Breast Self-Exam

What is a breast self-exam?

A breast self-exam (BSE) is a step-by-step way you can examine your breasts. The goal of doing a breast self-exam is to recognize what’s normal for you. Knowing how your breasts typically look and feel can help you notice a change, if one were to occur.

Self-exams should never replace breast exams from a provider and screening tests like mammograms. You should still see your primary care provider (if you have one) and/or gynecologist regularly for breast cancer screenings.

Research shows that many people with breast cancer say that finding a lump at home was how they first knew something was different. Knowing what’s normal for your breasts allows you to alert a provider as soon as you notice changes.

When should you do a self-exam?

Most healthcare associations recommend doing it every month. Even though it’s not a reliable way to detect breast cancer, it’s still the most helpful thing you can do at home for your breast health. If you still get regular periods, do your breast self-exam right after your period ends.

Why are breast self-exams no longer recommended?

Healthcare providers don’t think self-exams are bad. But they know there are better ways to detect and screen for breast cancer. Still, they want you to know your breasts. Doing breast self-exams at home is the best way to do this. That way, you’ll know what’s normal and you can tell your provider if something changes.

How do I do a breast self-exam?

You should examine your breasts both visually (with your eyes) and physically (with your fingers). Keep in mind that your breast tissue extends to your armpit, collarbone and top of your abdomen. Your breast tissue isn’t just your breast cleavage and nipples. A breast self-exam takes only a few minutes.

Visual examination

This involves looking at your breasts in a mirror with your shirt and bra off. Here are the steps:

1. Put your arms down by your sides. Look for any changes in breast shape, swelling, dimpling in your skin or the position of your nipples.
2. Raise your arms high above your head and look for the same changes.
3. Put your hands on your hips and squeeze your chest muscles so they’re flexed. Look for the same changes again.

Physical examination

There are two different ways to perform a physical breast exam at home. Both involve manually pressing on your breast tissue.

Standing breast self-exam

Many people perform a standing self-exam while in the shower. This is how you do a breast self-exam standing up:

1. Remove your shirt and bra.
2. Use your right hand to examine your left breast, then vice versa.
3. With the pads of your three middle fingers, press on every part of one breast. Use light pressure, then medium and then firm. Feel for any lumps, thick spots or other changes.
4. Move in a circular pattern so you cover every area of your breast.
5. Press the tissue nearest your armpit. Be sure to check under your areola and squeeze your nipple to check for discharge.
6. Repeat the steps on the other side.

Lying down breast self-exam

Performing a breast self-exam lying down evens out breast tissue. This makes it easier to feel changes, especially in large breasts.

Here’s what you do:

1. Lie down with a pillow under your right shoulder. Place your right arm behind your head.
2. With the pads of your middle fingers on your left hand, check all parts of your right breast. Use light, medium and firm pressure.
3. Make sure to check all areas, like under your armpit and around your areola. Gently squeeze your nipple to check for discharge.
4. Switch sides and repeat with your opposite hand and breast.

What are the problems with doing a breast self-exam?

There can be issues with breast self-exams. Some of the risks include:

• Replacing a clinical breast exam or mammogram with a self-exam: A breast self-exam is an at-home tool to help you become familiar with your body. Some people falsely believe that because they perform self-breast exams, they don’t need to see a healthcare provider.
• Anxiety that comes from thinking you have a lump or abnormality: Most lumps aren’t cancerous, but thinking you have a cancerous lump may give you unnecessary worry.

What kind of lumps are normal to feel in your breasts?

Lumps in your breast tissue are normal and not necessarily a reason to panic. Some people have naturally lumpier breast tissue. Becoming aware of what’s normal for you can better help you figure out when something isn’t normal.

When should I call my healthcare provider?

Contact a healthcare provider if you notice:

• A lump or other change in how your breast tissue feels
• Unusual discharge from your nipple
• Dimpling, redness or swelling of your skin
• Changes in the direction of your nipple, such as turning inward

A healthcare provider can perform a clinical breast exam to see if they think tests like an ultrasound or a mammogram are necessary.

What are the warning signs of breast cancer?

A breast self-exam isn’t a diagnostic tool for breast cancer. Only a trained healthcare provider can confirm if a lump you feel during a self-exam is potentially harmful. Knowing the signs of breast cancer can also be helpful as you get to know your breasts. Some warning signs of breast cancer include:

• Inverted nipple or nipples that stop sticking out
• Redness, soreness, a rash or swelling on your breasts
• Dimpling or puckering (like an orange peel) of the skin of your breasts
• Irregular nipple discharge

What are the seven Ps of breast self-examination?

The seven Ps are a guide to help you perform a self-exam. The P’s stand for:

1. Position: Inspect your breasts both in the mirror and lying down.
2. Perimeter: Include the area of your breast that extends to your armpit.
3. Palpation: Move your three fingers in a gentle, circular motion.
4. Pressure: Use light, medium and firm pressure.
5. Pattern: Use a pattern to make sure you cover your entire breast.
6. Practice: Perform self-exams regularly.
7. Planning: Know what you’re looking for and what to do if something seems unusual.