Breast Self-exam

What Every Woman Needs to Know

As a woman, you are at risk for breast cancer. In fact, American Cancer Society statistics show that one out of every eight women in the U.S. will develop breast cancer in her lifetime. Even men can get breast cancer. But thanks to better, more advanced treatments, many of those diagnosed with breast cancer will go on to live full, active lives.

Early detection is important, because when a cancer is detected in the early stages, treatments can be more effective. You may have heard about different ways to test for breast cancer. One of the easiest is the Breast Self-exam (BSE), a physical examination of your own breast tissue. The BSE is something you can do by yourself, in private, on your own schedule. By getting to know how your breasts normally look and feel, the BSE can be an added defense against dying of breast cancer. In fact, eight of 10 breast lumps are found by women themselves. The Breast Center at City of Hope follows the Breast Screening Guidelines recommended by the National Comprehensive Cancer Network ( NCCN ).

How Often Should I Perform my Breast Self-exam?

According to the NCCN guidelines, you should perform a BSE each month. By becoming more familiar with your normal breast tissue and appearance, it may make it easier for you to notice changes if and when they occur. When Should I Perform my Self-exam? The ideal time for a BSE is seven to 10 days after the first day of your menstrual period. Your breasts are naturally less lumpy and tender at this time. The same is true if you have breast implants. If you are pregnant, or no longer have menstrual cycles, you can perform your BSE at any time, but make it the same time each month. If you are breast feeding, you should also perform your monthly BSE at the same time each month. Be sure to do it after you have fed the baby, not before. Any time of the day is okay.

How do I Perform my Self-exam?

Your BSE will only take a few minutes, but it is best to choose a time when you have some privacy and will not be disturbed.
  1. Stand undressed from the waist up in front of a full length mirror with your arms relaxed at your sides. If you cannot stand comfortably, you can do this part sitting down. Get to know how your breasts look. Even a small visual change may be a significant early sign of a problem. Notify your health care provider immediately if you notice any changes.
  2. Compare your breasts while turning from side to side. Look for any changes in breast size, shape, skin texture or color including redness, dimpling, puckering or retraction (pulling back of your skin).
  3. Notice any nipple changes, such as scaliness, a pulling to one side, or a change in direction.
  4. Place your hands on your waist and press inward, then turn from side to side to note any changes. If you cannot place your hands on your waist, try clasping your hands together in front of you, to tighten the chest muscles.
  5. Tightening the chest muscles beneath the breasts in other ways can also help you notice changes. Try different positions, such as putting your hands above your head and turning side to side as you look.
  6. Place your hands at your waist and bow toward the mirror, letting your breasts fall forward. Note any changes in breast shape.
  7. Nipple discharge can be a sign of a problem. Look for any discharge in your bra or clothing, but do not squeeze the nipple or try to expel any secretions. Notify your health care provider if you notice any discharge.
  8. Feel above and below your collarbone for pea- and bean-sized lumps or thickening. Applying skin cream or lotion can make this easier.
  9. Check for lumps or thickening under your arm while relaxing your arm at your side. Reach across with your other hand to feel the area. Check deeply up and down the inside of the armpit, and up and forward toward your chest. Note any changes from previous self-exams. For the next steps, lie down. The bed is okay.
  10. Place a pillow or folded towel under your left shoulder. This helps your breast tissue spread evenly across your chest wall. Bend your left arm behind your head and reach across with your right hand to your left breast. A little skin cream or lotion on your fingers will make them more sensitive.
  11. Begin the exam at the armpit. Move your three middle fingers together using light, medium and deep pressures.
  12. Your hand should move in straight rows to cover all the breast tissue from the line where your blouse seam would fall (midaxillary line) to the bra line, the breastbone (sternum) and collarbone (clavicle). Then, repeat on the other side.
What if I Find Something?

Most commonly, lumps such as cysts, are benign and are usually not a serious health problem. However, always report any changes in your breasts to your health care provider. Remember, breast tissue can vary in density naturally. Your breasts may change during different times of the month if you are still menstruating. Breast tissue also changes with age.

Your Best Defense

Early detection is important, because treatments are more effective when cancers are small.

Take Your Time

Try to avoid being rushed during your BSE, so that you can pay careful attention to your body.