(MayoClinic.com) Breast self-exams, long advocated as essential for early breast cancer detection, are now considered optional. What's stressed today is breast awareness, which involves being familiar with the normal consistency of your breasts and the underlying tissue.
Breast self-exams contribute greatly to breast awareness, teaching you how your breasts vary in sensitivity and texture at different times during your menstrual cycle and different stages of life. This sense of what's normal is known as breast familiarity.
When you know the normal feel of your breasts, it's easier to notice subtle but potentially serious changes. These changes may become apparent quickly, over the course of just a few months.
Say, for example, you feel a barely perceptible area of thickening in the upper quadrant of your breast, next to your arm. If you've become familiar with how your breasts look and feel, you know your breast usually feels completely smooth in that area. Without a tactile memory from having done many breast self-exams, though, you might not notice this difference. Detecting such a change should prompt you to see your doctor.
Although most breast abnormalities discovered on breast self-exams aren't cancers, a small proportion are. Some of those cancers are at an early stage, when prompt treatment can be lifesaving. That's why regular breast self-exams — examining your breasts in a way that's comfortable to you, with an awareness of what's normal for you — are particularly important if you're at increased risk of breast cancer.
To gain the greatest benefit from regular breast self-exams, ask your doctor to review your technique at your next checkup.How to perform a breast self-exam
Start by looking closely at your breasts. Disrobe and stand in front of a mirror with your arms at your sides. While facing forward and turning from side to side, look for puckering, dimpling or changes in size, shape or symmetry. Check to see if your nipples are turned in (inverted). Inspect your breasts with your arms in two other positions: hands on your hips and hands raised overhead, palms pressed together.
Perform the manual part of the exam in the shower or lying down with no shirt or bra on.
If you choose the shower, lather your fingers and breasts with soap to help your fingers glide more smoothly over your wet skin. If you do the exam lying down, choose a bed or other flat surface to lie on.
Move your hand over your breast using one of three techniques: the clock pattern, the wedge pattern or the sweeping technique. No matter which method you choose, be sure to check your nipple for any discharge. Do this by gently pinching the nipple with your fingers positioned at 12 o'clock and 6 o'clock and again with your fingers at 3 o'clock and 9 o'clock.
Touching or gently pressing a breast lump may cause some discomfort. If you do detect any changes, such as a lump, thickening, asymmetry, dimpling, redness, nipple discharge or nipple inversion, see your doctor promptly.
Breast self-exam using a clock pattern
Breast self-exam using a wedge pattern
Breast self-exam using a sweeping technique
The American Cancer Society recommends that doctors inform women about the benefits and limitations of breast self-exams when they reach age 20. That's the age you should begin breast self-exams. Whether or not you perform breast self-exams, you should have a clinical breast exam by a health professional every three years until you're 40. After age 40, schedule a clinical breast exam and a mammogram every year.What's the best time for breast self-exams?
The best time to perform a breast self-exam is about a week after the start of your period. That's when your breasts are least likely to be tender or swollen. Your breast tissue undergoes changes each month during your menstrual cycle. Changes in hormone levels associated with menstruation cause your breasts to swell. Once your period starts, the swelling subsides and your breasts return to normal.
During pregnancy and nursing, your breasts may feel more lumpy than usual. If you have any questions about how your breasts look or feel, don't hesitate to ask your doctor about them.Pros and cons of breast self-exams
One benefit of breast self-exams is the potential to identify and treat a cancerous breast lump while it's still small and in an early stage of development. On the flip side, however, you might need a biopsy to evaluate an area of concern. If the biopsy results are noncancerous (benign), you might feel that you've undergone an invasive procedure unnecessarily. Breast self-exams may also be challenging if you have normally lumpy (fibrocystic) breasts.
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