Should You Give Yourself a Breast Exam?

Breast self-exams were once recommended as a monthly must-do to check for breast cancer, but in recent years they’ve fallen out of favor. Major organizations like the American Cancer Society (ACS) no longer recommend formal monthly exams because they can lead to more tests, including biopsies, to check out lumps that turn out to be benign or non-malignant. The ACS instead suggests that all women get familiar with the normal look and feel of their breasts so if they notice any changes, they can see their gynecologist right away. That could mean noting if you feel anything unusual in the shower, or even simply checking yourself out in the mirror every now and then.

Many doctors, however, still recommend self-exams as an appropriate way to spot any changes. And OBGYN Karen Knapp, MD, of Henrico Doctors’ Hospital, in Richmond, Virginia is one of those experts. As soon as her patients are through puberty, around 12 ½ years old, she starts breast education. “Sometimes it takes a couple of visits or even a couple of years for patients to get comfortable, but that is fine. There’s no wrong timing,” says Dr. Knapp.

Not sure where to start? Here are some tips that can help.

How to give yourself a breast exam

Knapp says you’ll want to perform a breast exam both standing up and lying down. Here’s an easy-to-follow guide:  

  1. Raise your left arm while examining your left breast, and raise your right arm while examining your right breast.
  2. To examine your breast, use the flat pads of your fingers rather than your fingertips. “If you use your fingertips, you may push so hard it will hurt. Your fingertips also have a pulse, so it's hard to know what you're feeling,” says Knapp.
  3. Using light, medium or firm pressure, check your breast tissue all the way up through your armpit area. “Think of it like the spokes of a bicycle. Using the flat part of your hand, start at 12:00 and work your way towards the nipple and then out and in, all the way around,” Knapp explains. Be sure to squeeze your nipple to check for any discharge.
  4. It’s important you don’t forget the area around your armpits. “Your breast tissue actually goes into and across your armpits. This area is called the axilla,” says Knapp. Your breast isn’t just the round, central area. Your breast includes your body and chest wall, too.
  5. Lie down and do the whole thing over again. Use a pillow under the shoulder of the breast you’re checking for more comfort. 

7 symptoms to watch out for

“Most breast lumps are benign and most biopsies end up being benign, but you don't know until you look,” says Knapp. If you notice any of the issues below, see your healthcare provider right away: 

  • Puckered or retracted nipple
  • Wrinkling or crinkling of skin 
  • Breast or nipple pain
  • Breast swelling
  • Nipple discharge
  • Swollen lymph nodes
  • New lump or mass

Timing is key

One of the most important parts of self breast examination is being consistent with when you’re inspecting yourself.  It’s best to perform a self examination on the same day every month. Knapp says if you’re premenopausal, at the end of your period is ideal. “I don't think there's a woman alive who won't tell you that their breasts are the fullest and the most tender, specifically, the week or so before their period,” she explains.

When you ovulate, you make more of the hormone progesterone. Your progesterone level is highest the week before your period and the lowest right after your period. “You want to do your exam when your breasts are least hormonally stimulated. It’s just more comfortable,” says Knapp.

For postmenopausal women, choose a day, like the 15th or the 25th, and perform your examination on that day every month. 

Don’t let fear stand in the way

Knapp says when a patient calls her office after finding something in their breast; her team gets them in for an appointment that day. “Every single one of us understands, appreciates and empathizes that it scares you. While it is scary, you can’t let fear get in the way of staying well.”

Socially, there is so much hype associated with a woman’s breasts, and that may be why some women don’t seek help. “We can answer most questions without doing something that’s really invasive and certainly not deforming,” says Knapp. 

Nowadays, a non-invasive ultrasound may be all you need. “If it looks like a benign cyst, we leave it alone. We don’t stick a needle in it or squish you with a mammogram,” she adds.

The bottom line: if something doesn’t look or feel right, it’s best to see your OBGYN to determine how serious the issue may be.

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