How to Do a Breast Cancer Self-Exam
Key takeaways:
Screening mammograms are the best way to diagnose breast cancer in the earliest stages. Early detection has important implications for treatment and prognosis.
Expert organizations have different recommendations about the role of breast self-exams in cancer screening. But they all agree that self-exams promote overall breast health awareness.
For women who choose to perform self-exams at home, there are specific techniques that make it easier to detect a possible cancer.
Table of contents
Breast cancer is the second most common type of cancer in women. About 1 in 8 women will be diagnosed with the disease in their lifetime. Routine mammograms are the best way to detect breast cancer in the earliest stages. But self-exams are also an important part of breast health. This starts with knowing your body and what's normal for you.
We’ll walk you through the best way to examine your breasts for any abnormal lumps or bumps. This way you don’t have to rely solely on yearly mammograms to know if something should be checked out.
The importance of early detection
Mammograms can detect breast cancer in the earliest stages and often before anything feels abnormal in the breast. But that doesn’t mean it's not important and helpful to perform regular breast self-exams at home. In fact, approximately 40% of women detected their breast cancer this way.
Early detection of breast cancer is important — clinical evidence has shown that early treatment can improve chances of survival. In addition, an early diagnosis often translates to a shorter, easier treatment course. For example, surgery and radiation can sometimes treat a small tumor without the need for chemotherapy that some later-stage tumors may require.
Self-exams are a great tool to help with early detection. But they shouldn’t be used alone. It’s important to make sure you’re getting your mammograms in addition to performing self-exams.
How to perform a self-exam one step at a time
There are many different ways to perform a self-exam. We used information from experts at Breastcancer.org and the National Breast Cancer Foundation to create a simple step-by-step guide to help walk you through the process.
No matter which approach you take, it’s important to be thorough and systematic. It’s also vital to examine both the breast and the areas that surround it to feel for lumps or abnormal lymph nodes.
Step one
The first step is to feel your breasts with your fingers. The shower is a convenient place to start. It provides a space free from distraction — and clothing — so you can familiarize yourself with your body. This step involves exploration with your hands, so the water from the shower helps to make your breasts slippery and easier to feel. Here are the initial steps:
Start by using your left hand to cup your right breast.
Using your right hand, begin to move your fingers in small, circular motions over the entire surface of the cupped breast. Try to identify any differences in the density of each breast. It’s perfectly normal to have breasts of slightly different sizes, but you should note any other differences.
Increase the pressure in your fingers so you can get to deeper tissues in and around the breast, including your armpits. Take note if you feel any soreness, lumps, or areas of swelling as you feel the deeper layers of the breast and surrounding areas.
Be sure to feel around the nipple, too. Start from the center and circle outward.
Once you are done with one side, perform the same action on the other.
Make sure to cover the entire breast from the very top to the bottom, as well as left to right. You can use different techniques to perform the exam. But it’s very important to cover both breasts and the surrounding tissues as thoroughly as possible.
Step two
For this step, you’ll do a visual examination of your breasts. So it’s important to use a mirror that’s big enough so that it shows your entire upper body. Follow these steps:
Stand up straight, and face the mirror with your hands resting on your hips.
Look at your breasts to see if you notice anything different about their size, shape, or color. Pay close attention to check for any lumps in one or both breasts, and look for puckering of the skin. Also scan for rashes or redness on skin near the breast.
Raise your hands over your head. When you do this, check for any discharge that comes from your nipples or differences in the size or shape of the nipples.
Step three
The final step of the exam is to feel your breasts while lying down. This can help you detect changes that may have been difficult to feel while standing up. Here are some tips:
Find a soft, level surface and lie down. A bed works well.
Place your left arm under your head, with your elbow relaxed out to the side.
As in step one, use your right hand to feel your left breast using the same circular motions. Also examine your armpits and the areas surrounding the breast.
Perform the same actions on the right breast, using your left hand.
To sum up, be sure to check for any abnormalities in the breasts, following the guidance from steps one and two.
