How to Perform your Breast Self-Exam
During Breast Self-Exam you are looking for changes on your breasts – a lump or change that stands out as different from the rest of your breast tissue. If you find any changes or a lump in your breast (during Breast Self-Exam or by chance) – you should examine the other breast. If both breasts feel the same, the lumpiness is probably normal. As you get to know your breasts better by doing Breast Self-Exam, you should be able to tell the difference between your normal lumpiness and what may be a change.
Besides a lump or swelling, some other changes could be discovered in your breasts:
- skin irritation and/or skin dimpling,
- nipple pain and/or retraction (turning inward),
- redness and/or scaliness of the nipple or breast skin,
- unusual discharge from breasts (other than breast milk).
All unusual things discovered during Breast Self-Exam should be immediately reported to your doctor.
To perform a breast self-exam, follow the steps described below.
Breast Self-Exam in the mirror:
Stand undressed from the waist up in front of a large mirror in a well-lit room. Look at your breasts. Don’t be alarmed if they do not look equal in size or shape. Most women’s breasts aren’t. 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.
Next, 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.
Then 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.
Now, 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.
Check your nipples for discharge (fluid). Place your thumb and forefinger on the tissue surrounding the nipple and pull outward toward the end of the nipple. Look for any discharge. Repeat on your other breast.
Breast Self-Exam in the shower
Now, it’s time to feel for changes in the breast. It is helpful to have your hands slippery with soap and water. 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.
Check both sides for lumps or thickenings above and below your collarbone.
With hands soapy, 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.
Breast Self-Exam while lying down
Next, 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.
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.
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.
Before starting your Breast Self-Exam, pay special attention to your menstrual cycle (regularity), menstruation (menstrual flow), hormonal status (hyperprolactinemia, PCOS, amenorrhea, PMS, menopause) and contraception used (pills, emergency contraception).
During your Breast Self-Exam with your right hand, keeping the fingers flat and together, gently feel your left breast without pressing too hard. During Breast Self-Exam the following 3 methodologies should be used: Lines, Wedge and Circle.
Lines. Begin in the underarm area. Slowly move your fingers down until they are below your breast. Move your fingers closer toward your nipple and go slowly back up, using the same motion. Use this up-and-down pattern all the way across your breast.
Wedge. Begin at the outside edge of your breast. Slowly work your way in toward the nipple, doing one wedge-shaped section at a time. Do this until the entire breast area has been examined.
Circle. Begin at the top of your breast and move your fingers slowly around the outside in a large circle. When you return to the top, move your hand a little closer to the nipple and make a smaller circle. Do this in smaller and smaller circles until you have examined all of the breast tissue