Breast self-exam: how to do one and what to look for
Medically Reviewed by Kara Leigh Smythe, MD
From picking the same time each month to unusual changes to look for, here’s what experts want you to know.
When performing a breast self-exam, check both breasts and the armpit for any unusual changes.
Once upon a time, lots of us would hang laminated placards in the shower that detailed a step-by-step guide to checking our breasts. The expectation: That you would examine your breasts in a very specific step-by-step manner every month and be on the lookout for anything that just felt different than usual.
Then, in 2015, the American Cancer Society (ACS) deemed these self-exams superfluous in terms of increasing overall breast cancer survival rates and even raised concern over unnecessary biopsies that ensued when women would find their own lumps and bumps. That’s why that year, the ACS announced that it no longer recommends breast self-exams as a screening tool for those women at average risk of developing breast cancer.
Breast Awareness and Knowing Your Normal
So where does this leave us seven years later?
The answer is that experts want individuals to shift the focus from breast “self-exam” to breast “self-awareness.”
“Years ago, what we found was that many women were concerned about technique when they practiced self-exams,” says Spring Piatek, an advanced practice nurse at the Northwestern Medicine High Risk Breast Clinic in Winfield, Illinois. “They were concerned about subtle lumps or bumps which were normal breast tissue. They would raise concerns with provider and there would be a lot of unnecessary exams, visits, and calls.”
Instead, healthcare professionals are committed to demystifying the breast self-exam.
In short, their message remains: Know your body.
Unusual Changes to Look For
“Consider how your breasts normally look and feel,” Piatek says. “We want women to look at themselves in the mirror at least once a month and look at their breasts.”
While looking in the mirror, zero in on any changes in the size or shape or either breast and look for any changes that may have occurred in the appearance of the skin on your breasts.
“For example, is there a rash or redness that’s not going away or is there any skin thickening,” Piatek says. “If you lift your arms up, is there any dimpling of your breast tissue, swelling around your collarbone or under your arm?”
Ultimately, the goal is to build awareness without adding additional stress, says Deanna J. Attai, MD, associate clinical professor in the department of surgery at UCLA David Geffen School of Medicine in Los Angeles and UCLA Health Burbank Breast Care.
“I tell patients now that we no longer scold you for not doing monthly self-exams anymore,” Dr. Attai says. “We want women to have a general idea of what’s normal for them and to be aware that breast cancer doesn’t always present as a lump. It can be a sudden swelling, a redness of the skin that doesn’t go away with antibiotics, blood from the nipple or a retraction or dimpling that can be a potential sign of an underlying cancer.”
Picking the same time of the month to do a self-breast exam can help create awareness around any changes.
Breast Self-Exam Tips
- Pick the same time each month.
- Look at your breasts in a mirror, with your hands at your sides, then above your head.
- Use the pads of the fingers to feel for any unusual changes around the breasts and armpit.
- Look and feel for lumps, hardened knots, or other changes.
- Check for signs of swelling, redness, or skin dimpling.
- Examine any changes in the nipples, including appearance, texture, or discharge.
And both experts agree: If you feel comfortable doing the steps outlined in your shower placard (or in our graphic), don’t hesitate to keep doing them. Most important: If a change in or around your breast lasts for more than a week (or two) always alert your primary doctor, gynecologist or breast specialist.
“There’s no harm in doing self-exams, but we want to make it simple,” Piatek says. “And we definitely don’t want women to dread doing this or feel ashamed if they forget.”