How do I perform a breast self-exam?

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Anne M. Kobbermann, MD
Hematology & Oncology
Performing regular breast self-exams can help detect anything that is irregular or out of the ordinary, but how do we know what to look for? In this video, Anne Kobberman, MD, explains breast self-exams and how often you should do them. 
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
A self-breast exam is crucial for breast cancer detection and prevention. In this video, Dr. Oz shows how to do a self-breast exam.
Ask your healthcare professional to show you how to perform a breast self-exam (BSE) correctly or check the American Cancer Society website for detailed instructions. The procedure for doing BSE is different from previous guidelines. There is now evidence that the right amount of pressure, the pattern of coverage of the breast and the position (lying down is best) increase a woman's ability to feel abnormalities. You may also want to ask your healthcare professional for a brochure to help when you get home. It may take several months for you to become familiar with the routine and to learn what to expect to feel. But with practice, BSE can increase your chances of noticing anything abnormal about your breasts.

If you find a suspicious lump or notice something else abnormal, make an appointment with your healthcare professional. He or she will perform an exam and will likely have you undergo a mammogram. The majority of breast changes found by women who regularly perform BSEs are not cancerous.
To perform a breast self-exam:

1. Stand in front of a mirror and with your arms at your side, check both breasts for puckering, dimpling, or anything unusual. Look for any discharge from the nipple.

2. Clasp your hands behind your head and check for changes in your breasts in this position.

3. Next, press your hands firmly on your hips and bend slightly toward the mirror as you pull your shoulders and elbows forward, checking for changes.

4. Raise one arm. Use the flat part of the middle three fingers of your other hand to check the breast and the surrounding area. Feel for any unusual lump or mass by firmly pressing your fingers in small, overlapping areas. Cover your whole breast and follow a definite pattern: lines, circles, or wedges. Gently squeeze the nipple and look for a discharge. Repeat the exam on the other breast.

5. Repeat Step 4 while you are lying flat on your back. Raise your left arm over your head and place a pillow or folded towel under your left shoulder. Check your left breast and the area around it very carefully. Repeat on the right breast.

6. You may repeat Step 4 in the shower. Your fingers will glide easily over soapy skin.
To do a breast self-exam:

1. Stand before a mirror. Inspect both breasts for anything unusual, such as any discharge from the nipples, puckering, dimpling, or scaling of the skin.

The next two steps are designed to emphasize any change in the shape of contour of your breasts. You should be able to feel your chest muscles tighten while doing these steps.

2. Watching closely in the mirror, clasp hands behind your head and press hands forward.

3. Next, press hands firmly on hips and bow slightly toward your mirror as you pull your shoulders and elbows forward.

Some women do steps 4 and 5 in the shower. Fingers slide over soapy skin, making it easy to concentrate on the texture underneath.

4. Raise your left arm. Use three or four finger as your right hand to explore your left breast firmly, carefully, and thoroughly. Beginning at the outer edge, press the flat part of your fingers in small circles, moving the circles slowly around the breast. Gradually work toward the
nipple. Be sure to cover the entire breast. Pay special attention to the area between the breast and the armpit, including the armpit itself. Feel for any unusual lump or mass under the skin. Repeat the exam on your right breast.

5. Gently squeeze each nipple and look for a discharge.

6. Repeat steps 4 and 5 lying down flat on your back, right arm over your head and a pillow or folded towel under your left shoulder.
How to examine your breasts
  • Lie down and place your right arm behind your head. The exam is done while lying down, not standing up. This is because when lying down the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue.
  • Use the finger pads of the 3 middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue.
  • Use 3 different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. It is normal to feel a firm ridge in the lower curve of each breast, but you should tell your doctor if you feel anything else out of the ordinary. If you're not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot.
  • Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle).
  • There is some evidence to suggest that the up-and-down pattern (sometimes called the vertical pattern) is the most effective pattern for covering the entire breast, without missing any breast tissue.
  • Repeat the exam on your left breast, putting your left arm behind your head and using the finger pads of your right hand to do the exam.
  • While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, or dimpling, or redness or scaliness of the nipple or breast skin. (The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.)
  • Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it harder to examine.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.