How to perform breast self-examination

Regular breast examination is an important feature of women’s health. This importance increases from age 30 onwards when periodic physician-performed clinical breast exams should supplement any breast self-examination (BSE) routines. It is advisable for women over 50 to have yearly screening mammograms in addition to yearly clinical breast exams and monthly breast self-exams.

BSE, done once a month, in shower or bath, can be an effective self-screening technique. The best time for BSE in women who are still having periods is approximately one week after their period. Before the period, the breasts can be tender and lumpy and are not as easy to ‘read’ as afterwards.

Every woman should know the texture and consistency of her own breasts and what her breasts feel like as she goes through her monthly cycle. BSE should be done in a relaxed place like in the bath or the shower. Wet soapy hands are ideal, using the flat part of the three middle fingers rather than the fingertips.

Breast cancer usually presents itself as a lump in the breast. Nine out of ten breast lumps are benign, however, and not cancerous. The experts recommend three different patterns of inspection (see figure). The spiral pattern starts at the outer edges of the breast making concentric rings ending up at the nipple. A vertical pattern of straight lines up and down from one side of the breast to the other is also recommended, as well as mentally dividing the breast into wedges. Each of these patterns should be included in a thorough test. Also check by feeling the area around the breast from the armpit to collar bone and inspect the nipple.
breastdiagrams

BSE also includes a visual check in front of a mirror under good visibility conditions. With arms at the sides, check for change in breast size, shape or position and dimpling or puckering of the skin. Also watch for any apparent tethering which manifest itself as the skin of the breast pulling inwards when arms are lifted or chest muscles flexed. Other abnormalities which should be reported to your doctor are inversion or retraction of the nipple, eczema of the nipple area (unless it is part of a pattern of eczema elsewhere) and red, black or brown or sticky clear discharges. A clear, yellowish or greenish discharge is almost always innocent.

Remember that since most lumps are benign, you should not be afraid to report to your doctor any abnormalities you discover. Cancer of the breast is a curable disease if detected and treated early.

Further details on detection and prevention of cancer – www.cansa.org.za