All three of these steps are important to fully examine your breasts. Using visual and tactile exploration in different positions can help you pick up on any changes in breast size or density from different angles.
How often do you need to do self-exams?
Experts all agree that mammograms are the most effective tools for breast cancer detection. But there’s some disagreement about whether a clinical breast exam or self-exam should be part of this screening process. This controversy and differing opinions among experts boils down to two points:
1) As mammogram technology improves, there isn’t strong evidence that breast exams further improve detection rates.
2) It’s common to feel normal lumps on breast exams. So there’s some concern that breast exams could lead to unnecessary testing of non-cancerous lumps.
The American College of Obstetricians and Gynecologists (ACOG), for example, recommends that yearly clinical breast exams be an option for women starting at age 25, if they so choose. On the other hand, the American Cancer Society (ACS), doesn’t recommend breast exams as a screening tool.
For women with average (not high) risk for breast cancer, both societies recommend that mammogram screening can be offered starting at age 40. For those at higher risk for breast cancer, their screening should start at age 30.
Women considered high risk include those with a family history, such as mothers who had breast cancer and those who tested positive for the BRCA1/2 gene mutations. Other factors like ethnicity, age, and weight can also influence your risk.
While self-exams aren’t formally recommended for women of average risk, both the ACOG and ACS recommend that all women should be counseled on breast “self-awareness.” This means being familiar with how your breasts normally look and feel, and seeing a provider when something seems different.
When should you do self-exams?
If you perform home self-exams, it’s important to take your monthly cycles into consideration. Hormonal changes during menstruation can impact breast size and density. Around the time of menstruation, the breasts are most tender and can feel lumpier. So it’s best to examine your breasts 7-10 days following menstruation each month.
Many women use apps or calendars to track their menstrual cycles. So you can take that same approach to get yourself on a regular self-exam schedule.
If you have irregular cycles or don’t experience menstruation, try to pick something easy to remember, like the first or fifteenth of the month. Then get it scheduled, and set a reminder for each month.
It’s also important to keep in mind that your body and breasts change with aging due to hormonal fluctuations. Menopause and other changes in reproduction, such as the use of certain times of birth control, impact breast health.
Self-exams in pregnant or breastfeeding women
Hormones associated with pregnancy and lactation can affect both the size and shape of the breast. Lactation can also naturally lead to lumps in the breast or abnormal discharge. This can make it harder to detect breast cancer on exams. For this reason, many people wait until after pregnancy to schedule a mammogram. But this can increase the risk of a delayed breast cancer diagnosis.
If you think you’re pregnant, or you’re breastfeeding and feel a lump during a self-exam, it’s best to consult with your provider rather than wait.
What to do if you find a lump
If you find any abnormalities from a self-exam, don’t panic. Lumps and bumps in the breast are common and can be normal. The next step is to schedule an appointment with your primary care provider. They can examine your breasts and help you figure out if more testing should be done.
The bottom line
While breast cancer can't always be prevented, early detection is within your control. Regular screening mammograms are the best way to detect breast cancer in the earliest stages. But breast self-exams can also be helpful. It’s important to be familiar with your breasts so that you can tell if there’s a lump that feels abnormal. If you notice any changes in the feel or appearance of your breasts, reach out to your provider. They can help determine if more testing should be done.
Why trust our experts?
References
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American Cancer Society. (2021). How common is breast cancer?
American College of Obstetricians and Gynecologists. (2021). Breast cancer risk assessment and screening in average-risk women.
Breastcancer.org. (2019). Breast self-exam.
Chen, L., et al. (2012). Bloody nipple discharge is a predictor of breast cancer risk: A meta-analysis. Breast Cancer Res Treat.
National Breast Cancer Foundation. (2020). Breast self-exam.
National Cancer Institute. (2018). Breast changes and conditions.
Roth, M.Y., et al. (2011). Self-detection remains a key method of breast cancer detection for U.S. women. J Womens Health (Larchmt).
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