Breast Self-Exam and Early Detection

Because more than 75 percent of malignant masses are found by women themselves, medical professionals encourage women to make breast self-examination part of their monthly routine.

Women should start monthly examinations as soon as their breasts develop, or at the latest by age 20. Because breasts tend to become firmer and fuller a few days prior to the menstrual cycle, pre-menopausal women should perform self-breast examinations about 10 days after their cycle begins. Post-menopausal women should examine their breasts on the same day every month. Women who have had breast surgery also should perform self-breast examinations on a regular basis. If you've had a mastectomy, examine the incision for firmness or discoloration and search for lumps above the collarbone and in the armpit.

Women who have had breast cancer sometimes fell they are immune to developing a second malignancy in the other breast. This is not the case. In fact, the risk can be quite high with certain types of breast cancer. Discuss your risk and any changes you detect with your doctor.

Self-Breast Examination

1. Stand before a mirror. Inspect your breasts for anything unusual, such as any discharge from the nipple, or a puckering, dimpling or scaling of the skin. If you've had a mastectomy, inspect the scar for new swelling, lumps, redness or color changes.

2. Watching closely in the mirror, clasp your hands behind your head and press your hands forward. Next, press your hands firmly on your hips and bow slightly toward the mirror as you pull your shoulders and elbows forward.

3. Raise your right arm. Using three or four fingers of your left hand, explore your breast firmly, carefully and throroughly. Beginning at the outer edge, press with the flat part of your fingers moving in small circles slowly around the breast. Gradually work toward the nipple. Be sure to cover the entire breast. Pay special attention to the area between the breast and underarm, including the underarm itself. Feel for any unusual lump or mass under the skin.

4. Gently squeeze the nipple and look for a discharge. Raise your left arm and repeat Step 3 with your right hand. Lumps, thickening and puckering of the skin are changes you should bring to your doctor's attention.

5. Repeat Steps 3 and 4 lying down. Lie flat on your back, raise your right arm over your head and place a pillow or folded towel under your shoulder. This position flattens the breast and makes it easier to examine. Use the same circular motion described earlier. Repeat on the left side.

Some of our patients share their stories:

My Right Breast

In February 2000, I was diagnosed with breast cancer. The only risk factor that seemed to fit was that I had had my children in my 30s. It is devastating to be told you will lose your breast that is coded with such intimate history that is often left unspoken. The frightening thought that this had been growing without my knowing and I was too young to be screened so I could be dead if I hadn't felt a tiny lump and felt intense pain.

Five months after my mastectomy I had my breast reconstructed from muscle and skin taken from my stomach and even though it was excruciating for a couple of weeks I have a warm breast there and it has made me much happier about the future.

It's only 2 months since my operation but I feel that life is beginning again and I'm not a victim but a survivor. My plastic surgeon is really gorgeous and I have a lot to thank him for.

I discovered that I had DCIS during my yearly mammogram...no lumps, pain, or other tell-tale evidence. A steotactic biopsy revealed malignant cells. The diagnosis indicated a mastectomy, as the calcifications had multiplied throughout the ducts down to the nipple. Subsequently, I had a total breast removal, utilizing a skin-saving technique, and simultaneous reconstructive surgery with a tram flap replacement. I awoke with a new breast, and simultaneous reconstructive surgery with a tram flap replacement and I believe that fact kep me from emotional collapse. I have had minor adjustive surgery and am now ready for the new nipple. My breasts are almost identical due to two surgeons with great skills. I have had digestive problems due to the surgery that have not yet been properly diagnosed and corrected. But, I only took a month off from work and have been able to resume exercising. Hooray!