How to Do a Breast Self-examination?

Breast cancer is the most common cancer in women in Singapore. Doing a breast self-examination (BSE) at home is good for you to pick up on any changes in your breast tissue.

Regular BSE are like a little personal checkup routine. They help keep tabs on your breast health and catch any signs of breast cancer early on, which makes treatment way more effective. It's important to remember that most lumps or abnormalities aren't cancerous, so don't jump to conclusions. But, and this is important, even if it seems minor, it's best to share any changes with your doctor or a breast specialist. Early detection is always the goal.

What is breast self-examination?

As the term itself implies, breast self-examination (BSE) is a physical and visual examination of the breasts done by an individual. BSE should be done monthly; in addition, breast screenings should be done by your doctor every three years if you are in your 20s or 30s, or every year if you are 40 or older. Mammogram screening should be included once a lady turns 40 years old.

Why is it important to do a breast self-examination?

Regular BSE will help you be familiarised with the feeling and look of your breasts. You can detect any changes and abnormalities more easily. Regular BSE can help detect and treat breast cancer as early as possible. If you notice a change in your breasts that seems abnormal or if one breast is different from the other while doing BSE, you should let your doctor know immediately. BSE is not always reliable in detecting breast cancer. However many women who have breast cancer reported that they discovered a new breast lump through BSE. This is the reason why doctors still recommend BSE so that you can be familiar with the normal consistency of your breasts.

How to do a self-breast examination?

It is best to check with your doctor on how to conduct BSE. Your doctor can explain what you are feeling in the breast tissue, so when you perform it on your own, you will be able to notice if there are changes that have occurred as you examine yourself each month. Alternatively, you can follow the detailed guide below before seeking professional advice. Begin with a visual examination of your breasts.

Step 1: Stand in front of a mirror

Stand straight with your hands on your sides so that you will be able to see your breasts clearly. Check for the following symptoms by using your hands to examine your breasts. Make sure to use the fat pads of the fingertips of the 3 middle fingers.

Make an appointment with your doctor if you notice any of the following symptoms:

• change in the size or shape of your breast
• development of a lump
• bloody discharge from the nipple
• breast swelling
• redness, thickening, or dimpling of the skin
• swollen lymph nodes under the arms
• pain and redness in the nipple
• pulling in of the nipple or other parts of the breast
• pain that is localized in one area and that does not vary with your monthly cycle

Step 2: Arms over your head

Stand straight with your arms raised above your head or interlocked behind your head. Observe your breasts the same way as mentioned in Step 1 to check for any symptoms.

Step 3: Hands on your hips while bending forward

Press your hands firmly on your hips and bend slightly toward the mirror as you feel your chest muscle tighten. Observe and check for any symptoms.

Step 4: Lie down flat on your back

It is best to examine the breasts lying down as your breast tissues spread evenly over the chest. Put one shoulder on a pillow or a folded towel and place one arm over your head. Your breast will be flattened in this position so that it is easier to check. Lotion or powder is used by some women so that their fingers can easily glide on the skin while feeling for lumps. Press your fingers in small areas the size of a dime. Make sure to cover the entire breast area.

Step 5: In the shower

Your soapy skin can easily make your fingers glide so that it becomes easier to feel for changes underneath. Using patterns will help you make a more thorough breast self-examination. The whole breast must be inspected, especially the area between the breast and the underarm. The area above the breast up to the collarbone all the way over to your shoulder should also be examined.

Below are some of the patterns you can use for your BSE.

• Line patterns: Your fingers need to move up and down starting in the underarm area and covering the whole breast area. Do the movement slowly.

• Circle pattern: Move your fingers slowly from the outer edge of the breast and around the whole breast in a circle. Work toward the nipple making smaller and smaller circles. Make sure to also check the areas under the arm and the upper chest.

• You can also begin from the nipple, moving in larger and larger circles until you reach the outer edge of the breast.

• Wedge pattern: Divide the breast area into wedge sections and start at the outer edge of the breast and move towards the nipple, then back to the edge.

Step 6: Examine your nipples

Bleeding discharges from the nipple should also be checked. To do so, squeeze the nipple gently to find out if there is bleeding or any discharge. Make sure not to skip any areas of the breast, whichever method you use.

FAQ

When should you do a breast self-examination?

You can start doing breast self-examination by the time you reach 20 years old.

Menstruating women should conduct their breast self-examination a few days after the period has ended. This will ensure that your breasts are not tender or swollen.

Women taking hormones should consult with their doctor about when to do BSE. If you see any breast changes such as swelling, redness, skin changes, presence of a lump, or discharge from your nipple, let your doctor know immediately. Make BSE a routine. The more you examine your breasts, the more you will learn about them and the easier it will be for you to tell if something has changed.

How often should you do a breast self-examination?

It should be conducted once every month so that you can become familiar with the looks and feel of your breasts. This way, it will be easier for you to detect any changes or abnormalities.

Women in the stage of menopause should conduct breast self-examination on any day of the month. In order not to forget, choose a day that you can easily remember as the first or last day of the month.

How hard should you press when checking breasts?

You also need to apply 3 different levels of pressure to examine your breasts.

• You need to exert light pressure when examining the tissue closest to the skin.
• Apply medium pressure so that you can feel a little deeper.
• Apply firm pressure to feel deeper tissues near the chest wall.

What should you do if you detect a lump?

It can be frightening to feel a lump or find some breast abnormalities. This is the reason why it's helpful to conduct regular BSE. You should not panic if you find a lump in your breasts during one of your BSEs as lumpiness can be caused by other reasons aside from having breast cancer.

Women often experience abnormalities such as lumps and breast changes during their period. Most of these symptoms will disappear after your period ends. However, if the lumps or changes last even after your menstrual period is over, or if the lump seems to get bigger or more prominent, then you should consult your doctor immediately.

On the other hand, not all lumps are cancerous; some breast lumps are benign. There are a lot of possible causes for non-cancerous breast lumps. This includes normal hormonal changes, injuries, or a benign breast condition. However, if it is accompanied by bloody discharges or changes in your skin such as puckering or dimpling, then you should seek professional advice immediately.

We recommend that you undergo a thorough examination at Thomson Breast Centre — a one-stop centre for all breast-related problems, we can help to diagnose and provide the necessary treatment for your condition. Book an appointment with us today.