Being familiar with what is normal for you will make it easier to recognize any new developments. Furthermore, knowing what’s not normal for anyone can help prompt you to bring such issues to your doctor’s attention, should you notice them during your BSE.
Breast Anatomy
There are three main sections of a breast. They are known as lobules, ducts, and connective tissue. The lobules are glands that secrete breast milk. The ducts are vessels or tubes that carry milk from the lobules to the nipple. The connective tissue surrounds the ducts and lobules and holds them in place. Breast cancers often start in the ducts or lobules and spread to other tissues.
Breast tissue extends from under your nipple and areola, the pigmented skin around the nipple, up toward your armpit, so a BSE should involve these areas. You’ll need a mirror that allows you to see both breasts, a pillow for your head and shoulders, and some privacy.
Breast Self-Exams: Do They Work?
Although a breast self-examination is an important way to check for breast lumps, some medical groups, like the American Cancer Society, don’t encourage it. That’s because BSE has not been shown to be effective in detecting breast cancer early or reducing mortality in people with breast cancer.
However, one study has shown that 25% of 361 people with breast cancer surveyed detected their disease through self-exam. If you are not sure whether you should perform a self-exam, check with your doctor.
Step-by-Step Instructions
Here are step-by-step instructions on how to do a breast self-exam, as well as some things to keep in mind as you perform yours.
Place Your Hands on Your Hip Strip to the waist and stand before a mirror.
You will need to see both breasts at the same time. Stand with your hands on your hips and check the overall appearance of your breasts. Look at the size, shape, and contour. Note changes, if any, in the color or texture of the skin on your breasts as well as on your nipples and areolas. Put Your Arms Over Your Head Now, raise your arms over your head. See if each breast moves to the same degree and in the same way and note any differences. Look at the size, shape, and drape, checking for symmetry. Look up toward your armpits and note if there is any swelling where your lymph nodes are (lower armpit area). Check Your Nipples Still facing the mirror, lower both arms. Check the nipples to see if you have any dimples, bumps, or retraction (indentation). With the index and middle fingers of your right hand, gently squeeze the left nipple and pull forward. It should spring back into place, as opposed to sinking back into the breast. Note whether or not any fluid leaks out. Reverse your hands and check the right nipple in the same way. Bloody (red) or clear discharge are potentially worrisome, especially if either is coming out of only one nipple. Discharge colors such as green, white, or yellow are usually signs of other conditions, such as an infection or a blocked milk duct. Stand and Stroke This is best done in the shower, as wet skin will have the least resistance to the friction of your fingers. Raise your left arm overhead and use the fingers of your right hand to apply gentle pressure to the left breast. Stroke from the top to the bottom of the breast, moving across from the inside of the breast all the way into your armpit area. You can also use a circular motion, being sure to cover the entire breast area. Take note of any changes in the texture, color, or size. Switch sides and repeat. Recline and Stroke This is best done lying down on a bed with your head and shoulders resting on a pillow. Lie down and put your left hand behind your head. Use your right hand to stroke the breast and underarm, as you did earlier. Take note of any changes in the texture or the size of your breasts. Switch sides and repeat.
General Tips
Mark your calendar to remind yourself to do your BSE regularly. This will help you determine if any changes are possibly due to the time of month, if you are still menstruating. Stay relaxed and breathe normally as you do your BSE. Report any changes or unusual pain to your doctor or nurse practitioner. Keep a log of changes if that helps you remember. Try not to panic if you find a lump. Most breast lumps are benign. Remember that a BSE does not replace the need to have an annual clinical exam as well as regular mammograms.
If You Find a Lump
Don’t panic if you feel a lump during your breast self-examination. Most times, women have lumps in their breasts that are noncancerous (benign). Things like hormonal changes, benign breast conditions, or injuries can cause benign growth.
If you are premenopausal and are still having periods, set a regular time to examine your breasts a few days after your period ends. At this time, hormone levels are relatively stable and breasts are less tender.
If you are already menopausal (have not had a period for a year or more), pick a particular day of the month to do the exam and then repeat your BSE on that day each month.
Look at the size, shape, and contour.
Note changes, if any, in the color or texture of the skin on your breasts as well as on your nipples and areolas.
Look up toward your armpits and note if there is any swelling where your lymph nodes are (lower armpit area).
Check the nipples to see if you have any dimples, bumps, or retraction (indentation). With the index and middle fingers of your right hand, gently squeeze the left nipple and pull forward. It should spring back into place, as opposed to sinking back into the breast.
Note whether or not any fluid leaks out. Reverse your hands and check the right nipple in the same way.
Bloody (red) or clear discharge are potentially worrisome, especially if either is coming out of only one nipple. Discharge colors such as green, white, or yellow are usually signs of other conditions, such as an infection or a blocked milk duct.
Raise your left arm overhead and use the fingers of your right hand to apply gentle pressure to the left breast. Stroke from the top to the bottom of the breast, moving across from the inside of the breast all the way into your armpit area.
You can also use a circular motion, being sure to cover the entire breast area. Take note of any changes in the texture, color, or size. Switch sides and repeat.
Lie down and put your left hand behind your head. Use your right hand to stroke the breast and underarm, as you did earlier. Take note of any changes in the texture or the size of your breasts. Switch sides and repeat.
Seek medical attention if the lump feels different from the rest of your breast. You should consider this if the lump lingers for more than a complete menstrual cycle and increases in size. If you are on your period, you can wait till after your period to check if the lump reduces before seeing your doctor.
A Word From Verywell
Breast cancer affects both men and women, but there’s a higher chance in women. A breast self-exam will help you to get familiar with what is normal in your breast and what is not. Don’t panic if you feel a lump during a self-exam. Rather, schedule a visit with your doctor for better evaluation. Early detection of breast cancer is highly recommended, so ensure you maintain your BSE routine.
What are the warning signs of breast cancer?
While different people have different symptoms of breast cancer—and some don’t have any at all—warning signs of breast cancer include new lumps in the breast and armpit, swelling of the breast, redness or pain in the nipple region, or change in the breast size.
Remember that some of these symptoms are associated with other conditions that aren’t cancer.
When should women start doing breast self-exams?
Women can start doing their BSEs at about three to five days before their period starts. This is because their breasts aren’t tender at this time of the cycle. They can mark the date that they choose on your calendar to be reminded monthly.
What do breast lumps feel like?
Breast lumps may feel round, soft, and tender, and they can be found on any part of the breast. Sometimes, the lumps are painful. Women who have denser and more fibrous tissues may have difficulty feeling lumps in their breasts.
