Topic Overview

What is a breast self-exam?

A breast
self-exam involves checking your breasts for
lumps or changes. Many breast problems are first discovered by women
themselves, often by accident. Breast lumps can be noncancerous (benign) or
cancerous (malignant).

Breast cancer can occur at any age, though it is most
common in women older than 50. Lumps or changes also may be signs of other breast conditions, such as
mastitis or a
fibroadenoma.

Medical experts don’t recommend regular breast self-examinations.footnote 1 Studies show that self-exams don’t save women’s lives and that they can lead to unneeded tests, such as biopsies. But some experts believe that women should know how their breasts look and feel (breast self-awareness) so any breast changes can be reported to a doctor.footnote 2

How do you perform a breast self-exam?

The best time to
examine your breasts is usually 1 week after your menstrual period starts,
when your breasts are least likely to be swollen or tender. Examining your breasts at other times in your menstrual cycle may make it hard to compare
results of one exam with another.

If your
menstrual cycle is irregular, or if you have stopped
menstruating due to
menopause or the removal of your uterus (hysterectomy), do your examination on a day of the
month that’s easy to remember.

A breast self-exam normally doesn’t cause any discomfort. If your breasts are tender because your menstrual
period is about to begin, you may feel slight discomfort when you press on
your breasts.

To do a breast self-exam:

  1. Remove all your
    clothes above the waist. Lie down. Lying down spreads your breasts evenly over your chest and makes it easier to feel lumps or changes. Check your entire breast by feeling all of
    the tissue from the collarbone to the bottom of the bra line and from the armpit to the
    breastbone.
  2. Use the pads of your three middle fingers-not your fingertips. Use the middle fingers of your left hand to check your right breast. Use the middle fingers of your right hand to check your left breast. You can use
    an up-and-down pattern or a spiral pattern. Move your fingers slowly in small
    coin-sized circles.
  3. Use three different levels of pressure to
    feel all of your breast tissue. Light pressure is needed to feel the tissue
    close to the skin surface. Medium pressure is used to feel a little deeper, and
    firm pressure is used to feel your tissue close to your breastbone and ribs. Avoid lifting your fingers away from the
    skin as you feel for lumps, unusual thicknesses, or changes of any kind.

When in doubt about a particular lump, check your other
breast. If you find the same kind of lump in the same area on the other breast,
both breasts are probably normal.

In addition to examining your breasts while lying down, you
may also check them while in the shower. Soapy fingers slide easily across the
breast and may make it easier to feel changes. While standing in a
shower, place one arm over your head and lightly soap your breast on that side.
Then, using the flat surface of your fingers-not the fingertips-gently move
your hand over your breast, feeling
carefully for any lumps or thickened areas.

It takes practice to perform a
breast self-exam. Having
fibrocystic lumps also may make a breast self-exam difficult, because
lumps occur throughout the breast. Ask your doctor for tips that can help
you do it correctly.

When should you see a doctor?

After you know what your breasts normally look and feel like, any changes should be checked by a doctor. Changes may include:

  • Any new lump. It may or may not be painful to
    touch.
  • Unusual thick areas.
  • Sticky or bloody discharge
    from your nipples.
  • Any changes in the skin of your breasts or
    nipples, such as puckering or dimpling.
  • An unusual increase in the
    size of one breast.
  • One breast unusually lower than the
    other.

Remember that most breast
problems or changes are caused by something other than cancer.

Even if you choose to do
breast self-exams, talk to your doctor about having regular
mammograms as well as regular breast checkups at your doctor’s office or the mammogram center.

What are the risks of doing breast self-exams?

The risk of doing breast self-exams is that
you may find a breast change that makes you anxious and may lead to unnecessary tests (such as a
biopsy).

Also, a change you notice on a breast self-exam may be a kind of cancer that would never cause symptoms or threaten your life. But because no one can tell what kinds of cancer will cause problems, all cancers are treated. This means that you may end up having treatments (such as surgery, radiation, and chemotherapy) that you don’t need. These treatments can cause harmful side effects.

Because of these risks, many experts don’t recommend breast self-exams. Others consider it an option for women. Talk with your doctor about breast
self-exams.

Other Places To Get Help

Organizations

Breastcancer.org (U.S.)
www.breastcancer.org

National Cancer Institute (U.S.)
www.cancer.gov (or https://livehelp.cancer.gov/app/chat/chat_launch for live help online)

Related Information

References

Citations

  1. U.S. Preventive Services Task Force (2009). Screening for breast cancer. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm.
  2. American College of Obstetricians and Gynecologists (2011). Breast cancer screening. ACOG Practice Bulletin No. 122. Obstetrics and Gynecology, 118: 372-382.

Other Works Consulted

  • American Cancer Society (2009). Prevention and Early Detection: American Cancer Society Guidelines for the Early Detection of Cancer. Atlanta: American Cancer Society. Available online: http://www.cancer.org/docroot/PED/content/ped_2_3X_ACS_Cancer_Detection_Guidelines_36.asp.
  • U.S. Preventive Services Task Force (2009). Screening for breast cancer. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm.

Credits

ByHealthwise Staff
Primary Medical Reviewer Kathleen Romito, MD – Family Medicine
Martin J. Gabica, MD – Family Medicine
E. Gregory Thompson, MD – Internal Medicine
Specialist Medical Reviewer Wendy Y. Chen, MD, MPH, MD, MPH – Medical Oncology, Hematology

Current as ofMay 3, 2017