In 2010, breast cancer affected over 200,000 women and 2,000 men, which lead to the death of almost 41,000 women and 450 men, according to the Center for Disease Control (CDC), and the numbers are rising each year. We all know that breast cancer is a risk -- yes, even for you men out there -- but I find that very few people actually perform self-breast exams (SBE). And even those that do may not know exactly what they're feeling for: which lumps are okay and which ones should send you running to your healthcare practitioner (HCP)! So here’s a little "how to" on the best times to perform SBE, what you’re feeling for, and when you should get a further workup.
Image: Breast Cancer via ShutterstockDoes it Matter When I Do a Self-Breast Exam?
Honestly, I am happy that people are aware of the need to perform SBE, so the first step is just remembering to do them! And truly, anyone from the age of 18 on up should be performing an SBE regularly. But, it is also important to perform your SBE at the right time.
If you are post menopausal woman or a male, you can do it the same day every month. (Do it the 1st of every month just so it’s easy to remember.) If you are a woman that has her period, you will want to perform your SBE three days after your period ends. (If you are on birth control, do it when you start your new pill set.) Your breast tissue responds to your levels of hormones, and if you feel the tissue right before your period, you may feel lumps and bumps that are nothing to worry about, just normal hormonal changes. So it is crucial to do it at the same time every month and at the right time.Okay, So How Do I Do a Self-Breast Exam?
To start, you need to take off your top and bra and look at yourself (in good light) in a mirror.
- You want to look for any changes in color of the skin, puckering of the skin, any bulges/lumps, and the difference between your two breasts. They are always different, but the key is to know your baseline and what are new changes.
- Look at yourself twisting side to side. Lift your arms up and make sure your breasts raise evenly. Lean forward to make sure that your breasts hang evenly.
- Inspect your nipples for any differences and squeeze your nipples for any discharge. If you see abnormal discharge, even if it is present in one nipple and not the other, you should talk to your HCP.
Next, get into position to palpate (feel) the tissue, one breast at a time:
- Lie down with a pillow under your back to help stretch your breast/chest tissue.
- Place the arm next to the breast that you will be feeling at an angle behind your head.
- Take your other hand, and with your pointer finger, middle finger, and ring finger together, start your exam using the three different methods below.
Lastly, feel your breast tissue and be gentle but firm (keeping those three fingers together):
- Start in your armpit and go up and down (like painting a fence) not missing any tissue from your armpit to below your breast
- Then start to feel in circles. Starting on the outermost area of breast tissue, make a large circle, and then spiral in until you have covered all of the tissue.
- Finally, starting from the most outside tissue, use the "clock" method, and start feeling the tissue from 12 o’clock to the nipple, then 1 o’clock to the nipple, etc.
Once you have completed feeling all of the breast tissue, squeeze your nipples again, not so hard to feel pain, but to check for discharge or any difference between the tissues.But What Does a Breast Cancer Lump Feel Like?
It is normal to have some small "lumpiness" in your breasts. It's most noticeable before your period, and those lumps tend to not be painful and come and go (which is why it is important to know what your breasts feel like).
The type of breast lump that you are feeling for during your SBE may be moveable or fixed in place, and it can be as small as the size of a pea. It may or may not cause pain. It sounds like I’m not being very helpful, BUT the key is consistency, so if you feel a possible lump in one breast during your SBE, and it doesn’t go away the next month, or you feel concerned, you should go see your HCP. If you feel a lump, see skin puckering or a rash, have new nipple discharge, or an inverted nipple, you should go to your HCP immediately.
The bottom line is that you need to know your body, how it feels, and what is new. It can be hard to learn your "normal" when you first start performing SBE, so ask your HCP to feel along with you when you go for your annual visit, so they can help you to understand more what you are feeling.
And, you can even make this less clinical and have your partner help you with your monthly SBE, so they can help you to notice any changes! Remember: anything that makes you feel concerned or seems not right to you, you should call your HCP and be seen for a further work up because prevention and early detection are crucial in beating cancer.
Yours in Good Health
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