in shape/direction or discharge.
- Skin changes. Look for any unexplained change in the size/shape of the breast, dimpling or swelling, unexplained shrinkage or asymmetry (although it is common for women to have one breast that is slightly larger than the other), or change in appearance, such as redness.
If you do see or feel something, remember not to panic, because eight out of 10 lumps are noncancerous. If you notice any of the above signs or symptoms, visit your health care provider for further evaluation.
Early detection of breast cancer leads to better treatment outcomes and survivorship. Being aware of your body and its changes is very valuable, but the most effective screening tool is mammography. Mammograms can detect the tumors before they can be felt through a BSE, so they are critical for early detection. The National Cancer Institute recommends that women aged 40 and older have mammograms every 1 to 2 years. Women with a higher than average risk of breast cancer, such as those with a family history of breast cancer or those who are carriers of the BRCA1 or BRCA2 gene, should talk with their doctors about when to begin mammograms and how often to have them.
To learn more about breast cancer, visit massey.vcu.edu.
About the author
Mary Helen Hackney, M.D., is associate professor of hematology-oncology and palliative care at VCU Massey Cancer Center. She specializes in the treatment of all stages of breast cancer and also teaches residents and health professionals about prevention, long-term patient management and survivorship issues.