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BREAST SELF-EXAMINATION

BAsic information

FINDING BREAST CANCER EARLY

• There have been many advances made in diagnosing and treating breast cancer. More and more women are surviving the disease. In many cases, breast cancers found early and treated promptly have a better chance for a cure.
• Tools to detect breast cancer include exams by a medical professional, mammography, and breast self-examination (BSE). BSE has come under some debate about how effective it is. Studies have shown that there is no difference in the number of lives saved among women who did perform a BSE and those who did not. Also BSE may increase unneeded biopsies and anxiety.
• The American Cancer Society continues to recommend that BSE be performed monthly beginning at age 20. BSE will help a woman under age 40 learn what her breasts feel like under normal conditions. If a lump or other change is discovered, she can see her health care provider about it. There is some added benefit to women over age 40 in doing a BSE. Exams by a medical professional and mammography should have the most emphasis in early detection of breast cancer.
• Several products have been approved by the Food & Drug Administration (FDA) to help women perform monthly breast self-examinations. They may help make the exams easier for some women. Ask your health care provider about their use.

WHEN TO EXAMINE YOUR BREASTS

• Follow the same procedure once a month, a few days to about a week after your period ends, when your breasts are usually not tender or swollen. Breast tissue in adult women changes throughout the month as it responds to hormone levels occurring during the menstrual cycle. Some women have normally lumpy breasts, but they can still learn the pattern of the lumps and should be able to detect new or unusual lumps.
• After menopause, check your breasts on the same day of each month. After a hysterectomy, ask your health care provider about the best time of the month.

BREAST EXAM WHILE LYING DOWN ON YOUR BACK

• To examine your right breast, put a pillow or folded towel under your right shoulder. Place your right hand under your head-this distributes breast tissue more evenly on the chest.
• Use the finger pads of the three middle fingers of your left hand. Press gently and firmly. A ridge of firm tissue in the lower curve of each breast is normal. Then move around the breast in 1) a circular pattern, 2) up and down line, or 3) in a wedge pattern. Always use the same pattern each month. Now repeat the procedure on your left breast with a pillow under your left shoulder and the left hand under your head. Notice how your breast structure feels.
• Check the area under each arm (with your elbow slightly bent). The lymph glands are in this area. They may become swollen if you are sick. If you feel a small lump that moves freely, check it daily for a few days. If it doesn't go away, call your health care provider.
• Any discharge from the nipple, clear or bloody, should be reported to your health care provider.

BREAST EXAM IN THE SHOWER

Examine your breasts during a shower (hands glide easier over wet skin). With the fingers flat, move the hand gently over every part of each breast. Use your right hand to examine the left breast, left hand for the right breast. Check for any lump, hard knot, or thickening.

BREAST EXAM IN FRONT OF A MIRROR

Inspect your breasts with arms at your sides. Next, raise your arms high overhead. Look for any changes in each breast (swelling, dimpling, or changes in the nipple).

SIGNS OF POSSIBLE PROBLEMS IN YOUR BREASTS

• Lumps, hard knots, or thickening in the breast.
• Unusual swelling, warmth, redness, or darkening that does not go away.
• Change in the size or shape of your breast.
• Dimpling or puckering of the skin.
• Itchy, scaly sore or rash on the nipple.
• Pulling in of the nipple or other parts of the breast.
• Nipple discharge that starts suddenly.
• Pain in one spot that does not vary or change with your monthly cycle.

WHAT TO DO

• It is important to see your health care provider as soon as possible if you find any suspicious changes in your breasts. Don't be frightened. Most breast lumps or changes are not cancer.
• Remember that a monthly breast exam is not a substitute for the other two critical parts of the guidelines for early breast cancer detection. The American Cancer Society recommends an annual mammogram after age 40, and an exam by a medical professional every three years for women ages 20 to 39, and annually for women over age 40. Ask your health care provider about when you should schedule mammography and a breast exam.
• To learn more: American Cancer Society, 1599 Clifton Rd., Atlanta, GA 30329, 800-ACS-2345, website: www.cancer.org; or National Cancer Institute, 800-4-CANCER, website: www.nci.nih.gov.