06 Jan How to Do Your Monthly Breast Self-Exam
In the past decade, some breast self-exam (BSEs) studies have suggested that regular BSEs do not improve breast cancer mortality rates. As a result, some organizations have stopped recommending that women perform monthly self-exams. However, a majority of doctors still recommend regular BSEs. Many women discover cancerous lumps during a self-exam, not just during mammograms. Familiarity with your breasts remains an excellent form of early detection.
This month, we’ll explore the benefits of BSEs, how to perform a breast self-exam, and the next steps if you discover changes in your breasts. Also, we’ll share tips to help you remember when your monthly self-exam is due.
Do You Really Need to Do Breast Self-Exams?
In the past decade, there has been controversy over whether breast self-exams are beneficial to women. A Russian study in 2008 found that BSEs do not have a “meaningful impact on breast cancer survival rates and may even cause harm by prompting unnecessary biopsies.” However, a 2003 study by the National Health Interview Survey (NHIS) found that 25% of women detected their breast cancer themselves through self-examination, and another 18% by accident.
While breast self-exams are NOT a substitute for annual exams and regular mammograms, they are part of a thorough, multimodal detection strategy. Robust screening should include self-exams, clinical exams, mammograms, ultrasounds, and genetic testing when applicable.
Young women and those who do not have a history of breast cancer in their families often do not begin regular mammograms until they are 40 years old. For those women, their only form of detection is yearly clinical exams and self-exams. Performing regular BSEs may be the best way for young women to detect changes in their breast health before it’s too late.
The Benefits of Clinical Exams
Mammograms are an incredible screening tool that often catch tumors when they are too small for women to detect in a physical self-exam. They are an essential step in early detection, but mammograms don’t find all incidences of cancer.
At your annual exam, your physician will perform a physical breast exam. A physician may detect a lump, often as small as a pea, that you may miss on your own. To the trained hand, benign and cancerous lumps feel slightly different. In most cases, a round, soft, movable lump is more likely to be benign. A hard, irregularly shaped, and immovable lump has the potential to be cancerous. If your doctor discovers something concerning, he or she will order imaging and possibly a biopsy.
Just as your self-exam is a critical part of breast cancer detection, so too is your annual breast exam with a physician.
How to Perform a Breast Self-Exam
Your BSE involves both a visual and physical inspection. Some women underestimate the area of their chest that is breast tissue. A breast self-exam should cover the area from your collarbone to where your breast meets your abdomen, and from your armpit to your cleavage.
Step 1: Visual Exam
Begin your BSE by looking at your breasts in the mirror, and asking yourself a few questions:
- Do you see any puckering, swelling, dimpling, or changes in size?
- Do you see abnormal asymmetry between your breasts?
- Are there scales, rashes, or sores?
Redness, warmth, and swelling are also warning signs of a possible lump.
Visually inspect yourself with your arms down at your sides, and then again with your arms raised over your head. If necessary, lift each breast to examine the bottom area where your breast and ribs meet.
Step 2: Physical Exam
You can examine your breasts while standing or laying, whichever is comfortable and allows you to perform a thorough examination.
Use the pads of your first three fingers and make small circles, about the size of a quarter, across your breast. Slowly work your way from the top of your armpit and down, from collarbone to cleavage. Try not to lift your fingers, but rather to slide them up and down, then over to the next section.
Move your fingers in a pattern to be sure that you don’t miss any areas. You can move in horizontal or vertical lines, or you can start at the nipple and work in circles outward. Use any method that works for you and which you can easily track.
Use varying pressure in each spot to feel the surface, middle, and deep tissue in your breast. It should take several minutes to examine both breasts thoroughly, so take your time.
How Should a “Normal” Breast Feel?
Each area of your breast may feel different. The outer edges near your armpits often have the largest natural lumps and bumps. The lower half of your breast may feel sandy or like there are small, soft pebbles inside. Breasts with more fatty tissue will feel different than dense breasts with less fat.
Your breasts may even feel different during different times in your menstrual cycle. It’s not abnormal to find small bumps in your breast that shrink or disappear as your hormones fluctuate throughout the month.
Not all breasts are the same, which is why it’s so important to familiarize yourself with your body and perform breast self-exams often. If something feels different than it did in the past, or if there are changes in your breast shape, schedule an appointment with a doctor right away.
How Can You Remember Your Monthly Breast Self-Exam?
If you’re still menstruating, the week after your period ends is an ideal time to perform your exam. If your breasts are swollen and tender, the exam will be unnecessarily uncomfortable.
Try to pick a specific date of the month or a time that lines up with your menstrual cycle. You can keep track of the date by setting a reminder on your cell phone, jotting it on the wall calendar in colored pen, or lining it up with another significant monthly date, like when you make your mortgage payment.
Creating a routine makes it easier for you to remember.
What Should You Do If Something Changes?
Some researchers and physicians find BSEs detrimental to women because finding a lump can be a source of extreme anxiety that may lead to unnecessary ultrasounds and surgical biopsies. However, it’s better to discover a change in your breast and have an unnecessary biopsy than to skip your monthly self-exam and leave a lump undiscovered.
At Breast Care Specialists of Carolina, we perform ultrasound guided biopsies that are minimally invasive and low risk. Using local anesthesia, Dr. Thomas uses an ultrasound to locate the abnormal area for a targeted biopsy. In most cases, the incision is so small that it doesn’t even require a stitch. There is no downtime after the biopsy, patients can shower after 24-hours, and they heal without a scar. With an ultrasound guided biopsy, patients gain peace of mind without undergoing major surgery.
Remember, Breast Lumps Aren’t Always Cancer
If you discover a lump, try not to panic. Many lumps are not cancerous. Benign breast disease can cause lumps that may present no risk for cancer now or in the future. The only way to know the cause is to visit your doctor.
If you’re worried about something you’ve discovered in your breast, get in touch with Breast Care Specialists of Carolina today.