2. PERFORM THE BREAST SELF-EXAMINATION

Now that we've scared the holy beejeeses out of you, you're ready to perform that Breast Self-Exam (BSE). You should conduct it once a month at about the same time each month. If you are a menstruating woman with regular cycles, it's best to conduct the BSE the week (2-5 days) after your period ends, because that's the point in your cycle when your breasts will be the least tender. If you have an irregular menstrual cycle, are pregnant, or have gone through "the change," you should pick the same date each month for your BSE (maybe the same day you pay your bills, so you'll remember).

There are two basic steps to conducting a BSE: first you look at your breasts, and then you touch them.

Visual Examination
Tactile Examination

Visual Examination

During the first part of the BSE, the visual examination, you are looking for changes in each breast. So if your breasts have always been mushy, that's not a concern unless this is a new change. The changes you are looking for include:

  • Shape
  • Size
  • Contour or symmetry (is there a difference in the level between your nipples? Do both breasts look symmetrical?)
  • Skin discoloration or dimpling
  • Bumps/lumps – NOTE: normal lumpiness, like in the week before and of your menstrual cycle, will appear as very small and separate lumps like the texture of an orange.
  • Sores or scaly skin
  • Discharge or puckering of the nipple

Stand in front of a mirror and look for the above changes in your breasts (from both a frontal and profile view) in 3 different positions:

  1. With your arms up behind your head
  2. With your arms down at your sides
  3. Bending forward
    • with your hands on your hips and shoulders turned in
    • with your arms relaxed hanging in front of you

Tactile Examination

Don't be shy, this is the part of the examination when you need to feel your breasts for any changes. Whether your boobs have been compared to melons or mosquito bites, the examination is the same. The only exception is that large breasted-women should be sure they see and feel the entire breast and surrounding region, while very thin women should figure out whether the hard lump they've been feeling is just a rib bone or something of concern.

Begin by looking for the changes listed above while standing up. Some women find it useful to do this part of the BSE in the shower, since soap or bath gel will aid in the ease of feeling your breasts. You can get a free BSE shower card from the American Cancer Society at 1-800-ACS-2345.

The first thing you have to do is pick a pattern. Not like 8th grade Home Economics class when had to choose between the pattern for sewing the duffel bag or the satin lips pillow. For the BSE, you need to pick a pattern to feel your breasts and surrounding areas, which include:

  • the breast itself
  • between the breast and underarm
  • the underarm itself
  • the area above the breast up to the collarbone and across to your shoulder

It is important to check surrounding areas because breast cancer may be found in the lymph node tissue around your breast and underarm.

You use the pads (where your fingerprints are) of your three middle fingers on your right hand pressed together flat to check your left breast, and do the opposite for the right breast. You should press on your breast with varying degrees of pressure:

  • light (move the skin without moving the tissue underneath)
  • medium (midway into the tissue)
  • hard (down to the ribs "on the verge of pain")

When using any of the 3 patterns, you should always be using a circular rubbing motion (in dime-sized circles) without lifting up your fingers.

Patterns:

1. Spiral (concentric circles): begin with a large circle around the perimeter of your breast and make smaller and smaller circles as you work your way toward the nipple.

2. Pie shape wedges: pretend your breast is divided into sections like pieces of a pie, begin in the nipple area and feel your breast in a small circular motion within one pie shape section, then move on to the next wedge starting in the nipple area again.

3. Up and down: pretend your breast is divided into vertical stripes, begin on one side and feel your breast in a small circular motion up and down in a zig zag pattern.

Then repeat the process for the other breast.

Once you've performed the tactile examination while standing up in front of a mirror, you should do the whole examination again, this time while lying down. Here's how to do so:

  • Put your left arm behind your head and use your right hand to examine your left breast.

  • Put a small pillow or towel under your left shoulder to aid you.

  • Again, use the pads of your 3 fingers of your right hand to check your left breast in the pattern of your choice (spiral, pie shape wedges, or up and down).

  • Be sure to always use the same pattern (it's the best way to know if there are changes).

  • And again, don't forget to feel your breast using light, medium, and hard pressure.

  • After you're finished, you must repeat the procedure again for your right breast.

Recently, a product called the B-D Sensibility Breast Self-Examination Pad has been put on the market. These pads supposedly help your fingers "glide" over the breast more easily. Some women prefer them, and some don't. If you're not currently experiencing any discomfort performing your BSEs, then don't bother, but if you are experiencing discomfort, then try 'em out and see if they help. It currently costs about $27 for a box.

Illustrations proivided by Julie Yu Chin Liu and are 2000, SoYouWanna.net, Inc.