Do It Yourself - Breast Self-Exam (BSE)

Pam Stephan

Breast self examination (BSE) is to be performed in addition to an annual mammogram or a professional exam. Knowing your cyclical changes, what is normal for you, and and what the regular monthly changes in the breast feel like is the best way to keep an eye on your breast health.

Your breast is more than the part of you that fits into a bra cup, although that is where the largest part of the breast is. Breast tissue actually extends up under each arm towards the area of the armpit.

Difficulty: Easy

Time Required: 15 minutes a month

Here's How:

1. Make a regular date for your BSE
   If you are pre-menopausal: Set a regular time to examine your breasts a few days after your period ends, when hormone levels are relatively stable, and breasts are less tender.
   If you are already menopausal: (have not had a period for a year or more), you can pick a particular day of the month to do the exam and then repeat your BSE on that day of each month.
2. Do a Visual Exam
   In the privacy of your bathroom, strip to the waist and stand before a mirror. You will need to see both breasts at the same time. Stand with your hands on your hips and check the appearance of your breasts. Look at size, shape, and contour. Note changes, if any, in the skin color or texture. Look at the nipples and areolas, to see how healthy they look. Raise your arms over your head and see if your breasts move in the same way, and note any changes.
3. Do a Manual Check on the Nipples
   Still facing the mirror, lower both arms. With the index and middle fingers of your right hand, gently squeeze the left nipple and pull forward. Does the nipple spring back into place? Does it pull into the breast? Note whether or not any fluid leaks out. Reverse your hands and check the right nipple in the same way.
4. Stand and Stroke
   Raise your left arm overhead, and use your right-hand fingers to apply gentle pressure to the left breast. Stroke from the top to the bottom of the breast, moving across from the inside of the breast all the way into your armpit area. You can also use a circular motion, being sure to cover the entire breast area. Take note of any changes in texture, color, or size. Switch sides and repeat.

5. Recline and Stroke
   Close your bedroom door and place a pillow on the bed so that you can lie with head and shoulders on the pillow. Lie down and put your left hand behind your head, and use your right hand to stroke the breast abd underarm, as in Step 4. Take note of any changes in texture, color, or size. Switch sides and repeat.

Tips:

1. Doing Step 4 in the shower is easiest, as wet skin will have the least resistance to the friction of your fingers.
2. Mark your calendar, to remind yourself to be regular about the BSE. This is a good way to prevent a panic attack, if you get off-schedule and find a normal cyclic change. Know your regular, normal changes.
3. Stay relaxed and breathe normally, because becoming tense will itself produce some knots.
4. Report any changes or unusual pain to your doctor or nurse practitioner. Keep a log of changes, if that helps you remember. Here is an overview on breast lumps.
5. Remember to have a regular clinical exam and a mammogram.

What You Need:

• A mirror which lets you see both breasts
• A pillow for your head and shoulders
• Privacy and time for your BSE

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