A breast self-exam is a screening technique women can do at home to check for breast lumps. The exam is sometimes referred to as a “BSE.” A breast self-exam can help screen for tumors, cysts, or other abnormalities in the breasts.
Once thought to be a good screen for breast cancer, a self-exam is now considered to be less effective than other techniques, such as regular mammograms. This has led groups such as the American Cancer Society (ACS) to deem breast self-exams optional.
However, breast self-exams help you familiarize yourself with the shape, size, and texture of your breasts. This is important because it can help you determine if what you are feeling is normal or abnormal. Any time you feel an abnormality in your breast, tell your doctor.
The best time to do a breast self-exam is a few days after your monthly menstrual cycle ends. Because hormonal changes can affect the size and feel of your breasts, it is best to perform the exam when your breasts are in their normal state.
Women who do not menstruate should choose a certain day to perform the exam, such as the first of each month.
The Mayo Clinic recommends keeping a journal of how your breasts feel in order to track and record any changes.
1. Start by standing topless in front of a mirror with your hands at your sides. Visually inspect your breasts for the following:
- changes in size, shape, or symmetry
- inverted nipples
- asymmetrical ridges at the bottom
Check for these signs with your hands at your sides, then with your arms over your head, and again when lifting one breast at a time.
2. Using the pads—not the tips—of your fingers, inspect your breasts while lying down and again in the shower. The water and soap in the shower will allow your fingers to glide easily over your skin.
3. Using varying pressure and taking your time, massage your fingers over your breasts in a spiral pattern starting at the nipple. Make your way up to the top of your breast near the collarbone, to the center by your breastbone, and to the sides near your armpits. Do this by putting one arm over your head while massaging your breast with the other hand.
4. Lastly, gently squeeze your nipples to check for discharge.
While there is no medical risk involved in a breast self-exam, it can cause anxiety. Finding a lump in your breast can be alarming, but an estimated 80 to 90 percent of breast lumps aren’t cancerous. They are typically caused by other, benign conditions, such as fibrocystic breast disease.
Breast self-exams have also been associated with an increase in unnecessary breast biopsies—procedures that involve the surgical removal of breast tissue. Because most abnormalities in breast tissue are non-cancerous, the extra surgical procedures put women at risk for rare complications, such as bleeding and infection.
If you find a lump or abnormality, don’t panic. Remember that the vast majority of breast abnormalities turn out to be benign (non-cancerous).
Besides cancer, breast lumps can be caused by:
- adenofibroma: a benign tumor of the breast tissue
- fibrocystic breast disease: painful, lumpy breasts caused by hormone changes
- intraductal papilloma: a small, benign tumor of the milk ducts
- mammary fat necrosis: lumps formed by bruised, dead, or injured fat tissue
However, this doesn’t mean that you should ignore a lump or abnormality. Make an appointment with your doctor to have your breast professionally examined.