Breast Self-Exam

Women older than 20 years should perform monthly breast self-examinations (BSE). If you still have menstrual periods, you should perform the examination a few days after your period has ended. During this time, your breasts are not tender. If you are not menstruating (such as in menopause), BSE should be performed on the same day each month.

Use the following techniques to perform a BSE. Choose the method that is best for you.

Facing a mirror

Stand before a mirror and compare both breasts for differences in size, nipple inversion (turning in), bulging, or dimpling. Note any skin or nipple changes, such as a hard knot or nipple discharge.

• Inspect your breasts in the following 4 steps:
  
  
  • With your arms at your sides
    
    
  • With your arms overhead
    
    
  • With your hands on hips - Press firmly to flex your chest muscles.
    
    
  • Bent forward - Inspect your breasts.
  
  
• In these positions, your pectoral muscles are contracted, and a subtle dimpling of the skin may appear if a growing tumor has affected a ligament.

Lying down

• Right breast
  
  
  • Place a pillow under your right shoulder.
    
    
  • Put your right hand under your head.
    
    
  • Check the entire breast area with the finger pads of your left hand.
    
    
  • Use small circles and follow an up-and-down pattern.
    
    
  • Use light, medium, and firm pressure over each area of the breast.
    
    
  • Feel the breast with the surfaces of the second, third, and fourth fingers, moving systematically and using small, circular motions from the nipple to the outer margins.
    
    
  • Gently squeeze the nipple for any discharge.
  
  
• Left breast
  
  
  • Repeat these steps on your left breast using your right hand.

In the shower

• A BSE can easily be performed while you're in the bath or shower. Some women discover breast masses when their skin is moist.
  
  
  • Raise your right arm.
    
    
  • With soapy hands and fingers flat, check your right breast.
    
    
  • Use the same small circles and up-and-down pattern described earlier.
    
    
  • Repeat on the left breast.

Your health care provider can show you the proper technique for a breast self-examination during your annual breast examination. This should be brought up during your general check up.

You should perform this exam monthly and immediately report any suspicious breast lumps or conditions to your doctor.

Routine breast self-examination has not been proven to reduce breast cancer deaths, nor has it been as helpful as routine screening by mammography. However, breast self-exams are very cost effective and have no side effects. Tumors that may be breast cancer, when found with this technique, can be in an early stage, may have a better outcome, and may possibly have higher cure rates (long-term survival).

|Web Links|

MEDLINEplus, Breast lump self-exam

American Cancer Society, How to Perform a Breast Self-Examination

Media file 1: Breast self-examination technique

Media type:  Illustration

BSE, breast self-exam, breast lumps, breast cancer, mammogram, breast self-examination

1. McKenna RJ, Greene P, Winchester DP, et al. Breast self-examination and breast physical examination. Cancer. Apr 1 1992;69(7 Suppl):2003-4. [Medline].

2. Miller AB, Baines CJ. Detection of breast cancer. Self examination contributes to reduction in mortality. BMJ. Mar 31 2001;322(7289):793. [Medline].

3. Smith TJ, Davidson NE, Schapira DV, et al. American Society of Clinical Oncology 1998 update of recommended breast cancer surveillance guidelines. J Clin Oncol. Mar 1999;17(3):1080-2. [Medline].

Author: Serdar H Ural, MD, Assistant Professor, Department of Obstetrics and Gynecology, Director of High Risk Obstetrics Clinic and Conferences, University of Pennsylvania School of Medicine.

Coauthor(s): Aneela Naureen Hussain, MD, MBBS, Assistant Professor, Department of Family Practice, State University of New York Downstate Medical Center.

Editors: Jerry Balentine, DO, Professor of Emergency Medicine, New York College of Osteopathic Medicine; Medical Director, Saint Barnabas Hospital; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, ; Lee P Shulman, MD, Professor of Obstetrics and Gynecology, Head, Section of Reproductive Genetics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.