While most of my patients have heard they should perform a self-breast exam (SBE), many say they have never heard all the tips I’d like to share with you. The key is to remember: “When, Look, Feel and Write!”
Tip #1: Do your breast exam at the same time each month
You should perform a SBE only once a month. Why? It’s like watching children grow up on a daily basis versus seeing a picture of them once a year; you are more likely to notice their changes over the time interval between pictures. Perform SBE the week after each period. For postmenopausal women, pick a day each month and stick to it.
Tip #2: Stand in the mirror and examine your breasts
Stand in front of a mirror and note the size and shape of your breasts. It’s normal for one breast to be larger or smaller than the other. However, do note a change over time as well as the position and size of your nipples and areolas (the darker pigmented skin around the nipple).
Next, lift your arms above your head, put your hands on your hips and tighten your pectoralis muscles (the ones between your breasts and your ribs) by shrugging your shoulders forward. Note any dimples, skin puckering or visible lumps during these maneuvers. Cancers can tug at the skin, nipples, and muscles. If you notice anything different or asymmetric (only on one side but not the other), see your doctor.
Tip #3: Check for changes or lumps in your breasts
Now, lie on your back and lift one arm above your head. Lying down flattens and thins out your breast tissue, allowing for easier examination.
Using your other hand, reach across your chest and use the fat pads of your index and middle fingers (not the tips, but the part of the finger you use to type on a keyboard) to gently press your breast tissue against your rib cage. Don’t pinch the tissue between your finger tips. Just press down onto your ribs. There may be some mild discomfort in areas, but you don’t need to push so hard that it hurts.
Now, gently slide your fingers in circles, working your way outward from your nipple, or use the clock (12 o’clock, 1 o’clock, etc) method to cover your entire breast tissue from the nipples outward. Cover the entire area up to your collarbone, across to your breastbone, and then laterally up into your armpit. Many women will feel thickening at the bottom part of their breasts (where an underwire would sit on a bra), which is frequently normal. However, if you’re not sure, check with your doctor.
This should take about 10 minutes for each breast – which would make it hard to miss a particular area. You could even use a timer. Also, note any nipple discharge that you have never seen before. This is usually normal, but if it is something new, talk to your doctor.
Tip #4: Track your results
My patients often tell me they have stopped doing self exams because their breasts have always felt lumpy. Here’s the solution: write down what you feel. I advise patients to get a small notepad and keep it in their bathroom cupboard. Each month, they can keep a written record of their SBE.
You can use your own words to describe what you feel, but a good method is to say something, for example, like “a quarter-inch thickening in the right breast at 3 o’clock, 2 inches from the nipple – mobile and a little tender.” That way, the next month you can feel the same area and note whether it has changed or not.
Most importantly, if you do notice a change or are just not sure, call or see your doctor. This is certainly one area of your health where it is best to be safe and seek an early professional opinion.