Learn what breast changes to look out for and how often to check.
Breast self-exams (BSE) are a DIY test that women can use to look at and feel their breasts to check for anything abnormal.
While BSEs aren’t as largely recommended as a screening tool for breast cancer as they used to be, they’re still an important way to get to know your breasts and learn what’s normal for you so you can detect anything out of the ordinary.
“There was a time decades ago where we recommended women do breast self-examinations every month; we have since moved away from making that recommendation,” says Brenda Panzera, MD, an oncologist at Lenox Hill Hospital in New York City. “Though we will discuss with women how to do a breast self-examination so that they have breast self awareness.”
Here’s Dr. Panzera’s step-by-step guide on how to do a breast self-exam:
Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
Here's what to look for:
- Breasts should be their usual size, shape, and color.
- Breasts should be evenly shaped without visible distortion or swelling. If you do find that your twins aren’t perfectly symmetrical, don’t panic. Here are good reasons why your breasts may be uneven.
If you see any of the following changes, the could be potential signs of breast cancer, so bring them to your doctor's attention:
- Dimpling, puckering, or bulging of the skin
- A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
- Look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).
- Redness, soreness, rash, or swelling
Step 2: Now, raise your arms above your head and look for the same changes.
Step 3: Next, lie down either on the bed or on the floor, placing one arm over your head (place the arm over your head of the breast that you’ll be examining). “So for example, she would place her right arm over her head if she is going to be examining her right breast. And with her left hand, she would begin the breast examination,” says Dr. Panzera.
Start at the top of the breast, and with circular motions of the balls of your fingertips, make concentric circles until you reach the nipple area. When you get to the nipple area, press the nipple between the first two fingertips to see if there’s any nipple discharge, says Dr. Panzera.
Cover the entire breast from top to bottom, side to side—from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Follow a pattern to be sure that you cover the whole breast.
“We typically recommend that women start all the way up at the collarbone, because we have breast tissue that extends all the way up there, although we don’t think of that,” says Dr. Panzera. “We recommend that they also examine all the way up to the arm pit, because we have breast tissue that extends into the armpit. It extends all the way to the middle of the chest and the sternum, and all the way down to the top of the abdomen.”
Step 4: Finally, stand up and repeat Step 3. “We would also recommend that women do the same while standing, because when they stand the breast tissue falls differently,” says Dr. Panzera. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so you might want to do this step in the shower.
“It should only take about 15 minutes or so to do a breast examination,” says Dr. Panzera.
Try to get in the habit of doing a breast self-examination regularly to familiarize yourself with how your breasts normally look and feel. It’s best to examine yourself several days after your period ends, when your breasts are least likely to be swollen and tender. If you no longer have periods, choose a day that's easy to remember, such as the first or last day of the month.
“Doing breast self-exams does not replace a mammogram, [which] is really the screening modality that’s recommended,” says Dr. Panzera. “However, there are many women who are diagnosed with breast cancer who will be the first to notice that something has changed.”
If you do find a lump, don’t panic. Most women have some lumps or lumpy areas in their breasts. In the United States, only 20 percent of women who have a suspicious lump biopsied turn out to have breast cancer, according to the Johns Hopkins Breast Cancer Center.
Still, when it comes to breast cancer, you can never be too cautious. “Anything that a woman discovers that they feel is different or unusual, or they question or they’re concerned about, should really immediately be brought to the attention of a healthcare provider,” says Dr. Panzera.
Now that you’ve gotten to know your breasts a little better, test your boob smarts with our breast quiz.
Dr. Panzera is a clinical instructor in hematology and oncology at the Mount Sinai School of Medicine, and attending physician at Mount Sinai and Lenox Hill Hospitals.
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A breast self-exam is when a women
does her own breast examination to
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assess whether or
not there are any abnormalities present.
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There was a time, decades ago,
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where we recommended that women do
breast self-examinations every month.
00:00:25,000 --> 00:00:28,450
We have since moved away from
making that recommendation,
00:00:28,450 --> 00:00:33,310
though we will discuss with women how
to do a breast self-examination so
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that they have breast self-awareness.
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In case there are any changes, they
will be familiar with their breasts and
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know when to bring something to
the attention of a healthcare provider.
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It would start by a woman
placing her hands on her hips,
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undressed from the waist up and
looking in the mirror.
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They are looking for
symmetry of the breast.
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They're looking at their skin to be
sure that there are no skin changes.
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Redness, darkening, nipple changes,
dimpling of the skin,
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swelling of the skin,
retraction of the skin or nipples.
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The woman would then raise
her arms over her head,
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again looking in the mirror for
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She would then lay down either
on the bed or on the floor,
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placing one arm over her head.
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She would place the arm over her head of
the breast that she would be examining.
00:01:27,080 --> 00:01:30,330
So for example, she would place
her right arm over her head if
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she were going to be
examining her right breast.
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And with her left hand,
she would begin the breast examination.
00:01:37,390 --> 00:01:41,730
We typically recommend that women start
all the way up at the collarbone because
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we have breast tissue that
extends all the way up there,
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although we don't think of that.
00:01:46,100 --> 00:01:48,870
We recommend that they also
examine all the way up
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under the armpit because we have breast
tissue that extends into the armpit.
00:01:53,250 --> 00:01:57,280
It extends all the way to the middle
of the chest and the sternum, and
00:01:57,280 --> 00:02:00,430
all the way down to
the top of the abdomen.
00:02:00,430 --> 00:02:04,170
And they would start at the top, and with
circular motions of the balls of their
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fingertips, making concentric circles
until they reach the nipple area.
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When they get to the nipple area,
they should then press the nipple between
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the first two fingertips to see
if there's any nipple discharge.
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After they've completed one
side of the breast examination,
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they would go on to then do
the same on the other side.
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We would also recommend
that women do the same
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when standing because when they stand,
the breast tissue falls differently.
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It should only take about 15 minutes or
so to do a breast examination.
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Doing breast self-exams does
not replace a mammogram.
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A mammogram is really the screening
modality that's recommended.
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However, there are many women who
are diagnosed with breast cancer who will
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be the first to notice that
something has changed.
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Anything that a woman discovers
that they feel is different or
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unusual, or they question,
or they're concerned about,
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should really immediately be brought to
the attention of a health care provider.
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Breast Cancer Screening (Beyond the Basics). UpToDate. (Accessed on June 7, 2018 at https://www.uptodate.com/contents/breast-cancer-screening-beyond-the-basics)
Breast Biopsy. Johns Hopkins Breast Cancer Center. (Accessed on June 7, 2018 at https://www.hopkinsmedicine.org/breast_center/treatments_services/breast_cancer_diagnosis/breast_biopsy.html)