Breast cancer is one of the most common forms of cancer affecting women in the United Kingdom and in North America. Throughout your life you may have heard of the importance of conducting regular breast self-examinations to check for signs of breast cancer. While breast cancer self-exams can be done, physicians and health experts now advise women to increase their breast awareness.
What is Breast Awareness?
Breast awareness simply means becoming familiar with how your breasts normally look and feel and knowing what changes to look and feel for in your breast. This means to be aware of changes in the size of your breasts, changes in the nipples, nipple rash, nipple discharge, breast puckering or dimpling, lymph node swelling, breast pain, skin redness or breast lumps.
When to Start Breast Self-Exams
Health experts advise women to begin breast self-exams by the age of 20. Women should have a clinical breast exam by a physician every three years until the age of 40. After the age of 40, women should have a clinical breast exam and mammogram every year. It is recommended that women do a breast self-exam about a week after the first day of their period, when breasts are no longer swollen and tender due to hormonal fluctuations.
How to Conduct a Breast Self-Exam
Breast self examinations involve a visual inspection and physical examination.
A visual examination involves standing in front of a mirror with your arms hanging down and looking at your breasts to check for puckering, dimpling, changes in breast size and texture and if your nipples are inverted. The two other positions to check for these changes are with your hands on your hips and your hands raised up with your palms pressed together.
The physical examination is to check for lumps or any changes in the breast tissue. You can conduct the exam in the shower or lying down on a bed. There are two methods to conduct the physical examination, the clock pattern and the wedge pattern.
The clock pattern is where you envision the face of a clock on each of your breasts. You lie down with your left hand behind your head, and use your right hand to examine your left breast. Put your hand at top of the breast using your middle three fingers in the 12 o’clock position. Use your fingers in a massaging, clockwise motion to check for lumps. Then you move hour by hour, using the same motion and feeling for any changes in your breasts. After you have repeated one cycle, move your fingers closer to your nipple and repeat the process until you get to your nipple.
You should check both your left and right nipple for discharge by pinching with your fingers at 12 o’clock and 6 o’clock and at 3 o’clock and 9 o’clock. When you are done with your left breast, put your right hand behind your head and use your left hand to examine your right breast in the same fashion. Make sure to feel your lymph nodes under your armpit as well as areas around your breasts for any tissue changes.
The wedge method entails envisioning each breast as a pie divided into equal wedges. Lie down on a bed and place your left hand behind your head. Use your right hand to examine your left breast beginning at the top of your breast and working your way down to your nipple. Use your middle three fingers to massage firmly but gently from the top of the wedge to the bottom. Once you have completed the wedge, move your fingers to the next wedge going in a clockwise direction. For the opposite side, put your right hand behind your head and use your left hand to massage your right breast. Do not forget about checking lymph nodes under your armpit and tissue around your breasts. Examine your nipples for discharge.
If you are not comfortable with the clock or wedge methods, then you can use a simple sweeping technique with your three middle fingers. You begin at your collarbone and work in a clockwise direction from the outside of your breast towards the nipple. If you have larger or thicker breasts, use a walking motion with your fingers to feel for any lumps or changes. Do not forget to check your lymph nodes and nipples.
Detection of a Lump
If you find a lump in your breast, you should contact your doctor as soon as possible. Keep in mind that 80% of breast lumps are non-cancerous. More than 50% of women have what is known as fibrocystic breasts usually during their periods and menopause. Fibrocystic breasts are lumpy, painful and tender and develop when breast cells fill with fluid and form benign cysts in the breasts. These changes are attributed to hormone fluctuations during a woman’s menstrual period and menopause.
Pros and Cons of Breast Self-Exams
Breast self-exams in combination with clinical breast exams and mammography can reduce the risk of terminal breast cancer. By checking your breasts regularly you can identify a possibly cancerous lump and have it treated when the cancer is still in its early stages.
Breast self-exams by themselves do not reduce the number of people dying from breast cancer. Breast self-exams can miss tumors so it is important to have more than one method for screening for breast cancer. You may discover a lump and have an unnecessary biopsy conducted if the lump turns out to be benign.