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Breast Self-exam (BSE)

What Is a Breast Self-exam?

IMAGE A breast self-exam (BSE) is a step-by-step examination of your breasts that you do yourself. It is one tool that can be used to help detect changes in your breasts that may or may not be a sign of cancer. It is a way for you to notice any changes, lumps, or abnormalities in your breasts. It is also a chance for you to become familiar with what is normal for your breasts.
The American Cancer Society (ACS) recommends that all women aged 20 years and older talk to their doctor about the benefits, harms, and limitations of breast self-exams. While BSE continues to be widely promoted, there is no evidence showing a decrease in death among women who do these self-exams. Women can choose to do BSE regularly, occasionally, or never. However, even if you never do a step-by-step self exam, you should still be familiar with your body and report any changes to your doctor.
If you and your doctor decide you will do breast self-exams, here is the best way to go about doing it. Do your breast self-exam when your breasts are not swollen or tender. Follow these guidelines from the ACS:

Steps for a Breast Self-exam

  1. How to Perform a Breast Exam 4 Lie down with a pillow under your left shoulder. Place your left arm behind your head.
  2. How to Perform a Breast Exam 6 Use the finger pads of your right hand to feel for lumps in your left breast. Move the finger pads in little circles to feel for any lumps.
  3. Use varying levels of pressure to feel the breast tissue:
    • Light pressure to feel tissue beneath the skin
    • Medium pressure to feel deeper tissue
    • Firm pressure to feel tissue near the chest and ribs
    A firm ridge in the lower curve of each breast is normal.
  4. How to Perform a Breast Exam 5 Move around the breast using a up and down pattern. Check the whole breast area—from the bottom of the breast up to the collar bone, as well as from the chest bone to the underarm.
  5. Repeat the exam on your right breast, using the finger pads of your left hand.
  6. How to Perform a Breast Exam 2 Stand in front of a mirror so that you can clearly see both of your breasts. Press your hands firmly on your hips. Look for any changes in the size, shape, or contour of the breasts. See if the skin (including the nipple) has any puckering, dimpling, scaliness, or redness.
  7. Lastly, check each underarm while you are sitting or standing. Raise your arm a little so that you can feel the underarm area. (Note: If you raise your arm too high, it will be harder to feel this area.)
Remember that breast changes are not always due to cancer. But, if you do notice lumps or other abnormalities, call your doctor right away.
If you are unsure as to whether you should do BSE, talk to your doctor about the benefits and risks the self-exam.

RESOURCES

American Cancer Society http://www.cancer.org/

Womens' Health.gov http://www.womenshealth.gov/

CANADIAN RESOURCES

Canadian Breast Cancer Foundation http://www.cbcf.org/

Canadian Cancer Society http://www.cancer.ca/

References

American Cancer Society guidelines for breast cancer screening: update 2003. CA-A Cancer Journal for Clinicians. May/June 2003.

Breast awareness and self-exam. American Cancer Society website. Available at: http://www.cancer.org/Cancer/BreastCancer/MoreInformation/BreastCancerEarlyDetection/breast-cancer-early-detection-acs-recs-bse. Updated October 4, 2011. Accessed June 5, 2012.

Breast cancer screening modalities. National Cancer Institute, United States National Institutes of Health website. Available at: http://cancer.gov/cancertopics/pdq/screening/breast/healthprofessional/page4#Section%5F243. Accessed June 5, 2012.

Smith N. How to perform a breast self-examination . EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about. Updated December 1, 2011. Accessed June 5, 2012.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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