Self Breast Examination

According to the American Cancer Society, when breast cancer is detected early, and is in the localised stage, the 5-year relative survival rate is 99%. Early detection includes doing monthly breast self-exams, and scheduling regular clinical breast exams and mammograms. Many breast cancer symptoms are invisible and not noticeable without a professional screening, but some symptoms can be caught early just by being proactive about your breast health. By performing monthly breast self-exams, you will be able to more easily identify any changes in your breast. Be sure to talk to your healthcare professional if you notice anything unusual.

How should a self-breast exam be performed?

1. Stand before a mirror and look at both breasts. Check for anything unusual, such as nipple retraction, redness, puckering, dimpling or scaling of the skin. Look for nipple discharge. All discharge should be reported to your doctor. Note the colour, whether it came from both breasts and whether it came from one or more openings
2. Next, press your hands firmly on your hips and lean slightly toward your mirror as you pull your shoulders and elbows forward with a squeezing or hugging motion. Look for any change in the normal shape of your breasts.
3. Looking in the mirror, raise your arms and rest your hands behind your head. This allows you to see the underside of your breasts.
4. Place your left hand on your waist, roll your shoulder forward and reach into your underarm area and check for enlarged lymph nodes (small glands that fill with fluid when you have an infection). An enlarged node would feel like a corn kernel or a bean. Also check the area above and below the collar bone. Repeat on the right side.
5. Raise your left arm. Use the pads of three or four fingers of your right hand to examine your left breast. Use three levels of pressure (light, medium and firm) while moving in a circular motion. Check your breast area using a set pattern. You can choose lines, circles or wedges.
6. Lines Beginning at the outer edge of your breast, move your fingers downward using a circular motion until they are below the breast. Then move your fingers slightly toward the middle and slowly move back up.
7. Circles Beginning at the outer edge of your breast, use the flat part of your fingers, moving in circles slowly around the breast. Gradually make smaller and smaller circles toward the nipple. Be sure to check behind the nipple.
8. Wedges Starting at the outer edge of the breast, move your fingers toward the nipple and back to the edge. *You should not lift your fingers while feeling the breast. Whatever method you choose, make sure to cover the entire area, including the breastbone, collarbone, upper chest area and bra line. Pay special attention to the area between the breast and the underarm itself. Feel for any unusual lump, mass or thickening under the skin.
9. When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently covering the entire breast area and armpit. Use light, medium, and fir pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast. Use the same motion described in step 5.
10. What do I need to check for?
11. Nipple tenderness or a lump or thickening in or near the breast or underarm area.
12. A change in the skin texture or an enlargement of pores in the skin of the breast (some describe this as similar to an orange peel’s texture).
13. A lump in the breast (It’s important to remember that all lumps should be investigated by a healthcare professional, but not all lumps are cancerous.)
14. Any unexplained change in the size or shape of the breast.
15. Dimpling anywhere on the breast.
16. Unexplained swelling of the breast (especially if on one side only).
17. Unexplained shrinkage of the breast (especially if on one side only).
18. Recent asymmetry (unequal or lack of sameness) of the breasts. Although it is common for women to have one breast that is slightly larger than the other, if the onset of asymmetry is recent, it should be checked.
19. Nipple that is turned slightly inward or inverted.
20. Skin of the breast, areola, or nipple that becomes scaly, red, or swollen or may have ridges or pitting resembling the skin of an orange.
21. It is also important to note that a milky discharge that is present when a woman is not breastfeeding should be checked by her doctor, although it is not linked with breast cancer.Let your doctor know about any nipple discharge, clear, bloody or milky.

How often do I need to perform self-breast exams?

Adult women of all ages are encouraged to perform breast self-exams at least once a month. Choose a day each month that will be easy to remember and make breast self-awareness a regular part of your good health routine. Breast self-awareness is also important in women with breast implants.

Can I completely rely on self-breast exams for diagnosis?

While mammograms can help you to detect cancer before you can feel a lump, breast self-exams help you to be familiar with how your breasts look and feel so you can alert your healthcare professional if there are any changes. Mammography can detect tumors before they can be felt, so screening is key for early detection. But when combined with regular medical care and appropriate guidelines- recommended mammography, breast self-exams can help women know what is normal for them so they can report any changes to their healthcare provider.

October is Breast Cancer Awareness Month and that little pink ribbon seems to pop up everywhere these days. Support for women with breast cancer is greater than ever before, with sports teams, organisations, and foundations all promoting awareness whenever they can. We urge you to do your bit and take the necessary precautions from today.