Breast Self-exams: Why, When, How

Physicians and the American Cancer Society recommend that all women over age 20 examine their breasts once a month.

They aren't trying to frighten you: Frequent self-examinations help you get to know how your breasts normally feel, and that could make recognizing a change much easier. The earlier you detect a problem, doctors say, the better your chances of successful treatment.

The good news is most breast lumps aren't cancerous. Only a doctor can tell for sure, though. Delaying a diagnosis of breast cancer doesn't change the facts -- it only worsens the outcome.

Physicians say the best time to do a self-exam is every month, two to three days after your menstrual period ends. If you have irregular periods, do the exam on the same date each month, the first or 10th, for example. Be aware that breasts may feel lumpy or tender during pregnancy, just before your period and if you take hormones. If you're on hormone treatment, ask your doctor for advice.

How to Do a Breast Self-exam

The Breast Cancer Information Service, a joint project of the Pittsburgh Breast Care Test Coalition, provided these guidelines:

1. Lie down on your back. Flatten your right breast by placing a pillow under your right shoulder. Place your right arm behind your head.

2. Use the sensitive pads (not tips) of the middle three fingers on your left hand. Feel for lumps using a circular, rubbing motion in small, dime-sized circles without lifting the fingers. Powder, oil or lotion can be applied to the breast to make it easier to glide your fingers over the surface and feel changes.

3. Press firmly enough to feel different breast tissues. Use three different pressures: light, moving the skin without jostling the tissue beneath; medium, pressing midway into the tissue; and deep, probing to the ribs or to the point just short of discomfort.

4. Completely feel all the breast and chest area up under your armpits, and up to and along the collarbones to your shoulders.

5. Use the same pattern to feel every part of the breast tissue. Choose the method easiest for you:

o Lines: Start in the underarm area and move your fingers downward little by little until they are below the breast. Move your fingers slightly toward the middle of your chest and slowly move them back up. Go up, down and across until you cover the whole chest and breast area.

o Circles: Beginning at the outer edge of your breast, move your fingers slowly around the breast in a circle. Move around the breast in smaller and smaller circles, gradually working toward the nipple. Be sure to check the underarm and upper chest areas, too.

o Wedges: Starting at the outer edge of the breast, move your fingers toward the nipple and back to the edge. Check your whole breast, covering one small wedge-shaped section at a time. Be sure to check the underarm area and the upper chest.

6. After examining your right breast completely, use the same method on your left breast with your right hand and a pillow under your left shoulder.

7. You may want to examine your breasts or do an extra exam while showering. It's easy to slide soapy hands over your skin, and to feel anything unusual.

8. You should also check your breasts in a mirror, looking for any change in size or contour, dimpling of the skin or a spontaneous nipple discharge.

This and other information about breast health can be found on the Internet. Look for World Wide Web indexes on women's health or breast health, or try one of these sites:

• Women's Health Issues (DoD initiatives), at http://www/ha.osd.mil/hmwhi2.html.
• Race for the Cure (locations, dates, pledge forms, survivors stories and related sites), at http://race4cure.lm.com/toc.html.
• National Breast Cancer Coalition, a grassroots advocacy effort in the fight against breast cancer, at http://www.natlbcc.org.
• 2 Chicks, 2 Bikes, 1 Cause, based on the Lifetime Television series and sponsored by the 2 Chicks Foundation, a nonprofit organization dedicated to creating breast health awareness, at http://www.2chicks.org.
• An In-depth Look at Breast Cancer, sponsored by St. Francis Hospital, Tulsa, Okla., at http://www.saintfrancis.com/look.html.