Breast Self-Exam Instructions

Conducting monthly breast self-exams is an important step in the early detection of breast cancer.  It is best to get in the habit of performing the self-exam at the same time each month. It is best to wait until several days after your period ends; if you no longer have periods, choose a day that is easy to remember, such as the first or last day of the month.

Most women have some lumps or lumpy areas in their breasts, which are normal and harmless.  It is important for you to become familiar with how your breasts feel so that you can detect any new lumps or changes.

The upper, outer area of the breast, near the armpit, tends to have the most prominent lumps and bumps.  The lower half of your breast may feel like a sandy or pebbly beach. The area under the nipple can feel like a collection of large grains, and another area may feel like a lumpy bowl of oatmeal.

Once you are familiar with the feel of your breasts, you will be able to notice if anything stands out as different from the rest.  Tell your doctor about any changes that last over a full month’s cycle or seem to get worse or more obvious over time.

Some women find it helpful to keep a record of their self-exam in a journal. This will help you to track any changes and help you to remember what is normal for your breasts.

Step 1: Begin with a visual examination by looking at your breasts in the mirror. Stand with your shoulders straight and your hands on your hips.  You should look for:

• Breasts that are their usual size, shape and color
• Breasts that are evenly shaped without visible distortion or swelling
• Tell your doctor if you notice any of the following:
  
  • Dimpling, puckering or bulging of the skin
  • A nipple that has changed position, discharge or an inverted nipple
  • Redness, soreness, rash or swelling

Step 2: While in the shower, perform the tactile examination.  During the first part of the breast self exam, you will need to feel your breasts and surrounding areas including:

• The breast itself
• Between the breast and underarm
• The underarm itself
• The area above the breast up to the collarbone, and across to your shoulder
  

Step 3: To check your right breast, place your right arm behind your head and use the pads of your three middle fingers on your left hand to feel all over for lumps, thickening, or any other changes.  Cover the entire breast from top to bottom, side to side - from your collar bone to the top of your abdomen and from your armpit to your cleavage. Follow a pattern to be sure that you cover the entire breast.  Begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. Perform the breast self exam the same way each time, using this pattern of circles.

Step 4: Repeat on the left side, using the right hand.

Step 5: Next, feel your breasts while lying down.  Place a pillow under your right shoulder and place your right arm behind your head.  Use your left hand to check your right breast using the same techniques as above.  Switch the pillow to the left side and check the left breast.

See your healthcare provider for regular exams and also if you notice any changes.