When should I perform a breast self-exam?
You should perform a breast self-exam once a month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month, such as the first day of the month or a day easy for you to remember, like your birth date. The exam will take several minutes to perform. With each exam, you will become familiar with the contours and feel of your breasts and will be more alert to changes.
1. The first part of the exam is the inspection, or looking at your breasts. Stand undressed from waist up in front of a large mirror in a well-lit room. Look at your breasts. Don't be alarmed if they do not look equal in size or shape. Most women's breasts are not. With your arms relaxed by your sides, look for any changes in your breasts' size, shape, texture, or skin. Look for any sores as well as any puckering, dimpling, or discoloration of the skin. Inspect your nipples and look for any sores, peeling, or change in the direction of the nipples.
2. Next, place your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. Turn from side to side so you can inspect the outer part of your breasts.
3. Bend forward toward the mirror. Roll your shoulders and elbows forward to tighten your chest muscles. Your breasts will fall forward. Look for any changes in the shape or contour of your breasts.
4. Now, clasp your hands behind your head and press your hands forward. Again, turn from side to side to inspect your breasts' outer portions. Remember to inspect the border underneath your breasts. You may need to lift your breasts with your hand to see this area.
5. Check your nipples for discharge (fluid). Place your thumb and forefinger on the tissue surrounding the nipple, and pull outward toward the end of the nipple. Look for any discharge. Repeat on your other breast.
In the shower
6. The second part of the exam is palpation, or feeling for changes. Use the finger pads of your three middle fingers on each hand to feel for lumps. It is helpful to have your hands slippery with soap and water. Check for any lumps or thickening in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat on the other side.
7. Check both sides for lumps or thickenings below your collarbone.
8. With soapy hands, support the breast with one hand while using the other hand to feel the tissue. Use the flat part of your fingers to press gently into the breast. Follow an up-and-down pattern along the breast, moving from bra line to collarbone. Continue the pattern until you have covered the entire breast. Repeat on the other side.
9. Next, lie down and place a small pillow or folded towel under your right shoulder. Put your right hand behind your head. Place your left hand on the upper portion of your right breast with fingers together and flat. Body lotion may help to make palpation easier.
10. Think of your breast as a face on a clock. Start at 12 o'clock and move toward 1 o'clock in small circular motions. Continue around the entire circle until you reach 12 o'clock again. Keep your fingers flat and in constant contact with your breast. When the circle is complete, move in one inch toward the nipple and complete another circle around the clock. Continue in this pattern until your entire breast has been palpated. Make sure to palpate the upper outer areas that extend into your armpit.
11. Place your fingers flat and directly on top of your nipple. Feel beneath the nipple for any changes. Gently press your nipple inward. It should move easily. Repeat steps 9, 10, and 11 on your other breast.