Breast Self-Examination

Definition

A breast self-examination (BSE) is an inspection by a woman of her breasts to detect breast cancer.

Purpose

A BSE is one of three tests the American Cancer Society recommends to help detect breast cancer in its earliest stages. By regularly examining her own breasts, a woman is more likely to find any changes that may have occurred. The best time to perform a BSE is about a week after a woman's period ends, when her breasts are not tender or swollen. If her periods are not regular, a BSE should be completed on the same day every month. A BSE should also be regularly completed by women who are pregnant, breastfeeding, or have breast implants. By combining a BSE with a mammography and clinical breast examination, a woman is offered the best opportunity for reducing chances of death from breast cancer through early detection. Close to 90% of breast cancers are found through a BSE. The American Cancer Society recommends that beginning at the age of 20, women complete a BSE each month by feeling for lumps or anything suspicious, as well as looking at their breasts carefully in a mirror for any changes in contour, swelling, dimpling, puckering of the skin, or changes in the nipple.

Description

To complete a monthly BSE:

• When lying down, place a pillow under the right shoulder and position the right arm behind the head. Using the finger pads of the three middle fingers on the left hand, check the entire breast area. Use small circles and follow an up-and-down pattern while pressing firmly enough to know how the breast feels from month to month. This exam should then be repeated on the left breast using the finger pads of the right hand with the pillow under the left shoulder.
• When standing before a mirror, any changes in the shape or look of the breasts should be checked. In order to look for any skin or nipple changes such as dimpling or nipple discharge, the arms should first be placed at the sides and then overhead. Hands are then placed firmly on hips to flex chest muscles, and then the body should be bent forward.
• When taking a shower, the right arm should be raised. By using soapy hands and fingers flat the right breast and outer part of the breast can be examined. The same small circles and up-and-down pattern used when lying down should be used in an upright position. Repeat on the left breast.

Preparation

Before beginning a monthly BSE, a woman's breasts should be completely exposed.

Normal results

Each woman's breasts has their own normal look and feel. By completing a BSE each month, a woman can determine what is normal for her and check for changes that may arise. A regular pattern of lumpiness in the breasts is normal.

Abnormal results

If any changes are noticed during a monthly BSE, such as a new, hard lump in the breast or underarms, a doctor should examine the area immediately. Other trouble signs that should not be ignored include:

• change in breast size or shape
• dimpling or puckering of the skin
• redness, swelling, or warmth that does not go away
• a pain in one area that does not vary with a woman's monthly cycle
• a nipple that pulls in
• discharge from the nipple that begins suddenly and appears only in one breast
• one nipple that has an itchy, sore, or scaling area

Resources

BOOKS

Altman, Roberta, and Michael J. Sarg. "Breast Self-examination." The Cancer Dictionary. Checkmark Books, 2000.

ORGANIZATIONS

American Cancer Society. 1599 Clifton Road NE, Atlanta, GA 30329. (800)ACS-2345. 〈http://www.cancer.org〉.

Komen Foundation. 5005 LBJ Freeway, Suite 250, Dallas, TX 75244. (972) 855-1600. 〈http://www.komen.org〉.

OTHER

"How to do a Breast Self-Exam." Women.com. May 5, 2001. 〈http://www.women.com〉.

BREAST SELF-EXAMINATION

The breast self-examination is an examination of the breasts, performed by a woman, ideally one time per month. The goal of the breast self-examination is for a woman to notice changes in the breast that should be brought to the attention of a physician for further evaluation. These include breast lumps, changes in the breast shape, size, or contour, or skin changes. Randomized trials have shown no decrease in breast cancer mortality among women performing monthly breast self-examination. Despite this, the American Cancer Society recommends monthly breast self-examination for women over the age of twenty.

Clifford Hudis

Arti Hurria

(see also: Breast Cancer; Breast Cancer Screening; Clinical Breast Examination )

Bibliography

Thomas, D. B.; Gao, D. L.; Self, S. G. et al. (1997). "Randomized Trial of Self Breast Exam in Shangai: Methodology and Preliminary Results." Journal of the National Cancer Institute 89:355–365.