•	About Breast Cancer
•	Breast Self Exam
•	Breast Lumps
•	Breast Cysts
•	Breast Pain & Injury
•	Caffeine
•	Hormone Replacement
•	Nipple Discharge
•	Local Support Groups
•	Breast Self Exam Pamphlet [pdf]
•	Breast Self Exam

Breast Self Examination

Step 1: Stand in front of a mirror.
With your shoulders straight and your hands on your hips, look at your breasts. Check for:

• breasts that are their usual size, shape and color.
• breasts that are evenly shaped without distortion or swelling.

If you see any of the following changes, bring them to your doctor’s attention:

• dimpling, puckering or bulging of the skin.
• a nipple that has changed position or a newly inverted nipple (pushed inward instead of sticking out).
• redness, soreness, rash or swelling

Step 2: Raise your arms in front of the mirror and look for the same changes.
As you raise your arms, also note if both breasts move smoothly and evenly over the ribcage.

Step 3: Exam your breasts while lying down.
Use a firm smooth touch with the first few fingers of your hand, keeping the fingers flat and together. Use your right hand to examine your left breast and your left hand for the right breast. Be sure to examine your entire breast from top to bottom and side to side - from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Follow a pattern to be sure you cover the entire breast. You can begin at the nipple and move your hand in larger and larger circles until you reach the outer edge of your breast. You can also move your hand up and down vertically in rows, as if you were mowing a lawn. With every spot you touch, be sure to feel all the breast tissue. Use a light touch to feel the tissue just under the skin and a firmer touch to feel the deeper tissue. Begin examining each area with a soft touch and then increase pressure so that you can feel the deeper tissue, down to your ribcage.

Whenever a lump is felt, you can compare it with the same area in the opposite breast. If both of these regions feel the same, then this is your normal breast tissue.
If you have large breasts, you should roll up on your right side when you examine the outer half of the left breast, and reverse the procedure for the other breast. Larger breasts tend to fall to the side, making them more difficult to examine. When you roll up on your side, the breast falls towards the middle, which straightens up the outer half of the breast so it’s easier to examine.

Step 5: Examine your breasts while standing or sitting.
Many women find this easiest to do while in the tub or shower when their skin is wet and slippery. Use the same hand movements described in Step 4 to examine the entire breast. It’s important to examine your breasts in both positions because some lumps can be felt best when lying down but others are felt best in the upright position.

Methods

To remember how your breast tissue feels and looks from one examination to the next, you can use the method that most physicians use—a diagram. This helps your physician remember the troublesome spots in your breasts. After you have left her office, she usually draws a diagram of your breasts in your patient chart and if there is an area which feels firmer in one breast, for example, than the same area in the opposite breast.

Then when you return for subsequent visits she will review your patient chart to refresh her memory. Although she may be an expert at examining breasts, she sees too many patients to be able to remember the details of each individual person’s breast examination. Therefore, she needs the aid of a diagram.

There’s no reason why you can’t use the same method to help you remember what your own breast tissue feels like. You should draw a picture of your breasts the first time you examine them, indicating little circles or outlines of areas where you feel breast tissue. You can label these areas firm, or soft, or use any description that you think explains how the area feels. Then the next time you examine your breasts, you can compare what you feel with the prior diagram that you made.

If you’re just beginning to learn how to do breast self-examination, it may help to do it more often. The first few times may take a while, but as you become familiar with the outline of your normal breast tissue, you’ll be amazed at how much quicker and easier it is. Don’t examine the breasts when they’re tender (usually just before menstruation but often at other times too, such as during ovulation), because that means the tissue will have fluid in it, which will make it feel lumpier. The discomfort will also make the tissue seem bigger than it really is. Once you’ve learned, you don’t need to examine the breasts as often. For many women, once a month is enough. If you find that it’s easier to remember when you do it more often, however, there’s no reason why you can’t do it more frequently.

When you first begin doing BSE, you may find all sorts of things that concern you and will want to have your doctor check. Normal breast tissue usually has a lumpy feeling to it. Learning to examine your breasts just before your doctor’s regular examination will make it more convenient for you to ask questions. Don’t be afraid to ask your doctor anything - this is important!

Breast-to-Breast Comparison

When doing BSE, you don’t have to know what you’re feeling as long as it feels the same as the matching area in the other breast. Like the wings of a butterfly, everything in one breast is a mirror image of the other side, even the ribs and muscles. The only trick in learning to compare, is to make sure you examine the exact same area on the other side. You might have to look in the mirror to make sure (otherwise it might not feel quite the same). Report to your doctor any lump that doesn’t match with the other side, even if it feels no harder than your normal glandular tissue, and is easily movable. Breast cancers are often small, soft feeling, and easier to move at an early stage—they only get harder and bigger later on. The idea is to catch breast cancer at an early stage, not later.
If you’ve had previous surgery on one or both of your breasts, the tissue may vary from one breast to the other. If one breast has had tissue removed, it may feel different in this region, compared with the opposite breast in the same area. Again, this is a good time to draw a diagram of both breasts. You can refer to these pictures when you examine your breasts the next time, which will help you remember the differences due to surgery. The diagram is also very helpful if one breast has been removed since it’s no longer possible to compare both breasts.

It’s quite common for women to feel so nervous about performing BSE incorrectly, that they just don’t do it. If this sounds like you, you can stagger your doctors’ checkups and your mammogram so your breasts are being checked in some way every few months. For example, see your internist in early spring, your gynecologist in late summer, and have your mammogram in the winter. Don’t be embarrassed to admit this to your doctor—about 25% of all women have the same problem, so you’re not alone. If there’s a significant other person in your life, show that person this pamphlet and maybe they’ll be willing to do the exam for you.

We recommend that women learn to examine their breasts after adolescence, preferably in their teens or early twenties. Cancer of the breast is extremely uncommon at this age, but if a woman gains enough experience at a younger age in examining her breasts, then she will be expert enough in her thirties, forties, and later life, to detect a small change more easily. However, it’s never too late to learn!!!

This page is intended as an educational resource only. It is not a substitute for professional care. Please see your physician if you have any concerns about your own health.

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