Breast Exams

Why do breast exams?

Breast exams are an important screening for breast cancer. Regardless of your age, it is important to be familiar with your breasts so that any changes are easily detected. If you have a family history or other reason to be concerned, it's important to discuss a plan for screening with your health care provider. In the absence of extra concerns, self-exams can be performed at any age to promote breast familiarity. Women ages 20-39 are recommended to continue self-exams as well as have a clinical breast exam every 1-3 years. This is performed by a health care provider. Along with this, a PAP test is recommended every 3 years starting at age 21. After age 40, yearly mammogram are recommended along with a clinical breast exam.

How do I do a breast self-exam?

Brest self-exams are a 5-step process:

  1. Look at your breasts in the mirror with your shoulders straight and your hands on hour hips. Look for the following changes:
    1. Changes in size, shape, or color
    2. Uneven shape with dimpling, puckering, or bulging of the skin
    3. Changed position of the nipple or inverted nipple (pushed inward)
    4. Redness, soreness, rash, or swelling
  2. Raise arms above head and look for the same changes.
  3. Look in mirror for any nipple discharge (watery, milky, yellow, or bloody).
  4. Lay down and feel your breasts, right hand for left breast, left hand for right breast. Use firm, smooth touch with finger pads, keeping fingers flat and together, using a circular motion the size of a quarter. Palpate breast from top to bottom, side to side, from your collarbone to abdomen, and armpit to cleavage. Cover the whole breast, usually in an up and down pattern, being sure entire breast is examined. Palpate more firmly where tissue is thicker, making sure you can feel rib cage underneath the tissue.
  5. Repeat same sequence when sitting or standing. This is often easier in the shower when skin is wet and slippery.

Any concerns after self-exam should be discussed with a health care provider for further evaluation. Early intervention is crucial.

What other options are there for breast exams?

Breast self-exams are a 5-step process:

If there are concerns with the breast self-exam, or if a woman is 20 years old or older, further evaluation is recommended. Here is a brief description:

Clinical breast exam: This is similar to a self-exam, but conducted by a health care provider. The health care provider palpates the breast looking for lumps of other changes. Based on history and exam, this may be recommended after age 20 every 1-3 years.

Mammogram: This is an x-ray of the breast and is recommended every year after age 40, or earlier if there are family history or clinical concerns. This is considered one of the best ways to find breast cancer early.

Other tests may be recommended by a health care provider such as ultrasound or biopsy if there are concerns. Most often, results of these tests are reassuring, but it is crucial to explore any concerns as early as possible. Call the health center to make an appointment to discuss any concerns you may have.

http://www.breastcancer.org/symptoms/testing/types/self_exam/bse_steps

http://www.cdc.gov/cancer/breast/basic_info/screening.htm

https://www.mdanderson.org/publications/focused-on-health/february-2015/FOH-women-screening-exams.html