Breast Self-Exam: Why and How to do it.

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Why should I do a breast self-exam?

Regular breast self-exam can help you know how your breasts normally feel and look, so you can notice any changes. When you find a change, you should see your health care provider. Most breast changes or lumps are not cancerous, but only a health care provider can tell you for sure. When breast cancer is found early, you have more treatment choices and a better chance of recovery. So, it is important to find breast cancer as early as possible.

Breast self-exam should not take the place of getting regular mammograms. Right now, mammograms are the best way to find breast cancer early and to improve your chances for survival.

What am I looking for when I do a breast self-exam?
You are looking for a lump or change that stands out as different from the rest of your breast tissue. If you find a lump or other change in your breast, either during breast self-exam or by chance, you should examine the other breast. If both breasts feel the same, the lumpiness is probably normal. As you get to know your breasts better by doing breast self-exams, you should be able to tell the difference between your normal lumpiness and what may be a change.

Besides a lump or swelling, other changes in your breast might be:

  • Skin irritation or dimpling
  • Nipple pain or retraction (turning inward)
  • Redness or scaliness of the nipple or breast skin
  • A discharge other than breast milk

If you see any of these changes, you should see your health care provider right away.

Is there a right way to examine my breasts?
Yes. There are several proper ways to examine your breasts. Ask your health care provider to teach you how to do a breast self-exam to make sure you are doing it correctly and thoroughly. The American Cancer Society also provides a document that shows the right way to examine your breasts. Remember that you should discuss any new lump or change with your health care provider.

How often should I do a self-exam?
A breast self-exam is recommended every month a few days after your period ends. During this time, your breasts are less tender or swollen. It is important to do your breast self-exam at the same time every month.

For more information...
You can find out more about breast cancer in women by contacting the National Women's Health Information Center (800-994-9662) or the following organizations:

National Cancer Institute's Cancer Information Service
Phone: (800) 422-6237
http://www.nci.nih.gov/

American Cancer Society
Phone: (202) 4-CANCER
http://www.cancer.org/

National Breast and Cervical Cancer Early Detection Program
Phone number: 1-888-842-6355 (select option 7),
http://www.cdc.gov/cancer/nbccedp/index.htm

The National Center for Human Genome Research, NIH
Phone: (301) 402-0911
http://www.nhgri.nih.gov/

National "Get A Mammogram: Do It For Yourself, Do It For Your Family" Campaign
(brochures in English, Chinese, Tagalog, and Vietnamese)
National Cancer Institute (NCI)

Phone Number(s): 1- 800- 4-CANCER / 1-800-422-6237
http://breasthealth.cancer.gov

This information was abstracted from fact sheets developed by the National Cancer Institute. All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the sources is appreciated.

The most effective way to fight breast cancer is to detect it early. Although the most effective tools to detect breast cancer are mammography and clinical breast exam by your health professional, the breast self-exam may also be an effective tool to find cancer early. In fact, women who perform regular breast self-exam find 90% of all breast masses.

What Is a Breast Self-Exam and Why Should I Do It?
The breast self-exam is a way that you can check your breasts for changes (such lumps or thickenings) that may signal breast cancer. When breast cancer is detected in its early stages, your chances for surviving the disease are greatly improved. While 80% of all breast lumps are not cancerous, you can help catch potentially serious changes in the breast early by regularly performing a self-exam.

When Should I Perform a Breast Self-Exam?
You should examine your breasts once a month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month, such as the first day of the month or a day easy for you to remember, such as your birth date. With each exam, you will become familiar with the contours and feel of your breasts, and will be more alert to changes.

How Do I Perform A Breast Self-Exam?
To perform a breast self-exam, follow the steps described below.

In the Mirror:

  1. Stand undressed from the waist up in front of a large mirror in a well-lit room. Look at your breasts. Don't be alarmed if they do not look equal in size or shape. Most women's breasts aren't. With your arms relaxed by your sides, look for any changes size, shape or texture, or any changes to the skin of the breasts. Look for any skin puckering, dimpling, sores or discoloration. Inspect your nipples and look for any sores, peeling or change in the direction of the nipples.
  2. Next, place your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. Turn from side to side so you can inspect the outer part of your breasts.
  3. 3. Then bend forward toward the mirror. Roll your shoulders and elbows forward to tighten your chest muscles. Your breasts will fall forward. Look for any changes in the shape or contour of your breasts.
  4. Now, clasp your hands behind your head and press your hands forward. Again, turn from side to side to inspect your breasts' outer portions. Remember to inspect the border underneath your breasts. You may need to lift your breasts with your hand to see this area.
  5. Check your nipples for discharge (fluid). Place your thumb and forefinger on the tissue surrounding the nipple and pull outward toward the end of the nipple. Look for any discharge. Repeat on your other breast.

In the Shower:

  1. Now, it's time to feel for changes in the breast. It is helpful to have your hands slippery with soap and water. Check for any lumps or thickening in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat on the other side.
  2. Check both sides for lumps or thickenings above and below your collarbone.
  3. With hands soapy, support the breast with one hand while using the other hand to feel the tissue. Use the flat part of your fingers to press gently into the breast. Follow an up-and-down pattern along the breast, moving from bra line to collarbone. Continue the pattern until you have covered the entire breast. Repeat on the other side.

Lying Down:

  1. Next, lie down and place a small pillow or folded towel under your right shoulder. Put your right hand behind your head. Place your left hand on the upper portion of your right breast with fingers together and flat. Body lotion may help to make this part of the exam easier.
  2. Think of your breast as a face on a clock. Start at 12 o'clock and move toward 1 o'clock in small circular motions. Continue around the entire circle until you reach 12 o'clock again. Keep your fingers flat and in constant contact with your breast. When the circle is complete, move in one inch toward the nipple and complete another circle around the clock. Continue in this pattern until you've felt the entire breast. Make sure to feel the upper outer areas that extend into your armpit.
  3. Place your fingers flat and directly on top of your nipple. Feel beneath the nipple for any changes. Gently press your nipple inward. It should move easily.

Repeat steps 9, 10 and 11 on your other breast.

What Should I Do If I Find A Lump?
See healthcare provider if you discover any new breast changes, changes that persist after your menstrual cycle, or other changes that you are concerned about. Conditions that should be checked by a doctor include:

  • An area that is distinctly different from any other area on either breast
  • Lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle
  • A change in the size, shape or contour of the breast
  • A mass or lump, which may feel as small as a pea
  • A marble-like area under the skin
  • A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly or inflamed)
  • Bloody or clear fluid discharge from the nipples
  • Redness of the skin on the breast or nipple
 

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