Some women are quite happy to do a BSE after each period. It is a step-by-step approach to examining (observing) and feeling the breasts. Others, however, prefer random checks and general awareness, such as checking while in the shower, getting up in the morning or going to bed at night - a less systematic approach.
It is important that the woman does what feels best for her and does not become over-anxious about whether she has got the technique right.
The aim of a monthly breast self-exam is to report any detected changes to a health care professional immediately.
In some countries, such as Russia and China, studies concluded that BSEs cause such an increase in unnecessary biopsies that they do not recommend BSE, and advise women to attend regular breast screening.
How to do a breast self-exam
- Stand in front of the mirror with your upper body exposed
- Look carefully in the mirror for signs of swelling, redness or dimpling either on the breast, or near it
- Repeat the instruction above in different positions, with hands on hips and arms overhead
- Palpate (touch exploringly) your breasts with the pads of your fingers and seek out any lumps which may be on the surface or deeper inside. Look out for any soreness as you do this.
Move the fingers up and down over the breast.
Then start at the nipples and move outwards.
Move the fingers around the nipples in concentric circles moving outwards.
- Some doctors or nurses advise the woman to imagine the breast is divided into four quadrants, and to check each one separately.
- Palpate the area including the part of the breast that extends to the armpit - the axillary tail. You should do this once while standing and once while lying down.
- Squeeze the nipple and check for any discharge. Do not do this if you are breastfeeding.
Pic 1 to 3 involves inspecting the breast with the arms hanging, behind head, and on hips. Pic 4 is the palpitation (touching) of the breast. Pic 5 is palpitation of the nipple. Pic 6 is a BSE while lying down.
Health care professionals say that women who menstruate (pre-menopausal) should perform their BSA at the same point in their cycle each month - hormonal variations during the cycle can cause changes in breast characteristics. Most doctors and nurses advise doing the BSE just after a period, when the breasts are most swollen and tender.
Tell your doctor or nurse if you notice any of the following:
- A lump inside the breast or underarm area
- A thickening inside the breast or underarm area
- A hard knot inside the breast or underarm area
- Darkening of the breast
- Swelling anywhere on the breast
- Redness on the breast
- Any alteration in the size of the breast
- Any change in the shape of the breast
- Puckering or dimpling of the skin
- A rash on the nipple
- Scaly skin on the nipple
- Itchiness on the nipple
- Nipple discharge, especially one that starts suddenly. If the discharge is clear (not milky), occurs just on one nipple, has blood in it, or comes out without squeezing, tell your doctor or nurse.
- A pain anywhere that does not go away.
In most cases, lumpiness is nothing to worry about - breast tissue has a bumpy texture anyway. If you feel any lumpiness, compare it to the lumpiness in the other breast - most likely it is nothing. If you are concerned, tell your doctor.