When to Perform a Self Breast Exam?
- The American College of Obstetricians and Gynecologists recommends monthly self-exams for all women, including women who are pregnant, women who are breastfeeding, women who have gone through menopause and women with breast implants. The American Cancer Society considers self-exams optional. Both groups see mammograms and clinical exams as essential to a woman's health. A mammogram can show breast cancer three years earlier than it can be felt.
The American College of Obstetricians and Gynecologists advises that a woman begin self-exams in her 20s. They recommend doing an exam every month. A few days after a woman's period is a good time for the self-exam, because the breasts are less tender and swollen. Women who aren't menstruating should do the self-exams on the same day every month.
All women should have clinical exams and mammograms, even if they are doing self-exams. Women between 20 and 39 should have clinical exams every three years. Women 40 and over should have clinical exams once a year and mammograms every one or two. Women with a family history of breast cancer or symptoms need to get mammograms more often. - During a breast self exam, a woman is looking for any change in the way the breasts look and feel, and whether there are hard lumps in or near the breast or the armpit.
Self breast exams should be done while lying down. In this position, the breast tissue spreads over the chest wall and is as thin as possible. Start with the right hand behind the head. Use the finger-pads of the middle three fingers of the left hand to examine the right breast. Start at an imaginary line that runs down from the right armpit and move across the breast to the breastbone. Move the finger pads up and down in overlapping dime-shaped motions. Go down until the ribs are felt. Go up until the collarbone is felt. Use light, medium and firm pressure so that the tissue closest to the skin, the tissue closest to the chest and the tissue in between are all examined. Then reverse sides, and examine the left breast with the right hand with the left hand behind the head. It's a good idea for a woman to have a doctor check her self-exam technique.
The breasts should also be examined visually. The woman should stand in front of a mirror with her hands on her hips and look for changes in breast size and contour, as well as dimpling, redness or scaliness of the nipple or breast skin, or a sudden inversion of the nipple. Also check for discharge other than milk, and redness, warmth, swelling or pain.
The woman should also examine the armpits while sitting or standing. She should only raise her arm slightly. Raising the arm straight up tightens the tissue and makes it more difficult to examine.
Diagrams of this breast-exam technique can be found on the American Cancer Society website. See references below.
It's important to note that no breast is typical. Many women's breasts are lumpy or uneven. Breasts are effected by menstruation, childbirth, aging, losing and gaining weight, certain medications and breast implants. - Most lumps are not cancerous. Fibrocystic conditions can make the breasts lumpy. Cysts--small fluid-filled sacs--also can cause lumps.
Sometimes breast cells become abnormal. The breast can grow new cells that don't function normally. When these cells gather they form a tumor, which can be cancerous or benign.
The best tools for fighting breast cancer are early detection through clinical exams and screening mammograms. Self-exams are useful, because when a woman is familiar with the usual condition of her breasts, it's more likely she will notice a change.
