Breast Self-Examination (BSE)

Women may perform breast self exams to help detect changes in their breasts to call to their physicians' attention. Performing regular breast self exams can help women become familiar with the individual characteristics of their breasts and notice any changes.

In recent years, organizations such as the American Cancer Society have changed their positions, no longer recommending that women perform self exams on a monthly basis. This decision was made after several studies revealed that the exams do not increase the chances that women will survive breast cancer. Despite the change in position, the American Cancer Society and other organizations suggest that self exams can be performed to help detect changes in the breasts to call to a physician's attention. Women who perform self exams should consult a healthcare professional to determine how to correctly perform the exam. If women learn to perform BSE correctly, they can help detect changes and bring them promptly to a medical professional. Finding a breast cancer tumor when it is smaller improves the chances of saving a breast by avoiding a mastectomy, and may reduce the need for chemotherapy.

It is important to remember that mammography is still the gold standard for early detection of breast cancer. Many cancer organizations, including the American Cancer Society, recommend that every woman 40 or older should have a mammogram every year. Unfortunately mammography misses 10% of cancers. So, it is still important for women to have their breasts examined on a regular basis by a healthcare professional, and perform monthly breast self-exams.

Click on one of the links below for more specific information on how to perform BSE or for additional resources.

• Click Here to Learn How to Perform Breast Self-Exam
• Click Here to View Breast Self-Examination Video
• Additional Resources on Breast Self-Exam and References

Introduction to Breast Self-Exam

Regularly examining her own breasts allows a woman to become familiar with how her breasts normally look and feel and can help her more readily detect any changes that may occur. Many women naturally have some lumpiness and asymmetry (differences between the right and left breast). The key to the breast self-exam is to learn how to find changes in the breasts that persist over time.

Many women do not know how to perform breast self exams properly. Performing BSE incorrectly can be almost as bad as not doing the exam at all since it can give women a false sense of security. After reading these sections on BSE, women should discuss any questions they might have about BSE techniques with their physicians and ask him or her to demonstrate how to perform BSE during the clinical breast exam portion of the physical exam.

When to Perform Breast Self-Exam

Menstruating women: Hormonal changes due to the menstrual cycle may make the breasts more lumpy or swollen. Women who are menstruating should perform breast self-exam from a few days to about a week after menstruation (period) has ended, when breasts are usually less tender or swollen.

Women who are no longer menstruating: should do their BSE on the same day every month. Try to pick a day that is easy to remember, such as the first or fifteenth of every month, and make that the day each month for breast self-exam.

Women using oral contraceptives: are encouraged to do their BSE each month on the day they begin a new package of pills.

Breast Changes and Warning Signs To Watch for During Breast Self-Exam:

• Any new lump or hard knot found in the breast or armpit
• Any lump or thickening that does not shrink or lessen after your next period
• Any change in the size, shape or symmetry of your breast
• A thickening or swelling of the breast
• Any dimpling, puckering or indention in the breast
• Dimpling, skin irritation or other change in the breast skin or nipple
• Redness or scaliness of the nipple or breast skin
• Nipple discharge (fluid coming from your nipples other than breast milk), particularly if the discharge is bloody, clear and sticky, dark or occurs without squeezing your nipple
• Nipple tenderness or pain
• Nipple retraction: turning or drawing inward or pointing in a new direction
• Any breast change that may be cause for concern

If any of these changes or other abnormalities are noted, women should see their physicians as soon as possible for clinical evaluation. However, it is important to note that in the majority of cases (80%), breast lumps and changes are not cancerous. Therefore, women should not allow their fear of breast cancer to keep them from visiting their physician if a lump or change is found.

Women with Normally Lumpy Breasts

Even if a woman has normally lumpy breasts (typically called fibrocystic breasts), she can still learn the usual pattern of lumps and then point out new or unusual lumps to her physician. Lumpy breasts or breasts with benign (non-cancerous) masses or cysts can be more difficult to examine. In fact, without knowledgeable direction from the patient, it may be more difficult for a physician to differentiate between a new mass and a stable lump. If a woman’s breasts are normally lumpy, she should note how many separate lumps she feels and their corresponding locations when performing self-exams. Then, during subsequent exams, she should check for any changes, particularly an increase in the size of lumps that persist after her period. Any changes should be reported to a physician or healthcare provider.

Breast Examination During and After Pregnancy

Many women continue to perform breast self exams during pregnancy. Clinical breast exams should be performed by a healthcare professional on a monthly basis during pregnancy. It is especially important that a clinical breast exam be performed during the first doctor visit of the pregnancy, before the breasts go through significant physiologic changes. Some changes or lumps are more difficult to evaluate once the breasts have enlarged and become more nodular.

 Click here to learn more about pregnancy and breast cancer.  

Click here to learn how to perform breast self-exam (BSE).

Updated: May 17, 2009