How to Give Yourself a Breast Exam

How to give yourself a breast exam?  What is the importance breast self exam? During self breast exam what to feel for ?

What is Breast Self Exam:

A  breast self-examination (BSE)  is a technique that women can use to check their breasts and underarms using varying degrees of pressure to monitor for any possible changes. The BSE is part of a three-step process, including clinical breast examinations (CBEs) and screening mammography, advocated by the American Cancer Society to screen for breast cancer. This article depicts how to give yourself a breast exam.

Breast Self Exam may be recommended for women starting in their 20s, even though the incidence of breast cancer in this age group is extremely low. In addition to annual screening mammograms and clinical breast examinations (CBEs) for women over 40, some experts also recommend performing a monthly breast self-examination.

Performing monthly BSEs was first advocated in the 1950s by Columbia University breast surgeon, Cushman Haagensen. At the time, mammography had yet to be developed and women were usually diagnosed when the breast tumor had become large and inoperable. Haagensen hoped that encouraging breast self-examinations would help catch tumors earlier when they were still treatable.

Since that time, several large studies have concluded BSE may not help find breast cancers at earlier stages and may in fact lead to a higher incidence of unnecessary surgical biopsies. For this reason, some health experts believe that as a method to detect breast cancer, BSE is ineffective. However, with long-term studies still being conducted, the debate is far from over.

For certain women who are at an increased risk of developing breast cancer, including a family history of the disease, the ACS recommends that:

  • Screening begin at an earlier age
  • Time between screenings be reduced

Include additional screening methods, such as an ultrasound or magnetic resonance image (MRI)
In addition, women at high risk are advised to begin annual mammograms and CBEs no later than 10 years before the age a first-degree relative (mother or sister) was diagnosed with breast cancer. For example, a woman whose mother was diagnosed at age 43 should begin additional screening by age 33. A woman should check with her physician to see if the additional screening includes monthly BSEs.

when to do self breast exam

There is some disagreement as to when a woman should perform monthly breast self-examinations. They should not be performed when a woman’s breasts are swollen or tender. Many health care experts believe that there is an advantage to performing the Breast Self Exam at the same time each month, usually five to seven days after menstruation. Other experts believe that there are distinct advantages to checking the breasts at different times of the month so that a woman becomes familiar with how her breasts feel at all times. Regardless of when women choose to conduct BSEs, they should have their examination technique reviewed by a knowledgeable healthcare professional. Conducting the exam regularly can help women learn the normal look and feel of their breasts.

Before, during and after the self-examination

For women who choose to do monthly breast self-examinations (BSEs) but have not been trained in the technique, it is highly recommended that they receive the proper instruction from a nurse, physician or trained healthcare professional. Having the technique can help ensure that the woman’s method is correct and effective.

How to Give Yourself a Breast Exam

A Breast Self Exam should be performed on each breast in a routine fashion to be sure no area is missed. To perform a breast self-examination, a woman should lie down and place her right arm behind her head to begin examining her right breast. It is not recommended to perform a BSE standing up because the position does not allow the breast tissue to spread evenly over the chest wall. By lying down, the tissue is spread thinner and thus makes it easier to detect any possible changes.

Next, using her finger pads of the middle three fingers (index, middle and ring fingers) of her opposite (left) hand, the woman uses tiny circular motions over the entire breast area. These dime-sized circular motions should overlap so that no area is missed.

During the breast self-examination, the breast area is examined with three different levels of pressure. The first is a light pressure, allowing the woman to check the tissue closest to the skin. A medium amount of pressure helps the woman to feel a little deeper; while a firm pressure will allow the woman to feel the tissue of the chest and ribs. The light, medium and firm pressure should be done at each spot before moving to the next. The process is then repeated on the left breast using the right hand and placing the left arm behind the neck or back.

The American Cancer Society (ACS) recommends the examination of the breast be performed using a vertical pattern, which helps ensure that no area is missed. In the vertical pattern, the exam involves an up and down motion (from the neck and collar bone to the ribs). After the breast has been examined, it is important for a woman to also examine each underarm for any lumps or signs of enlarged lymph nodes. This part of the exam can be done while sitting or standing. Each arm should be raised only slightly so that the tissue is not tightened.

