Breast self-examination

Download this Patient Note in PDF format

VOL 109 / NO 1 / JANUARY 2001 / POSTGRADUATE MEDICINE

Most breast cancers are detected by women themselves. It is a good idea to start examining your breasts monthly as early as age 20. The best time is two to three days after each menstrual period ends. If you've been through menopause, select an easy-to-remember date, such as the first day of every month.

The most important part of breast self-examination is becoming familiar with the normal findings of your own breasts. Breast size and consistency change with pregnancy and normal aging. Most cancers appear as single, hard, painless lumps. If you regularly examine your breasts, you can easily detect changes, which then can be evaluated by your physician.

If you discover a lump, pucker, dimple, or any suspicious finding or change from your previous examination, see your physician.

Breast cancer is usually curable if it is found and treated early enough. Unfortunately, if someone waits until obvious symptoms appear, the cancer may already be quite advanced. Then treatment becomes more difficult and less likely to be successful.

Who is most likely to get breast cancer?

While no one is immune, your risk is higher if:

• You have had a previous breast cancer.
• You have had some form of benign (noncancerous) breast disease, such as fibrocystic disease.
• You have a mother, daughter, or sister who has had breast cancer.

How can you minimize the risk?

Many experts believe that eating a low-fat diet will decrease your chance of developing breast cancer. You can also do a great deal to minimize the consequences of breast cancer. Three simple steps will help early diagnosis and treatment:

• Examine yourself once a month. Your physician or an assistant can teach you how to do this. The technique is illustrated on the front of this page.
• Be sure to have an annual checkup at your physician's office.
• Get a mammogram, a simple x-ray of your breasts, when you are about age 40--or sooner if you have any of the risk factors mentioned above. Then have a mammogram at least every two years between 40 and 50 or more often if your physician thinks that is a good idea. After age 50, have one every year.

What if you find a lump?

Discovery of a lump--whether it is found through self-examination or on a mammogram--does not necessarily mean you have cancer. The mass may be a cyst or other benign condition. To determine whether a lump is benign or malignant, the contents of the lump are removed and examined. The test is done using a fine needle (fine-needle biopsy) or through surgically removing tissue (excisional biopsy). When cancer is found or suspected, it is treated by surgery, drug therapy (chemotherapy or hormone treatment), radiation therapy, or a combination of these.

When cancer is found early, treatment may be fairly simple. New information is helping to improve the outlook. However, the key to successful treatment is early diagnosis. The information on the front of this page will help you understand what to look for. Please keep it handy and use the self-examination routine each month.

Self-examination is best done as the following three-part procedure.

1. Inspection--Sit or stand in front of a mirror. Carefully look at your breasts with your arms first at your sides, then raised over your head, and finally on your hips. You are inspecting for lumps or new dimples or puckers of the skin or nipple.

2. Checking in the shower--Using water and soap for lubrication, systematically feel all parts of both breasts. Holding your left arm above your head, use your right hand, with fingers held flat, to examine your left breast. Starting at the outside edge of the breast, work around it circularly, continuing inward in a spiral pattern to the nipple. Repeat the steps to examine your right breast.

3. Checking lying down--Put a pillow under the side to be examined and raise that arm above your head. Examine systematically as in the shower.

This information is not a substitute for medical treatment.

Please send technical questions related to the Web site to Ann Harste