Breast exam

Breast exams allow you  a greater awareness of the condition of your breasts. It may help identify potential breast problems. Breast exam is a self  inspection of your beasts. During a breast exam, you use your eyes and hands to observe the appearance and feel of your breasts.

Breast exams, once thought essential for early breast cancer detection, are now considered optional. While other breast cancer screening tests have been proved to save lives, there’s no evidence that breast exams can do this. What’s now stressed is breast awareness — being familiar with the normal consistency of your breasts and the underlying tissue, as well as inspecting your breasts for new changes.

To prepare for your breast exam you can:

  • Choose the time during your menstrual cycle when your breasts are the least tender. Your hormone levels fluctuate each month during your menstrual cycle, which causes changes in breast tissue. Swelling begins to decrease when your period starts. That’s why the best time to perform a self-exam is a few days after your period ends.
  • If you don’t menstruate, pick a certain day of the month. If you don’t get your period and would like to do breast self-exams, you could choose a certain day of the month on which to do the exam. But it’s OK if you choose not to perform exams every single month.
  • Keep a notebook handy. Use a notebook to record what you notice in your breasts. Some women may find it helpful to draw a map of their breasts after breast exams. For example, you could note that the upper portion of your left breast seems slightly thicker than the lower half. If the area of thickness becomes more prominent on subsequent exams, your drawings could help you see the change. Or you might note that the upper outer quadrant of your right breast is highly sensitive just before your period begins but improves after it starts.

    If you’ve recorded that sensitivity every month, you and your doctor might determine that the change corresponds with hormonal fluctuations and is nothing to be concerned about.

Begin with a visual examination of your breasts
Sit or stand shirtless and braless in front of a mirror with your arms at your sides. To inspect your breasts visually, do the following:

  • Face forward and look for puckering, dimpling or changes in size, shape or symmetry.
  • Check to see if your nipples are turned in (inverted).
  • Inspect your breasts with your hands pressed down on your hips.
  • Inspect your breasts with your arms raised overhead and the palms of your hands pressed together.
  • Lift your breasts to see if ridges along the bottom are symmetrical.

If you have a vision impairment that makes it difficult for you to visually inspect your breasts, ask a close friend or a family member to help you.

Next, use your hands to examine your breasts
Common ways to perform the manual part of the breast exam include:

  • Lying down. Choose a bed or other flat surface to lie on. When lying down, breast tissue spreads out, making it thinner and easier to feel.
  • In the shower. Lather your fingers and breasts with soap to help your fingers glide more smoothly over your skin.

When examining your breasts, some general tips to keep in mind include:

  • Use the pads of your fingers. Use the pads, not the very tips, of your three middle fingers for the exam. If you have difficulty feeling with your finger pads, use another part of your hand that is more sensitive, such as your palm or the backs of your fingers.
  • Apply enough pressure. Use enough pressure so that you can feel through the tissue but not so much that you cause discomfort or press into your ribs. The goal is to feel different depths of the breast.
  • Take your time. Don’t rush. It may take several minutes to carefully examine your breasts.

Use a methodical technique to ensure you examine your entire breast:

  • Visualize your breast as a circle divided into wedges, like pieces of a pie or the numbers on a clock.
  • Place your left hand behind your head and examine your left breast with your right hand.
  • Place your right hand at the very top of your breast near the collarbone.
  • Press the pads of your three middle fingers firmly on your breast and slide down toward the nipple. If it causes discomfort, lighten the pressure slightly.
  • Examine the breast tissue in the entire wedge, moving your fingers from the outside of the breast toward the nipple.
  • Move your fingers clockwise to the next wedge in the circle.
  • Continue examining your breast in this manner until you’ve completely examined your breast and underarm.
  • Place your right hand behind your head and repeat the examination on your right breast using your left hand.
  • Examine your upper chest area, above your breasts.
  • Examine your armpits while sitting or standing with your arm partially raised above your head.
  • Examine your nipples and look for discharge. Do this by gently lifting the region (areola) around the nipple with your fingers positioned at 12 o’clock and 6 o’clock and again with your fingers at 3 o’clock and 9 o’clock.

If you have a disability that makes it difficult to examine your breasts using this technique — for instance, you have use of only one hand or you have trouble steadying your hands — you likely can still conduct a breast self-exam.

Doing breast exams helps you learn the normal feel and appearance of your breasts. That makes it easier to notice subtle changes, should they occur.

For example, you feel a noticeable area of thickening in the upper area of your breast, next to your arm. If you’ve become familiar with how your breasts look and feel, you know your breast usually feels completely smooth in that area. Without a tactile memory from having done frequent breast exams, though, you might not notice this difference. Detecting such a change should prompt you to see your doctor.

Finding a breast lump when it’s small increases the chance for a cure, if the lump is determined to be cancer. A smaller cancer may mean you have better surgical and other treatment options, compared with a cancer that is larger.