BREAST SELF - EXAMINATION

Introduction to Breast Self-Exam

Regularly examining her own breasts allows a woman to become familiar

with how her breasts normally look and feel and can help her more readily detect
any changes that may occur. Many women naturally have some lumpiness and
asymmetry (differences between the right and left breast). The key to the breast
self-exam is to learn how to find changes in the breasts that persist over time.

What is BREAST SELF - EXAMINATION?

Breast self-examination (BSE) is a method for finding abnormalities of the

breast. The method involves looking at and feeling each breast for possible
distortions or swelling.

Self- Examination involves both inspection and palpation procedures and should
be conducted once a month.

Why it is done?

A breast self-examination is done to detect breast problems, such as a

lump or change in appearance, that may indicate breast cancer or other breast
conditions that may require medical attention (such as mastitis or a fibro
adenoma).

When is the best time to examine?

The best time to examine your breasts is usually one week after your
menstrual period begins, when your breast tissue is least likely to be swollen or
tender. If you’re menstrual cycle is irregular, or if you have stopped menstruating
due to menopause or the removal of your uterus (hysterectomy), do your
examination on a day of the month that's easy to remember. Women who are
pregnant or breast-feeding can continue to examine their breasts every month.
Breast-feeding mothers can examine their breasts after a feeding or after using a
breast pump so that the breasts have as little milk as possible, making the
examination easier and more comfortable. For premenopausal women, BSE is
best done at the same stage of their period every month to minimize changes due
to the menstrual cycle. Older, menopausal women should do BSE once a month,
perhaps on the first or last day of every month.

How to perform BSE?

The steps involved in self exam are:

• Stand in front of a mirror with top exposed.

• Place hands on hips.
• Look for signs of dimpling, swelling, soreness, or redness in all parts of
your breasts in the mirror.
• Repeat with arms raised above your head.
• While still standing, palpate your breasts with your fingers, feeling for
lumps. Try to use a larger area of your fingers rather than prodding. Feel
both for the area just beneath the skin and for the tissue deeper within.
• Go over the entire breast while examining. One method is to divide the
breast into quadrants and palpate each quadrant carefully. Also examine
the "axillary tail" of each breast that extends toward the axilla (armpit).
• Repeat palpation while lying down.
• Check the nipples and the area just beneath them. Gently squeeze each
nipple to check for any discharge.

Palpation: lying position

- Place a pillow under your right shoulder and place the right hand behind your
head. This position distributes breast tissue more evenly on the chest.

- Use the finger pads (tips) of the three middle fingers on your left hand to feel
for lumps.

- Press the breast tissue against the chest wall firmly enough to know how your
breast feels. A ridge of firm tissue in the lower curve of each breast is normal.

- Use small circular motions systematically all the way around the breast as many
times as necessary until the entire breast is covered.

- Bring your arm down to your side and feel under your armpit where breast
tissue is also located.

- Repeat the exam on your left breast, using the finger pads of your right hand.

Optional: Do the upright BSE in the shower. Soapy hands glide more easily over
wet Skin.
The Seven P's method

A similar method of self-examination is known as the Seven P's of BSE:

1. Position: Inspect breasts visually and palpate in the mirror with arms at
various positions. Then perform the examination lying down, first with a
pillow under one shoulder, then with a pillow under the other shoulder,
and finally lying flat.
2. Perimeter: Examine the entire breast, including the nipple, the axillary
tail that extends into the armpit, and nearby lymph nodes.
3. Palpation: Palpate with the pads of the fingers, without lifting the fingers
as they move across the breast.
4. Pressure: First palpate with light pressure, then palpate with moderate
pressure, and finally palpate with firm pressure.
5. Pattern: There are several examination patterns, and each woman should
use the one which is most comfortable for her. The vertical strip pattern
involves moving the fingers up and down over the breast. The pie-wedge
pattern starts at the nipple and moves outward. The circular pattern
involves moving the fingers in concentric circles from the nipple outward.
Don't forget to palpate into the axilla.
6. Practice: Practice the breast self-exam and become familiar with the feel
of the breast tissue, so you can recognize changes. A health care
practitioner can provide feedback on your method.
7. Plan: Know what to do if you suspect a change in your breast tissue. Know
your family history of breast cancer. Have mammography done as often as
your health care provider recommends.