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Healthy Women's World

The Breast Self Exam (BSE)

Breast health is important to the physiological and psychological health of both men and women. Therefore, a program of "preventive" care that includes self examination is crucial to detecting breast changes and early signs of breast cancer before symptoms progress. Research suggests that a majority of women do not conduct regular self exams.

Regular breast self examination is one of the best ways of protecting yourself against breast cancer. Breast cancer cannot be prevented, but treatment is far more successful when it is detected early. By learning to do breast self exams, you increase the chances of detecting an abnormal lump while it is still easily treatable.

When Should the Examination Be Conducted?
One purpose of a breast self exam is to get to know the way each breast normally feels. This allows easier detection of abnormal lumps that may be cancerous, and irregularities such as cyst lumps, which are benign (non-cancerous). Some lumps are not visible with x-ray so the self exam is crucial.

The description "normal" changes in each phase of a woman's life. Therefore, doctors recommend that women begin performing self exams in their late teens when their breasts are fully matured.

Because physiological changes occur that are linked directly to the menstrual cycle, becoming familiar with normal changes before and after menses is important. Doctors commonly recommend that the breast self exam be performed monthly and at the same time in the menstrual cycle (i.e., two or three days following the cessation of flow). Women with irregular menstrual cycles should perform the self exam on the same calendar day each month.

During pregnancy and following childbirth the breasts change with the onset of milk production and its eventual ebb. For example, during lactation, milk-filled ducts may be felt.

With physiological changes in the mammary glands at menopause, health professionals recommend that the examination be conducted more frequently.

New American Cancer Society BSE Recommendations
The ACS was for many years a proponent of monthly breast self exams. They have recently taken a different stance on the issue for women in their twenties, however. According to their research the majority of young women do not perform regular breast self exams, either at all or correctly, and do not ask their doctor to show them how. The ACS now considers a monthly BSE for women in their twenties as optional rather than necessary.

How Do I Conduct a Breast Self Exam?

Breast self-exam.

To carry out the self exam, lie on your back, place a pillow under your right shoulder and place your right arm behind your head; this position will flatten the right breast. With your left fingers together and extended, move the three middle finger pads in tiny circles (palpate) across the gland counterclockwise covering the entire region. Feel for cyst lumps.

Repeat twice using a different pressure with each complete coverage. Vary from light pressure to deep pressure. Extend the area of coverage to the armpit, collarbone and shoulder.

Alternate patterns of feel may be used as long as the entire region is covered. You may use longitudinal lines (in the direction of head to foot) or radial lines from the outer margin to the nipple and back to the margin.

Finish the breast self exam by gently squeezing the nipple and checking for a discharge. Finally, repeat this entire examination in the left breast.

Sexual partners may also perceive changes. These should be confirmed with a self exam.

Resources National Library of Medicine. (updated 2004). Breast lump self exam. MedlinePlus Medical Encyclopedia.

Susan G. Komen Breast Cancer Foundation. (nd). How to do breast self-exams (BSE).

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