How to do a Self Breast Examination

Monthly Breast Self Examination (BSE) can be a life saving practice when it is done skillfully. You may have tried BSE and felt unsure of what you were doing or what you were supposed to be feeling for, or how much breast area you should cover. The instruction below adapted from MammaCare program, can help you learn what to feel for and how to do a thorough examination of your breast.

FIRST: DEFINE THE BREAST PERIMETER OR BOUNDERIES

  1. Middle notch of the collar bone to the center of the arm pit ( Axilla)
  2. The middle of the axilla to just below the bra line
  3. Follow the bra line across until reaching the middle of the sternum (Breast bone)
  4. Follow the sternum up until you reach the collar bone notch

SECOND: POSITION

The goal with regard to position is to always have the breast tissue spread out as thinly as possible.
Rotate the side of the body of the breast being examined to a 45 degree angle. Use a pillow to support your back. The nipple of the breast being examined should be facing the ceiling. Raise that same arm and rest on the forehead with the palm up. This position with the palm on the forehead, relaxes the pectoralis (chest) muscle for easier palpation. Remain in this “side up” position until you have palpated all of the lateral tissue to the nipple. At this point lie flat and resume the remainder of the examination.

THIRD: PALPATION

Using the pads of your middle 3 fingers is very important when palpating the breast tissue.
The pads are very sensitive and can detect very subtle changes in the structure of the breast.

DO NOT use your finger tips as you might miss a spot.

Use three levels of consecutive pressure making small, dime sized circles:

  1. Pressing straight down you use a very light pressure, barely moving the top layer of skin
  2. The second pressure is a medium pressure, going halfway down through the thickness of the breast tissue
  3. The third pressure is a deep pressure that could go to the back of the breast tissue

FOURTH: PATTERN

Research has shown that a Parallel Vertical Strip Method ( up and down) is more accurate when used as a search pattern when compared to the circular method.
The Parallel Vertical Strip method begins under the arm in the center of the armpit.

VISUAL EXAM:

After palpating the tissue of your breasts, you should do a visual exam. look in the mirror with your arms at your side and note the followings:

SHAPE AND SIZE CHANGE OF BREASTS,compare one to the other. One breast may be normally have a different shape than the other and that is normal. What you are looking for is a sudden change in shape.

Inspect for Rash. The most common rash is Candida, a yeast infection most commonly seen in older women with pendulous breasts. This is found in the folds under the breasts. This type of rash we do not worry about, although it can be uncomfortable, especially in the Arizona heat. What we are looking for is a new unexplained rash which needs to be investigated by your doctor.

Look for discoloration, redness, swelling, and thickened skin. Note any new nipple inversion or nipple discharge. If present, report to your physician.

WHAT IS THE OPTIMAL TIME TO EXAMINE YOUR BREAST TISSUE?

Preferably at a time when the tissue is the least filled with fluid. In the menstruating women this is usually approximately day 6-9 counting from the 1sth day of menstruation.

Menopausal women can just select the same date each month.

Breast feeding moms should examine their breasts when all of the milk has recently been expressed.

Mastectomy and lumpectomy patients need to be very vigilant about examining the surgical site ( incision area). Also they need to pay close attention to lymph node enlargement above and below the clavicle ( or collar bone).

The MammaCare method described in this article was developed by the University of Florida and founded by the National Cancer Institute.

To discover your path to wellness and schedule a health assessment, contact us today.