Breast Self-examination

For years physicians have taught that performing BSE can reduce risk of death from breast cancer. However, recently a very large study involving over 250,000 women over a 10-year period did not find this to be true. A women should discuss BSE with her health care professional for the latest recommendations regarding this. The American Cancer Society feels that BSE is an option for women to consider.

During a BSE, a woman checks for lumps and any changes in her breasts. Becoming familiar with how her breasts normally feel and look is an important part of this exam. This makes it easier to notice changes over time. A woman who feels unsure about how to do a BSE or what to look for should ask her healthcare professional to do an exam with her.

This is an example of how to perform a three-step BSE. Doing the first step of a BSE in the shower helps because soapy or wet fingers slide across the skin.

1. While standing in the shower, a woman should raise her right arm overhead. The finger pads of three middle fingers on the left hand should be used to make tiny circles on the skin of the right breast. One way to cover the whole breast is to move in a spiral pattern from the outer edge of the breast to the nipple. Another way is to move straight across the breast from the top edge to the bottom. The skin under the arm and the skin between breast and armpit should be carefully checked as well. Most cancerous lumps are found in the quarter of the breast closest to the armpit. Next, the woman should switch arms to do the same exam of the left breast.

2. After coming out of the shower, the woman should lie down on her back. She should put her right arm overhead and a pillow under that shoulder. The steps followed in the shower should be repeated on the right breast. She should then switch and do the same exam on the left breast.

3. Standing in front of a mirror, the woman should look for:

• redness or scaly skin on the breast or nipples
• changes in the nipple, such as fluid leaking from it or the nipple turning inward
• dimpled, puckered, or swollen spots on the breast

She should then tuck her hands behind her head and check again for these signs. Next, she should put her hands on her hips and tip her elbows toward the mirror. Bending forward a bit, she should look for the same signs again. Last, she should squeeze the nipples on both breasts to see if any fluid leaks out. (If a woman is breastfeeding, it is normal to see drops of breast milk.)

A woman should report any lumps or changes in her breasts or any of the signs mentioned above to her healthcare professional immediately. While women fear finding a lump, most often this is not a sign of cancer. It may instead be a fluid-filled sac called a cyst or another benign clump of cells. However, it is very important to have any such problem checked by a healthcare professional.