Breast self-exam (BSE) is a technique that women can perform on themselves to become aware of what is normal for their breast tissue and notice if any changes occur. Any changes should be brought to the attention of a healthcare professional for further evaluation.
In the past, BSE was recommended as a screening tool. Screening techniques are designed to catch breast cancer in its earliest, and most curable, stages in hopes of reducing the risk of dying from breast cancer. However, data from two large population studies found that BSE was not beneficial as a screening tool. Results from these trials found that BSE did not reduce the mortality (death) rate. In addition, BSE led to more biopsies and diagnoses of benign (not cancerous) breast conditions.1,2 While BSE is no longer recommended as a screening tool for breast cancer, it is important for women to be familiar with what is normal for their breasts and alert their doctor if any changes are found.3
How to do breast self-exam
Breast self-exam consists of looking and feeling for changes. During the visual examination, the breasts should be examined while naked in front of a mirror. Start with your arms at your sides, then raise your arms up, touching your hands together overhead. Last, press the hands on the hips. At each position, notice how the breasts look, including the size and shape of them. Notice if the nipples are inverted (turned inward), and look for any dimples, puckering, or changes in the size or shape of the breasts (and if one breast suddenly appears abnormally different in size or shape from the other). (While it is normal for women to have one breast that is slightly larger than the other, any sudden change should be brought to the attention of a medical professional.)3
The second portion of BSE is examining your breasts by touch. Some women find this easiest to do while in the shower, while others prefer lying down to spread the breast tissue out on the chest. Using the pads of the fingers (not the tips of the fingers), feel the different layers of the breast tissue including the most superficial to the deepest. While breast tissue is often somewhat lumpy, any new, hard lump or swollen lymph nodes under the arm, or changes in the feel or appearance of the breast(s), should be reported to your doctor. Also, tell your doctor if your breast becomes red, swollen, scaly, or if you notice an unusual discharge from the nipple.3
The best time to do BSE is approximately 3-5 days after your period has started when the breasts are the least tender and lumpy. If you no longer get regular periods due to menopause, do BSE on the same day each month.4 Discuss with your doctor if you have any questions regarding BSE.
Benefits of breast self-exam
A significant number of women who are diagnosed with breast cancer find the first signs themselves, and BSE enables women to learn what’s normal for them, so they can notice when changes occur. It’s helpful to remember that most lumps are not cancerous, but it’s best to get any new changes checked by a doctor.3
Risks of breast self-exam
There are some risks of doing BSE, including anxiety if you find a lump and the financial and emotional cost of additional tests and procedures that may need to be done to determine if the lump is cancerous or not. Patients should talk with their doctor regarding the potential risks and benefits of BSE.3
Patients should discuss their individual screening plan with their doctor to determine the risks/benefits of screening options (such as mammograms), and to ensure they have the best plan for them as an individual.
Kösters JP, Gøtzsche PC. Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database Syst Rev. 2003;(2):CD003373. doi: 10.1002/14651858.CD003373. https://pdfs.semanticscholar.org/5ac9/43e0db77e31f83f13e63a75d5e8429d11dc2.pdf.
Breast cancer screening (PDQ) – health professional version. National Cancer Institute. Available at https://www.cancer.gov/types/breast/hp/breast-screening-pdq#link/_34_toc. Accessed 8/20/18.
Breast self-exam for breast awareness. Mayo Clinic. Available at https://www.mayoclinic.org/tests-procedures/breast-exam/about/pac-20393237. Accessed 8/20/18.
Breast self-exam. MedlinePlus, U.S. National Library of Medicine. Available at https://medlineplus.gov/ency/article/001993.htm. Accessed 8/20/18.