Breast Self-Exams

One of the ways that you can take responsibility for your own good health is by doing a monthly breast exam. The purpose of this exam is to look for a lump that may be cancerous. It is reassuring to remember these two facts: eight out of ten lumps are not cancerous, and up to 90% of women with breast cancer who are treated early can be cured. We recommend that you begin examining your breasts once a month when you are in your late teens or early twenties. By doing these exams on a monthly basis, you will get to know your breasts better than anyone does—every woman's breasts are different. Although your doctor will conduct a full breast exam at your annual visit, doing your own monthly breast exam will make you very aware of any changes in your breasts.

Many women and girls are afraid to examine their breasts, because they fear they might find something or because they do not understand what they are feeling. However, if you understand both what you are looking for and the importance of why you're doing it, the exam will be easier.

The monthly breast self-exam should be done after your period, when estrogen and progesterone levels are at their lowest, so there is less tenderness and swelling. After a few months of checking, you will become the expert on your breasts. It's a good idea to go through the self-exam with your doctor to make sure you are performing it correctly. And remember, if you feel a lump or something abnormal, don't wait for it to go away. Consult your physician immediately.

Some things to look for when examining your breasts are:

•Breast lump •Any change in the direction of the nipples, including an inversion of the nipple •Any changes in the coloration of the skin •Skin that looks dimpled or has enlarged pores (like the skin of an orange) •Persistent rash or skin eruptions near the nipple or on the skin •A lump in the underarm or above the collarbone •Dimpling, pulling, or retraction in one area of the breast •Nipple discharge, particularly bloody discharge

We have outlined below the necessary and easy steps that you can follow to perform a breast self-exam. Please consider the above signs when examining your breasts. If you notice any abnormality or change in your breasts, report them to your doctor right away.

Breast self-exam steps:

STEP 1
Turn on a good light and stand in front of a mirror and observe. Do you notice any changes in your breasts such as an inverted nipple, dimpled areas or rashes on the skin? Next, place your hands on your hips and push down while pushing your chest out. Do you see anything unusual? Each breast should look the same without any dimpling or puckering of the skin. Squeeze each nipple gently to check for discharge. A clear discharge is normal. However, if the discharge is tinged with blood, contact your doctor.

STEP 2

Now, lie down on your back (flat) with a pillow under one shoulder and your arm (from the same side) under your head. Imagine your breast is the face of a clock. With the opposite (free) hand begin the examination by making circles from the outermost to the innermost portion of your breast. First at 12:00, then at 1:00 and so on, till you are back to the 12:00 position. Go around the clock face again. Repeat until you've examined all the breast tissue and the nipple area as well. Don't forget to probe a bit more by making more gentle circles under your armpit because breast tissue extends up and under the armpit. Also, if you have larger breasts, you may have to use both light and heavy pressure during your examination to make sure you have checked all of your breast tissue. Now do the other side.

These steps are all you need to do. The risk of cancer increases with age, so you must do your monthly check even after menopause. Your self-examination will be further enhanced by the doctor's exams and mammography. If you do discover an abnormality or possible symptom, tell your doctor immediately so he/she can evaluate the problem with further testing.

If you feel or notice anything unusual and your doctor seems unconcerned—be persistent. Bring it to your doctor's attention again and make sure the doctor provides another thorough breast exam. If you pefer, you can get a second opion from another doctor. Be your own advocate in the prevention and cure of breast cancer in your life.

The American Cancer Society has made the following recommendations for routine breast evaluations for those women with no abnormalities nor any risk factors for breast cancer:

•Examine your breasts every month for life beginning at age 20 or earlier •Breasts should be examined by your doctor every three years from age 20 to 39, and every year after that •Initial mammography between the ages of 35 and 40 •Mammography every year beginning at age 40

The American Cancer Society recently changed their recommendations concerning mammograms. Previously, the recommendation was to obtain mammograms every other year for a woman in her 40's and annually after the age of 50. Please note that they now advise annual mammograms for all women over 40. Some astonishing data that was introduced to support this change includes:

•One out of every 66 women in their 40s develops breast cancer. •18% of all breast cancers occur in women in their 40s. •13% of the 44,000 women expected to die of breast cancer in 1997 are in their 40s. •A Metanalysis (a statistical tool that allows results of many studies to be evaluated together) found 18% fewer deaths from breast cancer among women in their 40s who had regular mammograms.

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The contents of this Web site are for informational purposes only and are not intended to be used for medical advice. You should consult your physician or health care provider on a regular basis. You should consult your physician immediately with any problem about which you are concerned.