Breast cancer: How to do a self-examination
Practicing monthly breast self-examination can help detect abnormalities or changes that may indicate cancer. Before menopause, carrying out a check at the same stage of the menstrual cycle each month can help people spot any unusual features.
In the past, doctors and health authorities recommended breast self-examinations for all women. Now, some authorities, including the American Cancer Society, no longer recommend these. Despite these recommendations, it is important for people to be familiar with how their breasts look and feel and for them to report any changes to their doctor.
There are no guidelines on when or how to perform this self-examination.
Nevertheless, a person who is familiar with the features of their breasts has a better chance of spotting any changes that do occur, and this can increase the likelihood of early detection and effective treatment.
The carousel below is a step-by-step guide, with pictures, on how to perform a self-examination of the breasts.
Where breast cancer forms
Knowing how the breasts usually feel can help a person detect changes that may need attention.
Most breast cancers begin in the milk ducts, the tube-like structures that deliver milk to the nipples.
Cancer may also form in the lobules, the glands that produce milk. Individual lobules form larger structures called lobes, and ducts connect the lobes.
As this system of lobes and ducts surrounds the nipple from within, ductal or lobular cancers may affect the appearance and feel of the nipples and the areolae around them.
Apart from a lump, what are some other early signs of breast cancer? Find out here.
How to do a breast self-exam
The National Breast Cancer Foundation suggest three steps for an effective breast self-examination:
- visual examination
- physical examination while standing
- physical examination while lying down
The following pictures show the areas that a person should examine and give an idea of how to carry out the examination.
Visual and standing examination
A person can do a visual examination in front of a mirror. They should check the breasts and nipples for abnormalities or discharge.
People often do a standing examination in the shower because the skin is easier to examine when slippery.
They can start by checking each breast, feeling with the fingertips from the sides to the center for lumps or knots.
It is best to use circular motions, applying varying amounts of pressure to each spot along the breast to check both the superficial and deep layers of the breast tissue.
Laying down examination
A lying-down exam allows the breast tissue to spread out evenly along the chest wall. In this position, a person can check the whole of both breasts and examine the armpit, collarbone, and breastbone areas.
The Maurer Foundation suggest following the steps below:
- Starting at the armpit, feel for lumps by making circles with the pads of the fingers.
- After making three circles at varying pressures, slide downward a finger's width and begin a new set of circles.
- Repeat as far as the top of the abdomen. Next, shift a finger's width horizontally and progress upward toward the collarbone.
- Follow this up-and-down pattern all the way to the space between the breasts.
- Next, do the same on the opposite side of the body.
Nipples and areolae
Changes to look for in the nipples and areolae include:
- redness or swelling
- the nipple turning inward
- a scaly or ridged texture to the skin
- discharge that is clear, yellow, or contains blood
- tenderness or pain
If a tumor has formed in the ducts or lobules, the cancer may spread to nearby fatty tissue.
Breast abnormalities that may indicate cancer include:
- a lump in the breast
- an unexplained change in breast shape
- unusual breast shrinkage or swelling
- dimpling of the skin or enlarged pores
- skin that has become irritated, scaly, or ridged
- a thickening of the breast skin
- changes in color affecting at least one-third of the skin
- pain or a burning sensation
A person should see their doctor about these or any other unexplained changes, especially if they only appear in one breast.
Armpits, collarbone, and breastbone
Swollen lymph nodes may be an early sign of breast cancer.
A person should look out for a lump or swelling around the underarm or collarbone area. If cancer is present, there may also be a thickening of the skin in the armpit area.
When to self-examine
An individual should do a self-examination once a month, at the same time each month.
Before menopause, it is best to do the self-examination a few days after menstruation ends. At this time, the breasts are least likely to be swollen or sore.
The normal texture and appearance of breasts can vary among individuals. Certain areas might feel sandy or grainy, and others might even have small lumps.
Routine self-examination helps people develop a sense of what is normal for them and makes it easier to spot any changes.
What to do if you find a lump
If a person notices changes in their breasts that could indicate cancer, they should see a doctor.
Very often, the change is not a sign of breast cancer. However, as early detection significantly increases the chance of survival with breast cancer, it is a good idea to seek a professional medical opinion on any changes.
Combined with a routine mammogram, breast self-examination can help catch breast cancer in its early stages.
For most people with breast cancer, the earlier the diagnosis, the better the outlook.