Breast Implants and Breast self Exam

Women who have breast implants should consult with their physicians about the most effective way to conduct a Breast Self Exam. These women need to learn how to distinguish breast tissue from the implant device. Physicians can instruct women on ways to apply pressure to check for changes without causing leakage or damage to the implants.

During self breast exam what to feel for

For women who choose to perform monthly breast self-examinations, it is important to do the exam regularly and become familiar with their breasts. A woman (or man) who detects a change or lump in the breast should first check the other breast. It is normal to find some lumpiness, especially if both breasts feel the same.

However, a patient should contact their physician if any of the following signs or symptoms develop:

  • Development of a lump in the breast or underarm area
  • Irregular thickening of breast tissue
  • Swelling
  • Skin irritation
  • Dimpling or puckering
  • Nipple pain
  • Nipple retraction (turning inward)
  • Redness or scaliness of the nipple or breast
  • Discharge from the nipple (other than breast milk)

Some changes in the breast are normal. There are many explanations for these changes, including aging, the menstrual cycle, pregnancy, menopause, taking birth control pills or taking other hormones, such as estrogen or progesterone. It is important for women to know that, more often than not, these changes are not cancer. In fact, one of the most common causes of breast lumps are fibrocystic changes, sometimes referred to as fibrocystic disease. This condition, which is technically not a disease, is not cancerous.

Generally found in both breasts, these changes form as a result of repeated exposure to hormones, which in turn increase the firmness of the breast tissues leading to the creation of fluid-filled cysts. More than 60 percent of women in their childbearing years have fibrocystic changes or “lumpy” breasts. However, only a physician is qualified to make that determination.

Some women who have breast implants question their ability to perform monthly breast self-examinations, or even the value of mammography. Breast Self Exams and clinical breast exams, however, are the same for women with breast implants as they are for those without them. These women should inform their physicians and mammography technicians of the implants prior to their examinations.

Potential benefits and risks of  breast self-examination

The American Cancer Society (ACS) is among those that recommend breast self-exams, but only as part of the three-step process to screen for breast cancer. The three steps include:

  • Breast self-examination (BSE)
  • Clinical breast examination (CBE)
  • Mammography

Many health experts disagree about the potential benefits and possible risks of performing monthly breast self–examinations (BSEs). Several large clinical studies have reached conflicting conclusions regarding the value of BSEs. Advocates believe that it encourages women to become more familiar with their bodies and thus be more apt to notice changes. Others point to the sharp increase in unnecessary biopsies and the possible anxiety that comes with finding a lump. However, it is unlikely an unecessary biopsy would be done. A biopsy is typically ordered only if there is a concern by a physicianand unnecessary biopsies are not common.

Not all screening tests are helpful and BSEs come with certain risks, including increased anxiety and unnecessary surgeries. According to the ACS, more than 75 percent of breast biopsies are benign. Most experts believe that the lumps that women detect during their BSEs are benign lumps that otherwise would not be biopsied. Health experts also worry that some women will mistakenly substitute monthly BSEs for regular screening mammography and clinical breast exams by a qualified physician or healthcare professional.

The ACS, along with other leading health organizations, such as the Centers for Disease Control and Prevention (CDC), state that while breast self-examinations play a small role in finding breast cancer, studies have shown that BSEs alone do not lower a woman’s risk of dying from the disease. In the end, whether or not a woman chooses to perform monthly BSEs, the most important goal is to report any changes in her breasts to a physician.

Questions for your doctor about Breast Self Exam

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Women may wish to ask their doctor or healthcare professional the following questions about breast self-examination (BSE):

  1. Where can I get instructions in conducting a Breast Self Exam?
  2. When is the best time for me to conduct my BSEs?
  3. How often should I perform them?
  4. What factors can cause changes in my breast that might be detected in a Breast Self Exam?
  5. What steps should I take if I notice a change or lump?
  6. Will a mammogram show lumps or changes that I find in a Breast Self Exam?
  7. How should I conduct a BSE if I have breast implants?
  8. How important do you think BSEs are for women?
  9. If my BSE is painful, is that a sign of a problem?
  10. If there is a family history of cancer, when should my daughters start BSEs?

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