Rhode Island Hospital
Providence, RI 02903
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The Miriam Hospital
164 Summit Avenue
Providence, RI 02906
The most important function that a breast self-exam serves is to allow you to become more familiar with your breasts and aware of their normal look and feel. By knowing the everyday condition of your breasts, it's easier to notice changes.
A breast self-exam is not an adequate screening tool on its own for breast cancer, but supports clinical breast exams (performed by your doctor) and mammography. When you combine all three methods, your chances increase of finding breast cancer in an early, treatable stage.
A breast self-exam is an inspection of your breasts that you perform. Proper self-exams include visual observation of the appearance of your breast, as well as how it feels. You should examine your breasts once a month.
Preparation for a breast self-exam is very easy:
Choose a time when your breasts are least tender. Usually this is a few days after the end of your menstrual cycle, as any breast swelling that accompanies your cycle should be gone.
Pick a certain day of the month to perform the self-exam. This is especially helpful for women who no longer menstruate.
Record what you notice in your breasts. Try drawing a simple diagram of your breast and divide it into quadrants. This makes it easy to record changes and to compare from month to month. You should record the appearance of your breasts as well as their sensitivity.
Begin with a visual assessment of your breasts:
Stand undressed from the waist up in front of a mirror with your arms by your sides.
Take note of the size, shape and color of your breasts.
Record any dimpling or puckering of the skin, as well as redness, soreness and swelling.
Use different positions to check the appearance of your breasts. For example, note how they look when you lean forward, when your chest muscles are tightened, when your hands are clasped above your head, and from both sides.
Inspect each breast separately with one arm raised.
Raise your right arm over your head to observe your right breast, and then raise your left arm over your head to observe your left breast.
Lift your breasts to check if the ridges along the bottom are symmetrical.
Continue your breast self-exam with a physical assessment of your breasts. Choose the body position and physical technique that is most comfortable for you.
Choose a bed or other flat surface. When you lie down, your breast tissue will spread out, making it easier to feel.
Place a pillow under your left shoulder.
Put your left hand behind your head.
Place your right hand on the uppermost part of your left breast, beginning just below the collarbone and extending into your armpit. (You can use body lotion to help your fingers move easier.)
Think of your breast as the face of a clock. Starting at 12 o'clock, move the pads of your fingers in a small, circular motion toward one o'clock. Continue around the entire circle.
Once you reach 12 o'clock again, move one inch toward the nipple and do another full circle. Repeat until you have examined your whole breast.
Feel beneath the nipple and gently press inward. Your nipple should move easily.
Repeat the entire process on your other breast.
In the shower:
Use ample soap and water to help your fingers move smoothly.
Raise your left arm behind your head to help spread out the breast tissue.
Place your right hand on the uppermost part of your left breast, beginning just below the collarbone and extending into your armpit.
Using the pads of your fingers, move down firmly, from collarbone to nipple. Move one inch over and repeat, always moving from the outer areas to your nipple.
Continue until you have examined your whole breast.
Repeat on your other breast.
Use the pads, and not the tips, of your three middle fingers.
Apply as much pressure as you can without causing discomfort to your ribs. You want be able to feel through the breast tissue.
Take your time.
Most breast cancer is found in the upper part of your breast, toward the armpit. Examine this area very closely.
Remember, "normal" is relative to what's normal for the look and feel of your breasts, which is why it's important to regularly examine them. It's common to find lumps in your breast, especially during a menstrual cycle. Finding a lump is not a cause for immediate concern. Breasts can have a natural, bumpy texture and usually feel differently throughout.
If you notice any of the following, you should schedule an appointment to discuss with your doctor.
A lump (no matter how small) in the breast that can be felt after the menstrual cycle.
A lump or knot near your underarm.
Changes in the way your breasts look or feel, such as thickening or fullness in one area.
Changes in color, size, shape or texture (dimples, puckers, bulges or ridges on the skin).
Redness, warmth, swelling or pain.
Itching, scales, sores or rashes.
Bloody or clear nipple discharge.
An inverted nipple.