A breast self-examination (BSE) is a personal check of the breasts, performed by sight and by touch, to understand how the tissue normally looks and feels. The purpose of this regular self-assessment is to establish a baseline familiarity with one’s own body. By recognizing the typical textures, contours, and characteristics, individuals are more likely to notice and report any subtle or persistent changes to a healthcare provider.
Establishing a Regular Monthly Schedule
The recommendation for performing a breast self-examination is once a month. This consistency makes it easier to track any variations over time. Performing the examination monthly allows for the detection of changes that might occur between professional clinical visits or scheduled imaging studies.
For those who still have menstrual cycles, the timing of the examination is best scheduled for the few days following the start of the period. This window, typically between three to five days after the cycle begins, is when hormonal fluctuations cause the breasts to be least swollen and tender. Examining the breasts during this time provides the most consistent tissue texture for comparison month-to-month.
If an individual is post-menopausal, pregnant, or has irregular cycles, the specific timing is less dependent on hormonal shifts. In these situations, choose a specific, easy-to-remember date each month, such as the first or last day. Selecting a consistent date ensures the examination is not missed and maintains the regularity needed for effective self-monitoring.
Step-by-Step Guide to the Examination
The breast self-examination involves both a visual inspection and a manual, tactile assessment. The visual inspection should be performed first, while standing in front of a mirror with the shoulders straight and the arms at the sides. Look for any changes in the size, shape, or symmetry of the breasts, and note any skin changes such as puckering, dimpling, or redness.
Next, raise the arms high overhead and then press the hands onto the hips to flex the chest muscles, observing the breasts again for the same visual changes. This movement can exaggerate subtle retractions or dimpling that might not be visible when the arms are relaxed. After the visual check, the tactile examination should be performed, which is often easiest while lying down or in the shower.
When lying down, the breast tissue spreads out more evenly, which makes it thinner and easier to feel, particularly for those with larger breasts. Place the hand on the same side as the breast being examined behind the head to further flatten the tissue. Use the pads of the three middle fingers of the opposite hand, keeping the fingers flat and together, to perform the palpation.
The examination requires using three distinct levels of pressure to cover all depths of the tissue. Use light pressure for the surface tissue, medium pressure for deeper tissue, and firm pressure for tissue nearest the chest wall and ribs. Follow a specific, methodical pattern to ensure no area is missed, such as moving the fingers in a vertical strip or in increasingly larger circles from the nipple outward.
The entire breast area must be covered, extending from the collarbone down to the top of the abdomen, and from the armpit (axilla) over to the cleavage. The axilla should be checked thoroughly, as breast tissue and lymph nodes are located there. Gently squeeze the nipple to check for any unusual discharge, and note any lumps, thickening, or knots found.
BSE in the Context of Modern Screening
While breast self-awareness is widely encouraged, formal, step-by-step breast self-examination is generally no longer recommended as a stand-alone screening procedure by major medical organizations. Research has not shown a clear benefit of regular BSEs in lowering the risk of death from breast cancer. Studies suggest that structured BSE might lead to unnecessary biopsies due to the detection of benign changes.
The current medical consensus emphasizes “breast self-awareness,” which means knowing the normal look and feel of one’s breasts and promptly reporting any changes to a healthcare provider. Most breast cancers discovered through symptoms are found by individuals themselves during routine activities, not necessarily during a formal self-exam.
Self-awareness is a supplement to, and not a replacement for, professional screening methods. Clinical breast examinations (CBEs), performed by a doctor or nurse, and imaging like mammography are the established tools for early detection. Mammography remains the most effective method for finding breast cancer early, often detecting lesions before they are large enough to be felt. If any persistent changes, such as a new lump, skin dimpling, or unusual nipple discharge, are noted during a self-check, immediate consultation with a healthcare provider is the appropriate action.