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Breast Cancer: Self-Examination

Jessica Evert, MD

Although the American Cancer Society no longer states that women need to perform a BSE every month, nearly all physicians agree that it is a good idea for women to become familiar with the characteristics of their breasts so that they can report any changes to their physician. If you do decide to do a regular BSE here are some general guidelines to follow.  Again remember that it is best to consult your doctor before beginning regular BSE.

Try to time the BSE during the week after you finish menstruating, because you can get breast lumps and bumps just before and during your period. Also, time the exams at the same time every month so it is easy to detect changes.  Follow these simple steps to perform a complete BSE:

  • Stand topless in front of a mirror with your shoulders square and level and your hands on your hips. Check to make sure that your breasts are their normal size, shape, and color. Check for any swelling or rashes, or any physical changes like the inversion of a nipple.
  • Next, raise your hands above your head and check again to see if your breasts still appear to be their normal size, shape and color.

  • While still in front of the mirror gently squeeze your nipples to check for any fluid discharge. A discharge that is yellowish in color or bloody may be a warning sign of a breast lump.

  • Next, lie down flat on your back and examine your breasts with your fingers checking for lumps or irregularities. Follow a pattern while doing this examination insures that you do not miss any portion of your breasts. One method to ensure that you cover the entire breast is known as the "Lawn mower method."  Start in the armpit moving down then move a bit closer to the center of the breast and go back up.  Proceed in a similar manner as you cover the entire breast, much like you would mow the lawn in rows. At first, apply only mild pressure so as to check the outer layers of your breasts for lumps. Later, increase the pressure to check the deeper tissues for lumps or irregularities. Breast tissue extends all the way up into your armpit. Make sure to exam all the breast tissue.

  • Lastly, stand up straight and again examine your breasts with your fingers, checking for lumps and irregularities as in the previous step. As before, it is a good idea to follow a pattern so that you do not miss any spots.

Any lumps, irregularities or other significant changes you find during your self-examination that aren't normal for you should be reported to your doctor. If you find a new lump or irregularity, do keep in mind that most lumps you find within your breast will not be cancerous.