Dear Dr Mitchell,
How do I perform a proper breast self-exam? Is it better to do it lying down or standing up, and what exactly am I feeling for? I've always had some nodule-type things in my breasts, and I don't know the difference between these and an actual abnormality.
Examination of your breasts should become part of your regular daily routine. You should try to familiarise yourself with how your normal breast tissues feel so that when a problem shows up you will be the first to detect this change very early.
You should feel for any change in the normal look or feel on a monthly basis. The breast tissues tend not to be sensitive at the end of the menstrual period and this is a good time to do your routine check. A breast self-examination should be done in addition to your yearly checks done by your doctor.
You should follow these basic steps while doing your self-examinations:
Step 1: Lie down
•Lie down on your back and put a pillow under your right shoulder.
•Use the soft pads of your three middle fingers on your left hand to check your right breast. Press and feel all around in a circle without lifting your fingers off the skin. Follow an up and down pattern.
•Check for changes above and below your collarbone and in your armpit.
•Repeat on your left breast using your right hand. You should repeat these steps while bathing using soapy hands.
Step 2: Stand in front of the mirror
Look for any changes from the normal. Inspect your breast in the four steps below:
1.Hold your arms at your side.
2. Hold your arms over your head.
3. Press your hands on your hips and tighten your chest muscles.
4. Bend forward with your hands on your hips.
In general, cancerous lumps tend to be more irregular in shape, feel firm or solid and might be fixed to the tissue in the breast. Fluid filled lumps (cysts) are common in the breast and are usually not cancerous.
If you detect any changes in the breast which include:
•Development of a lump
•Discharge from the nipple
•Swelling of the breast
•Skin irritation or dimpling
•Nipple abnormalities such as pain, redness, paleness or inversion of nipple (turning inward), you should visit your doctor for a repeat examination and additional tests which might include a mammogram and breast ultrasound, depending on the findings of your doctor.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to firstname.lastname@example.org; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.