Self-Examination Instructions

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Breast Self-Examination (BSE)

Ideally, the BSE should be done regularly every month on the same day after your period. This way you can get to know what is normal for your breasts and become more skilled at determining what is not normal. Many women's breasts become lumpy and tender before their periods so it is a good idea to choose a day after your menses. Keep in mind that you are not just looking for lumps. You also need to check monthly for changes in texture, shape, color and symmetry. Another important thing to check for is nipple discharge.

What you're looking for:
GENERAL VISUAL EXAM: changes in symmetry, contour, shape, overall texture
SKIN: look for dimpling, scaling, redness, sores, enlarged pores
NIPPLES: discharge, scaling, sores, puckering, inversion
GENERAL TOUCH EXAM (PALPATION): unusual lumps, bumps, thickenings, tender or enlarged lymph nodes (under arms, along collar bone, in center of chest between breasts)

1. Stand before a mirror to examine your breasts visually. Note the shape and also the texture and color of the skin and nipples. Are they symmetrical? Most women have one breast that is slightly larger, rounder or flatter than the other.
2. Next, place your hands behind your head so that your breasts elevate slightly. Note the contour and texture. Is there pulling of the skin or indentation underneath the skin? You are looking for changes that appear new or unusual.
3. Now place your hands on your hips and press into your hips so that the pectoralis muscle flexes slightly. Again, note the contour and texture and any unusual changes.
4. While standing you can begin your initial palpation (touch) exam. Always use the same pattern, beginning in the same place and proceeding in the same fashion; either vertically up and down or in circles inward or outward.



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5. When you have covered the entire area, end by gently squeezing the nipple between your finger and thumb. Check for any sign of discharge. Then on to the other breast.
6. Repeat the entire palpation portion of the exam while lying down with the side you are examining slightly propped up with a pillow under your shoulder. The BSE usually takes between 5 and 10 minutes a month and it can save your life.

Use powder or lotion if you like to help your fingers move smoothly over the skin. Keep in mind that the primary goal of the BSE is not to detect cancer but rather to get to know what is normal for your breasts so that you will recognize any changes that may indicate a problem. Obviously, if you do notice a lump or change that is not normal for you, notify your primary health care practitioner.

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