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Breast cancer: Self exam as a preventive measure

Recently, several scientific studies have created confusion by reporting that breast self-exams (BSE) do not reduce a woman's chances of dying of breast cancer, and implying that women no longer need to examine their breasts. However, most experts still agree that if women learn to perform BSE correctly, they could find a tumor earlier, when it is still very small. A smaller tumor improves the chances of saving a breast by avoiding a mastectomy, and may reduce the need for chemotherapy.

It is important to remember that mammography is still the gold standard for early detection of breast cancer. Many cancer organizations, including the American Cancer Society, recommend that every woman 40 or older should have a mammogram every year. Unfortunately mammography misses 10% of cancers. So, it is still important for women to have their breasts examined on a regular basis by a healthcare professional, and perform monthly breast self-exams.

The Five Steps of a Breast Self-Exam

Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.

Here's what you should look for:

  • breasts that are their usual size, shape, and color
  • breasts that are evenly shaped without visible distortion or swelling

If you see any of the following changes, bring them to your doctor's attention:

  • dimpling, puckering, or bulging of the skin
  • a nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
  • redness, soreness, rash, or swelling

Step 2: Now, raise your arms and look for the same changes.

Step 3: While you're at the mirror, gently squeeze each nipple between your finger and thumb and check for nipple discharge (this could be a milky or yellow fluid or blood).

Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few fingers of your hand, keeping the fingers flat and together.

Cover the entire breast from top to bottom, side to side—from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. Be sure to feel all the breast tissue: just beneath your skin with a soft touch and down deeper with a firmer touch. Begin examining each area with a very soft touch, and then increase pressure so that you can feel the deeper tissue, down to your ribcage.

Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in Step 4.

Last updated on 29 April 2009