Healthy how to: Breast self-exam

Advances in imaging techniques have led some to question whether women still need to perform breast self-exams. According to Cathy Scallon, RN, MSN, a nurse navigator with Lankenau Medical Center's Comprehensive Breast Center, the answer to that question is easy—"Yes!"

"It is still very important for women to know how their breasts normally look and feel," says Scallon. "A breast self-exam can help women detect abnormalities or other breast problems between checkups. It can also help some women detect breast cancer, although finding a lump or other change doesn't necessarily mean there is cancer."

Scallon recommends that women examine their breasts once a month beginning in their early 20s. Women should perform their exam at the same time each month, because breasts usually change with the menstrual cycle. The best time to do a self-exam is about a week after your period starts, since the breasts are usually not tender during this time.

"If you notice a change in your breasts, you should report it to a health professional as soon as possible," says Scallon.

The American Cancer Society offers the following  guidelines for women when they perform a self-exam:

• Lie down and place your right arm behind your head. Lying down causes the breast tissue to spread evenly over the chest wall and makes it as thin as possible. This makes it easier to feel all the tissue.
• Use the finger pads of the three middle fingers on your left hand to feel for lumps in the right breast. Use your right hand for your left breast. Use overlapping dime-sized circular motions of the finger pads to feel the tissue.
• Use three different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. It is normal to feel a firm ridge in the lower curve of each breast, but you should tell your doctor if you feel anything else out of the ordinary.
• Move around the breast in an up and down pattern starting at an imaginary line drawn straight across your side from the underarm and moving across the breast to the middle of the chest bone. Be sure to check the entire breast area going down until your feel only ribs and up to the neck or collarbone.
• While standing in front of a mirror, press your hands firmly down on your hips. Examine your breasts for any changes of size, shape, contour, or dimpling, as well as redness or scaliness of the nipple or breast skin.
• Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel this area.

"It's also a good idea for women who examine their breasts to have their technique reviewed during their regular exams with their doctor," says Scallon.

Next time you're at an appointment with your gynecologist, be sure to review the self-exam method to ensure you're doing it properly and not at risk of missing any warning signs. To make an appointment with a Main Line Health physician to discuss breast health or schedule an appointment, call 1.866.CALL.MLH (1.866.225.5654).