Breast Self Exam

What is a breast self-exam?

According to the American Cancer Society’s Breast Cancer Screening Guidelines: Update 2003, a breast self-exam is an important part of general breast health, as opposed to cancer detection. It is important to understand and discuss with your provider about the limitations and benefits of BSE and know that it is acceptable to choose not to do BSE or to do it occasionally. Women should be aware of what their breasts normally feel like and look like, and to be attuned to any change. It is important to report any change to your provider promptly.

Why should I do a breast self-exam?

Breast cancer is the most common type of cancer that afflicts American women and the second leading cause of death from cancer for women (after lung cancer). About 1 in every 11 women eventually develops breast cancer. However, when breast cancer is found early and treated immediately, the chances for cure are much improved. For this reason, women should be sure to perform monthly self-exams.

When is the best time to examine my breasts?

Examine your breasts a week after the end of your period, when your breasts usually aren't tender or swollen.

How do I do a breast self-exam?

To perform a breast self-exam, follow the steps described below.

In the mirror:

1. Stand undressed from the waist up in front of a large mirror in a well-lit room. Look at your breasts. With your arms relaxed by your sides, look for any changes in size, shape or position, or any changes to the skin of the breasts. Look for any skin puckering, dimpling, sores or discoloration. Inspect your nipples and look for any sores, peeling or change in the direction of the nipples.
2. Place your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. Turn from side to side so you can inspect the outer part of your breasts.
3. Bend forward toward the mirror. Roll your shoulders and elbows forward to tighten your chest muscles. Your breasts will fall forward. Look for any changes in the shape or contour of your breasts.
4. Clasp your hands behind your head and press your hands forward. Again, turn from side to side to inspect your breasts' outer portions. Remember to inspect the border underneath your breasts. You may need to lift your breasts with your hand to see this area.
5. Repeat steps 1-4 on your other breast.

1. To feel for changes in the breast, it's helpful to have your hands slippery with soap and water.
   
2. Check for any lumps or thickening in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat on the other side.
3. Check both sides for lumps or thickenings above and below your collarbone.
4. Raise one arm behind your head to spread out the breast tissue. Use the flat part of your fingers from the other hand to press gently into the breast. Follow an up-and-down pattern along the breast, moving from bra line to collarbone. Continue the pattern until you have covered the entire breast. Repeat on the other side.

1. Lie down and place a small pillow or folded towel under your right shoulder. Put your right hand behind your head. Place your left hand on the upper portion of your right breast with fingers together and flat. Body lotion may help to make this part of the exam easier.
2. Think of your breast as a face on a clock. Start at 12 o'clock and move toward 1 o'clock in small circular motions. Continue around the entire circle until you reach 12 o'clock again. Keep your fingers flat and in constant contact with your breast. When the circle is complete, move in one inch toward the nipple and complete another circle around the clock. Continue in this pattern until you've felt the entire breast. Make sure to feel the upper outer areas that extend into your armpit.
3. Place your fingers flat and directly on top of your nipple. Feel beneath the nipple for any changes. Gently press your nipple inward. It should move easily.
4. Repeat steps 1-3 on your other breast.

Want to see a diagram of a breast self exam?
Breastcancer.org has illustrations of five key steps of a breast self exam.

Want to see a multimedia demonstration of a breast self exam?
The Susan G. Komen Breast Cancer Foundation has an online BSE tool, which provides step-by-step instruction using animation and voice-over audio clips in English or Spanish.

When should I call the provider?

If you find a lump, dimple, or discharge during your breast self-exam, see your provider as soon as possible. Don't be frightened. Most lumps are not cancerous, but only a health care provider can make the diagnosis.