Alison Marie, PhD
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The Why, What, and How of Breast Self Exams

10/15/2015

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My gyno always asks me if I regularly did my self-exam.  For a long time answered yes, but that wasn't the whole truth.  Yes, I poked around in the shower, I even made nice circles to make sure I didn't miss a spot, but I didn't do it a regularly as I should.  I didn't think I would recognize something if it was there so I thought why bother….until I got up the guts to admit one time that I didn't know what I was looking for.  She said very simply, you are just getting familiar with your breasts, the more you do it, the more you will know what is normal FOR YOU and what is not normal FOR YOU. 
Lesson 1: Don't be shy to admit to your doctor when you aren't sure about something.
Lesson 2: REGULARY (at least once per month) do your breast self-exam.

Why?
Johns Hopkins Medical center states, “Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.”
While mammograms can help you to detect cancer before you can feel a lump, breast self-exams help you to be familiar with how your breasts look and feel so you can alert your healthcare professional if there are any changes.

What are you looking for?
You are looking for changes.
Changes in in how they feel:
  • Nipple tenderness or a lump or thickening in or near the breast or underarm area
  • A change in the skin texture or an enlargement of pores in the skin of the breast  (some describe this as similar to an orange peel’s texture)
  • A lump in the breast (It’s important to remember that all lumps should be investigated by a healthcare professional, but not all lumps are cancerous.)
Changes in how they look:
  • Any unexplained change in the size or shape of the breast
  • Dimpling anywhere on the breast
  • Unexplained swelling of the breast (especially if on one side only)
  • Unexplained shrinkage of the breast (especially if on one side only)
  • Recent asymmetry of the breasts (Remember it is common for women to have one breast that is slightly larger than the other, the problem lies if the onset of asymmetry is recent)
  • Nipple that is turned slightly inward or inverted
  • Skin of the breast, areola, or nipple that becomes scaly, red, or swollen or may have ridges or pitting resembling the skin of an orange
Again, remember you are looking for changes.  One of the most important things about starting you regular self exams early  is to become familiar with YOUR breasts so that you can notice if/when changes occur.
How to do it?
1) In the Shower
Using the pads of your fingers, move around your entire breast in a circular pattern moving from the outside to the center, checking the entire breast and armpit area. Check both breasts each month feeling for any lump, thickening, or hardened knot. Notice any changes and get lumps evaluated by your healthcare provider.
2) In Front of a Mirror
Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead.
Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match—few women's breasts do, so look for any dimpling, puckering, or changes, particularly on one side.
3) Lying Down
When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently in small circular motions covering the entire breast area and armpit.
Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.
Picture
Every person should know the symptoms and signs of breast cancer, and any time an abnormality is discovered, it should be investigated by a healthcare professional. 
Most people who have breast cancer symptoms and signs will initially notice only one or two, and the presence of these symptoms and signs do not automatically mean that you have breast cancer.
*This information was taken from the National Breast Cancer Foundation http://www.nationalbreastcancer.org/breast-self-exam
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