How to Do a Breast Self-examination

How women feel about their breasts largely determines how they feel about themselves as women. Because of this, breast cancer and with it the thought of losing a breast generates more fear among women that almost any other single disease. This fear keeps the average woman at home for five or six months before she consults her doctor about a lump she has found in her breast. Not every lump, however, has to be a cancer. If fact, very few are. Even so, breast cancer is the most common form of cancer among women. For this reason, it is essential to be especially vigilant - and vigilance begins at home. Early detection depends, first and foremost, on regular monthly self-examinations. The more practiced you get at examining and feeling your breasts and the irregularities between them, the greater your chance of spotting a significant change at the earliest possible opportunity. Examine your breasts once a month just after your period has finished. Breasts undergo glandular changes through the menstrual cycle and many people find that their breasts are naturally lumpy and tender just before menstruation. If you have been through menopause, you should examine your breasts on the first day of each calendar month. Most breasts are naturally asymmetrical - the shape may be uneven, the nipples may point in different directions or one breast may be significantly higher or lower or larger or smaller than the other. Study your breasts to see whether any of these apply. The key to successful, less anxious breast examination is change, so you must be aware of what is normal for you. What to watch out for:     * A lump in the breast. Only a very small proportion of all lumps are cancerous, bit it is impossible to tell by feeling whether a lump in innocent or not. Only a doctor can decide whether or not this is the case.     * Any moles that have changed in sized, shape or color.     * Dimpling or puckering of the skin, an unusual prominence in the blood veins on either breast, or a retraction (drawing in of the skin tissue). Any of these many indicate the presence of a lump pressing on the ligaments inside the breast, this affecting the contour and appearance. Again only a doctor can decide whether or not this is the case.     * Inverted nipples. Some women have naturally inverted nipples, or, more rarely, one nipple may always have been inverted while the other one is not. If your nipples have always been this way, you have no cause for concern. Any situation, however, in which the nipple has recently become inverted, requires further investigation.     * A discharge coming from one or both nipples. Check for this by looking inside your bra before carrying out your monthly breast self-examination. Although a discharge is not uncommon when taking or, particularly, when coming off the contraceptive pill, just prior to menstruation, or after breastfeeding, when a small secretion may persist for some months, it should never be ignored, particularly if it is persistent, coming from one nipple only or is bloodstained. So consult your doctor and, in the meantime, do not squeeze or interfere with the nipples in any way. Consult your doctor also, if you have an ulcer or sore on the nipple that does not heal.     * Enlarge of inflamed lymph glands. The lymph glands surrounding the breast lie on the outer sides and run up towards the armpit. They are essential for regulating the body's fluid balance and for fighting off infection. Although they may enlarge quite naturally if you have an infection or before menstruation, you should see a doctor if the inflammation has not subsided after three weeks. 1. Start with a visual inspection.     * Stand in front of a large mirror with a good light placed to the side, not overhead. Now look at your breasts. If this is the first time you have carried out a breast examination, take the opportunity to note exactly how they look. 2. To help check the differences between the two breasts, place the hands on top of the head.     * Turn slowly to the left and the right. The crossways angle of the lighting should help you to spot any irregularities or dimpling in the skin surface. 3. Place you hands on your hips and press firmly down and inwards.     * This should tighten the pectoral muscle and help you to spot any dimpling. Then, keeping your hands where they are, lean forwards from the hips so that the breasts fall straight downwards and inspect them head-on. Look particularly for any tautness in the skin tissue, any change in the way the nipple is pointing, and for a nipple that becomes inverted on leaning over but everts itself naturally as you stand up again. 4. Lie down on a firm surface and place a folded towel or pillow beneath the shoulder of the side you examine first.     * This is especially important if your breasts are large, as the breast will then sit evenly on the chest wall. Feel each breast in turn with the opposite hand and, to begin with, keep your arm by your side. Feel with the flat surface of your middle three fingers, keeping them straight, but not tense, and the wrist flexible. The amount of pressure you exert should be firm enough for the skin surface to move with your fingers but not so firm that the natural texture becomes hard and lumpy if you press too hard. Press the breast tissue gently but firmly towards the chest wall, starting just above the nipple and tracing small circles radiating outwards in a spiral the whole way round the breast. Be particularly on the look-out for any fixed, hard lump that will not move away easily when you press the breast tissue between your fingers. Make sure that you feel every part of the breast, beneath as well as above. 5. Finally place your arm above your head so that the outer side of the breast is stretched and accessible.     * Repeat the examination and pay particular attention to the upper part of the breast which extends up into the armpit.