BREAST SELF EXAMINATION (BSE)

A breast self-exam is a screening technique women can do at home to check for breast lumps. It is an important, potentially life-saving procedure and should be known and practiced by all women.  A breast self-exam can help screen for tumors, cysts, or other abnormalities in the breasts. Breast self-exams help you familiarize yourself with the shape, size, and texture of your breasts. This is important because it can help you determine if what you are feeling is normal or abnormal.

 Beginning in their 20s, women should be told about the benefits and limitations of breast self-exam (BSE). Finding a breast change does not necessarily mean there is a cancer.

‘ Majority of breast masses are detected by women themselves, therefore monthly self breast examination, in combination with regular, annual, professional examinations and periodic mammography offers the best chance of reducing the risks of advanced breast cancer.’

The best time to examine the breasts is immediately following a menstrual period. The breasts are the smoothest (least lumpy) and easiest to examine at this time. The completion of a menstrual period is a convenient reminder to examine the breasts.

HOW TO PERFORM A BREAST SELF-EXAM

 1. Start by standing topless in front of a mirror with your hands at your sides, with your hands on your hips, and with your arms raised over your head. Visually inspect your breasts for the following:

Ø  changes in size, shape, or symmetry

Ø  redness

Ø  visible lumps

Ø  nipple crusting

Ø  dimpling

Ø  inverted nipples

Ø  puckering

Ø  asymmetrical ridges at the bottom 

2. With one arm raised begin feeling for lumps or masses using the pad of your fingers (note: the left hand for the right breast and right hand for the left breast).Move your hand in small circles while feeling for lumps

 

After examining the first area with circular motions of your hand, move to another area and again feel for lumps, using a circular motion. 

Many people find it easiest to progress in a clock-wise fashion around the breast until the entire breast has been examined. 

3. Don’t forget the “tail” of the breast.

Remember that the breast is not perfectly round, but has an extension ("tail") that extends up into the armpit. It is important to examine that portion of the breast too.

Using the same circular motions, examine the armpit, feeling for any lumps in the "tail" of the breast or any lymph nodes. Lymph nodes are normally so small they cannot be felt. If enlarged due to infection or inflammation, they grow to about the size of a pencil eraser but are long and narrow rather than round.

4. Feeling for lumps in the breast is repeated with the person lying down. Place a pillow under your right shoulder and place the right hand behind your head. This position distributes breast tissues more evenly on the chest.

5.  Lastly, gently squeeze your nipples to check for discharge

Using the thumb and fingers, squeeze the breast toward the nipple to try to express any discharge. This stripping of the milk ducts can be useful in identifying early problems with the ducts. You should squeeze not only from side to side, but also from top to bottom and at an angle. 

In normal breasts, you can, with effort, usually produce a drop or two of clear, milky, or slightly green-tinged discharge. Abnormal findings would be a bloody discharge, or so much discharge that it squirts across the room or consistently stains the inside of your bra.

6. Then move to the other breast, performing the same maneuvers feeling for lumps.

HAVE A PROFESSIONAL BREAST EXAM EACH YEAR

In addition to your monthly breast self-examinations, an annual professional exam by a physician or other qualified health professional is important. At that time, you can ask questions about findings that you didn't consider abnormal but were nonetheless troubling.

MAMMOGRAMS

Mammography is the final part of routine breast screening that can detect tumors before they can be felt. For women without significant breast disease or a family history of breast cancer, mammography is probably useful about every other year from age 40 to age 50. After age 50, most health providers recommend annual mammograms. Check with your own health care provider to find out what would be best for you

‘If you find a lump, schedule an appointment with your doctor, but don't panic — 8 out of 10 lumps are not cancerous. For additional peace of mind, call your doctor whenever you have concerns.’

The most effective way to fight breast cancer is to detect it early. Although the most effective tools to detect breast cancer are mammography and clinical breast exam by your health professional, the breast self-exam may also be an effective tool to find cancer early. In fact, women who perform regular breast self-exam find 90% of all breast masses.