Breast self-examination (BSE) should be performed each month in addition to an annual mammogram or a clinical exam. Knowing your cyclical changes, what is normal for you, and what regular monthly changes in the breast feel like is the best way to keep an eye on your breast health.
Here is a step-by-step guide to BSE. It should only take you 15 minutes—once every month. All you will need is a mirror which lets you see both breasts, a pillow for your head and shoulders, and some privacy.
Hands on Hips
In 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.
Here’s what you should look for:
The size, shape, and contour. Check if see you any changes, in the skin color or texture. Look at the nipples and areolas to see how healthy they look.
Arms Over Your Head
Still standing in front of the mirror, raise your arms over your head and see if your breasts move in the same way and note any differences. Look at the size, shape, and drape, checking for symmetry.
Pay attention to your nipples and areolas to see if you have any dimples, bumps, or retraction. Look up toward your armpits and note if there is any swelling in your lower armpit area.
Stand & Stroke
Raise your left arm overhead and use your right-hand fingers to apply gentle pressure to the left breast. Then, 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. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Take note of any changes in the texture, color, or size. Switch sides and repeat.
Check Your 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 back into the breast?
Note whether or not any fluid leaks out. Reverse your hands and check the right nipple in the same way.
Recline & Stroke
Lie down and put your left hand behind your head. Use your right hand to stroke the breast and underarm, as you did earlier. Take note of any changes in the texture, color, or size. Switch sides and repeat. 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.
Keep It Regular
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 periods for a year or more), pick a particular day of the month to do the exam and then repeat your BSE on that day each month.
- Mark, your calendar to remind yourself to do your BSE regularly. This is a good way to prevent worry and find a normal cyclic change.
- Stay relaxed and breathe normally as you do your BSE. Becoming tense will produce some knots that you may mistake for something worrisome.
- Report any changes or unusual pain to your doctor or nurse practitioner. Keep a log of changes if that helps you remember.
- Remember to have an annual clinical exam and a mammogram.