Breast Self-Examination
Monthly Self-Exam Is a Must
Every woman, regardless of age or family history, should perform a breast self-examination once each month to detect any lumps. Even though most breast lumps are not cancerous, it is extremely important to find any lump early enough so that it can be tested for cancer cells. If cancer cells are present, early detection increases the chances of a cure since the cancer is less likely to have spread. Even if a mammogram is done each year, a small cancer could be missed. Most doctors recommend a breast self-exam one week after the first day of each menstrual cycle, when breast tissue is least sensitive and swollen. For postmenopausal women, the first day of each month is usually the easiest to remember.
It is important for every woman to routinely check her breasts for changes every month.
It is easy to get into the habit of a monthly breast self-examination by deciding a convenient time and recording it on a calendar or schedule. The illustrations on the reverse show the proper self-examination techniques. The following descriptions will help you perform breast self-examination correctly. All three procedures should be performed.
Examining Your Breasts—At the Mirror: Relax your hands at your sides, then clasp them behind your head, and finally place your hands on your hips while flexing your chest muscles. In each of these positions, look carefully for any changes in the appearance of your breasts or nipples, such as a dimple or pucker, lump or rash. Squeeze each nipple gently to check for discharge. A drop of clear or milky fluid is normal.
In the Shower: Raise your left arm over your head and imagine that your breast is divided into small strips. With your right hand, start at the center of your armpit and move across your left breast to your breastbone along the imaginary strips, pressing firmly in small circular motions using the flat part of your middle fingers. Continue to follow the imaginary lines until you have checked the entire area from your collarbone to your bra line. Repeat these steps for the right side. Wet, soapy skin makes this step easier to do in the shower.
Lying Down: First, place a pillow under your left shoulder to flatten the breast over the chest wall. Raise your left arm over your head and with your right hand using flat fingers, begin at the armpit and make small circles across the breast, pressing straight down, until you reach the breastbone. Follow imaginary lines across the entire breast as above. Repeat this technique for the right side.
Noncancerous (Benign) Lumps: Most normal breast tissue does not feel perfectly smooth. Also, breast tissue will not be exactly the same in both breasts. Breasts are made up of fibrous tissue, which is firm and supports the breast, and fatty tissue in between. The fatty tissue is soft, and the more fat there is, the softer the breast feels. Most benign lumps are fluid-filled sacs in the fibrous tissue called cysts. Other benign lumps are due to a thickening of the fibrous tissue, a condition known as mammary dysplasia. In both these conditions, the lumps are tender, especially just before menstrual flow begins. The most common solid tumor in women ages 18-35 is a fibroadenoma. This solid tumor is neither painful nor malignant. When bacteria enter the mammary gland through the nipple, an infection known as mastitis can develop, causing a painful lump in a mother who is breast-feeding. A benign lump in the breast can also be a result of an injury to the breast tissue.
Cancerous (Malignant) Lumps: A cancerous lump has usually been growing for a long time before it is discovered. Malignant lumps are usually firm and painless. The earlier it is spotted, the better are the chances for a complete cure because the cancer cells have had less time to spread (metastasize) to other parts of the body. Remember, if you detect a lump during your monthly breast self-examination, see your doctor right away. In most cases the lump is benign. But if not, you will gain valuable time in treatment and greatly increase your chances for a cure.
