A breast self-exam is no substitute for a screening mammogram, but has benefits

Knowing how to check your breasts can be an effective way to be aware of any changes in your breasts. Here’s a step-by-step guide.

Knowing how to check for breast cancer with a self-exam can be an effective way to be aware of any changes in your breasts, but isn’t a replacement for an annual screening mammogram or a clinical breast exam.

Breast self-awareness is a way to improve overall breast health and make it more likely you will notice if something changes that could be a reason to talk to your primary care provider.

“It is so important for women to be aware of their breasts to know if there are any concerning changes that could be a sign of breast cancer.” said Laila S. Agrawal, M.D., a breast medical oncologist with Norton Cancer Institute.

About half of all cases of breast cancer in women 50 and older, and almost three-quarters of breast cancer cases in women under 50 are detected by women themselves, according to the American College of Obstetricians and Gynecologists.

Looking for changes in your breasts includes checking under each breast, underneath each arm and under the nipples. Breast tissue extends from armpit to armpit and from the collarbone to the top of the abdomen.

Breast self-awareness is important for women who aren’t old enough or at high enough risk for screening mammograms.

How to check for breast cancer

In the mirror

To check your breasts, stand in front of the mirror with your shirt and bra off and your hands at your side.

  • Look for any breast change — size, shape or symmetry.
  • Check the skin for redness, soreness or itchiness, for puckering or dimpling of the skin, for the nipple pulled inward, and for nipple discharge or scabbing over the nipple.

Raise your arms over your head with your palms pressed together and look for the same things. Put your hands on your hips and flex your chest muscles and look one more time.

In the shower

Next, do a manual check in the shower, using the pads of the middle three fingers of the left hand to check the right breast, and the vice-versa. Use a circular motion about the size of a quarter, varying pressure to feel breast tissue at different depths. Take your time and make sure to hit every spot.

You are feeling for lumps, thick spots, or other changes.

Lying down

Finally, check your breasts lying down. With a pillow behind your right shoulder and your right arm behind your head, use your left hand to check your right breast. When you’re done, switch the pillow to your left shoulder and repeat the process with your left breast.

A breast check should be done at least once a month. If you menstruate, choose a time in your cycle when your breasts are the least tender, usually a week after your period ends. Women who are postmenopausal should check their breasts on the same day of each month.

If you feel a lump in your breast

Don’t panic, but don’t ignore it either.

Contact your primary care provider or OB/GYN.

Make a primary care appointment

Find an OB/GYN

What to do if you feel a lump

If you feel a breast lump, do not panic. Eight out of 10 lumps are not cancerous.

Don’t ignore it either. Call your provider if you feel or a lump or other change in how your breast feels, if there is dimpling, redness or swelling on the skin, if there are changes in the direction of your nipple, or if there is irregular or bloody discharge from your nipple.

Inflammatory breast cancer, which is rare, can cause redness, swelling, dimpling and changes to the nipple. The cause of the symptoms can be the result of cancer cells blocking the lymph vessels and making them appear inflamed.

Breast self-awareness does not replace visits to your health care provider or an annual breast cancer screening. Screening mammography usually can detect breast cancer before it can be felt.

The American Cancer Society no longer recommends self-exams as a screening method because there is no evidence they reduce overall deaths from breast cancer, but many breast cancer survivors say they discovered their breast cancer themselves.

Knowing your risk

Risk factors for breast cancer, according to the Centers for Disease Control and Prevention, include

  • Aging. Breast cancer risk increases with age, and most breast cancers are diagnosed after age 50.
  • Inherited genetic mutations. Changes to certain genes such as BRCA1 and BRCA2 are associated with higher risk for breast and ovarian cancer.
  • Menstrual history. Starting menstruation before age 12 and starting menopause after age 55 increases exposure to hormones, increasing breast cancer risk.
  • Dense breasts. Having more connective breast tissue than fatty tissue — dense breasts — increases likelihood of breast cancer. Breast MRI screening may be appropriate for some people with dense breast tissue.
  • Personal history of breast cancer. New breast cancer diagnosis — not a recurrence of a previous diagnosis — is a risk in women who have had breast cancer previously.
  • Family history. Having a mother, sister or daughter with the disease increases risk for breast or ovarian cancer, as does having multiple family members on either your mother’s or father’s side who have had breast or ovarian cancer.
  • Radiation therapy. Radiation treatment on the chest or breasts before the age of 30 increases the risk of breast cancer.
  • Exposure to diethylstilbestrol (DES). This drug was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage. Women who took the drug and their daughters are at higher breast cancer risk.

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