Breast Self-exam

GENERAL INFORMATION:

What is it? Checking your own breasts for lumps and other changes is called a breast self-exam (BSE). Doing BSE's can help you learn how your breasts normally look and feel. Then if you have breast changes, you may find them and tell your caregiver right away. Although most breast lumps or changes are not cancer, you should always have them checked by a caregiver. Breast cancers that are caught early may be better treated than breast cancers caught later.

Why should I do a BSE? Breast cancer is the most common type of cancer in women. It is best to find breast cancer early. Even if you have yearly mammograms, you should still do a BSE regularly. Knowing how your breasts normally look and feel may save your life. Mammograms can miss some cancers. Sometimes, a woman can find a lump during a BSE that did not show up on her mammogram. Men can also do BSE's to check for breast changes. It is uncommon, but possible for men to get breast cancer too.

When should I do a BSE? Start checking your breasts when you are 20 years or older. Mark your calendar to help you remember to do BSE on a regular schedule. One easy way to remember to do BSE is to do the exam on the same day of each month. Do your BSE one week after your monthly period. This is the time when your breasts may be the least swollen, lumpy, or tender. If you are pregnant or have gone through menopause (change of life), do a BSE on the same day of each month. Breast feeding women and women who have breast implants can do regular BSE's too. Talk to your caregiver and make your own personal decision about doing BSE.

How should I do a BSE? Divide your BSE into two steps.

• 1. Look at your breasts in a mirror. Look at the size and shape of each breast and nipple. Check for swelling, lumps, dimpling (looks like orange peel), scaly skin, or other skin changes. Look for nipple changes, such as a nipple that is painful or beginning to pull inward. Gently squeeze both nipples and check to see if fluid (that is not breast milk) comes out of them. If you find any of these or other breast changes, call your caregiver right away. Check your breasts while you sit or stand in three different positions. Look at your breasts while you:
  
  
  • Hang your arms down at your sides.
    
    
  • Raise your hands and join them behind your head.
    
    
  • Put firm pressure with your hands on your hips. Bend slightly forward while you look at your breasts in the mirror.
  
  
• 2. Lie down and feel your breasts. Lying down is the best position for doing a BSE. When you lie down, your breast tissue spreads out evenly over your chest. This makes it easier for you to feel for lumps and anything that may not be normal for your breasts. Do a BSE on one breast at a time.
  
  
  • Place a small pillow or towel under your left shoulder. Put your left arm behind your head.
    
    
  • Use the three middle fingers of your right hand to do the BSE. Use your fingertip pads to do the exam. Fingertip pads are the top parts of your fingers. For example, you may use your fingertip pads to type on a computer.
    
    
  • Use three types of pressure while you do your BSE. First, press lightly. Second, press with medium pressure to feel a little deeper into the breast. Last, use firm pressure to feel deep within your breast.
    
    
  • Use small circles to feel your breast tissue. Use your fingertip pads to make dime-sized, overlapping circles on your breast and armpits.
    
    
  • Examine your entire breast area using up and down lines. Examine the breast area from above the breast (collarbone) to below the breast where you feel only ribs. Examine the area from the armpit and all the way over to the middle of your chest. Make small circles with your fingertips starting in the middle of your armpit. Make the circles going up and down the breast area in up and down lines. Continue making the up and down lines toward your breast and all the way across it. Stop at the middle of your chest. This way you will not miss any breast tissue that could have lumps or other changes.
    
    
  • Move the pillow or towel to your right shoulder, and put your right arm behind your head. Using the three fingertip pads of your left hand, repeat the above steps to do a BSE on your right breast.
    
    
  • Sit or stand up to examine your armpit areas again. Raise your arm up slightly, but not all the way above your head. Raising your arm too high may tighten the skin too much and make it difficult to examine. Feel for lumps or other changes in each armpit.

How can I know if I am doing my BSE correctly? When you go to your caregiver, show the caregiver how you give yourself a BSE. The caregiver can teach you how to do the BSE if you do not know how to do it. The caregiver can help you if you are not doing it the right way.

What else can I do to check for breast problems or cancer?

• Women 40 years and older should have a mammogram (breast x-ray) each year. They should do this as long as they are in good health. If you have a serious illness or health problem, talk to your caregiver about when to have mammograms. Women 40 years and older should also have a breast exam done by a caregiver each year.
  
  
• Younger women who are high risk for breast cancer should talk to their caregivers about mammograms. This includes women with family members who have had breast cancer. Women between 20 to 39 years old should have a breast exam done by a caregiver at least every three years.
  
  
• Schedule a medical exam with your caregiver close to the date of your mammogram. It is best to have your caregiver examine your breasts before the day of your mammogram. If the caregiver finds changes, these breast areas can be examined more closely during your mammogram.

Call your caregiver if:

• You find any lumps or changes in your breasts.
  
  
• You have breast pain or fluid (other than breast milk) coming from your nipples.

CARE AGREEMENT:

You have the right to help plan your health care. To help with this plan you should learn about breast self-exams. Ask caregivers questions about the breast self-exam. You can work with them to decide what is the best way to check your breasts. You always have the right to refuse treatment.

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