Striving for Breast Health
Striving for Health
SELF-BREAST EXAMINATION:
In regards to your individual breast health it is important to know what is normal for you. Thus, below is a brief description of things to look for during your monthly self-breast examination (SBE).
Self-breast examination:
Visual inspection looking in mirror with arms down and hands on your hips
Visual inspection looking in mirror with arms down pressing hands into hips
Visual inspection looking in mirror with arms raised above your head
Palpation laying down on your back with breast being examined as centered as possible (not falling to the side); putting a pillow under the shoulder can help
Palpate in a consistent pattern every time; I personally like using the vertical up and down pattern
This should be seen as a CHEST EXAM and includes the tissue as high as the collar bone (clavicle), as low as the junction of the upper abdomen, as medial the cleavage area, as lateral as the side of the chest and also includes the underarm (axilla)
Palpation should include 3 levels of pressure:
Superficial – for findings in or just under the skin
Medium – for findings in the main breast tissue
Firm – for findings in the deep tissue next to the chest wall
In the visual inspection, it is not uncommon for women to notice that the breasts may not be symmetric and one is slightly larger than the other. As long as this is normal for you, it is okay. If the proportion of the difference changes or the size difference is new, then please report this to your doctor. Changes in weight (loss or gain) are benign factors that can contribute to a change. But, consultation with your doctor is recommended to exclude more concerning reasons.
Also, in the visual inspection it is important to notice dimpling or skin findings with positional changes. This is why I recommend pressing your hands on your hips and raising the arms as ways to accentuate skin changes that might not be readily evident otherwise. Additionally, with the arms up this allows for better visualization of the underside of the breast.
Palpation is primarily performed to feel for a mass, thickening, hardening or anything that feels different from the rest of the breast. Getting familiar with your “lumps and bumps” is key to detecting new changes that may be concerning. I have had many women who found their own cancers by this method, some that were not evident on the clinical breast examination by the doctor.
Self-breast examination is a good tool in the toolbox for assessing for breast lesions.
Perform monthly
Document on a sheet of paper so that you can recall any areas of concern
Initially, confirm your exam during or after you see your doctor (so that you and your doctor agree with the accuracy of the findings)
Ideally, perform a week or so after the start of your period (you will be less tender and has fewer hormone related changes)
Familiarity breeds confidence. Be your own breast expert.