Breast Self-Examination

Self Breast Exam (SBE)

How It Is Done

It takes practise to perform a thorough breast self-examination. Ask your health professional for tips that can help you perform a breast self-examination correctly.

The best time to examine your breasts is usually one week after your menstrual period begins, when your breast tissue is least likely to be swollen or tender. 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. Women who are pregnant or breast-feeding can continue to examine their breasts every month. Breast-feeding mothers can examine their breasts after a feeding or after using a breast pump so that the breasts have as little milk as possible, making the examination easier and more comfortable.

To do a breast self-examination, remove all your clothes above the waist and lie down. The examination is done while lying down so your breast tissue spreads evenly over your chest wall and is as thin as possible, making it much easier to feel all your breast tissue.

Use the pads of the three middle fingers of your left hand—not your fingertips—to check your right breast. Move your fingers slowly in small coin-sized circles.

Use three different levels of pressure to feel of all 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. A firm ridge in the lower curve of each breast is normal. Use each pressure level to feel your breast tissue before moving on to the next spot.

Check your entire breast using a lengthwise strip pattern. Feel all of the tissue from the collarbone to the bra line and from the armpit to the breastbone. Start in the armpit and work down to the bottom of the bra line. Move one finger-width toward the middle and work up to the collarbone. Repeat until you have covered the entire breast. Repeat this procedure for your left breast. See an illustration of BSE using a lengthwise strip pattern.

You also can examine your breasts using a spiral pattern. Again, use three different levels of pressure to examine all your breast tissue. Avoid lifting your fingers away from the skin as you feel for lumps, unusual thicknesses, or changes of any kind. See an illustration of BSE using a spiral pattern.

Most breast tissue has some lumps or thick tissue. 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. Pay attention to any lump that feels much harder than the rest of your breast.

If you find anything that concerns you, schedule a visit with your health professional. The important thing is to learn what is normal for you and to report any changes to your health professional. Remember that most changes you find are not breast cancer but should be checked. These 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.

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 increase your chances of detecting a change. 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 (in the strip pattern described above), feeling carefully for any lumps or thickened areas.

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Author:	Jan Nissl, RN, BS	Last Updated: April 11, 2007
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology Anne C. Poinier, MD - Internal Medicine
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