How to perform a monthly breast self-exam step by step
This guide by Dr. Fung explains how to incorporate monthly breast self-exams (BSE), visual checks, and tactile screening into your regular wellness routine to detect changes early.
Takeaways:
Monthly breast self-exams (BSE) help you learn what is normal for your tissue so you can spot changes quickly.
Not all breast lumps indicate cancer, but every new lump or texture change requires prompt medical evaluation.
Performing the exam while lying down flattens the tissue over the chest wall, making deep changes easier to feel.
The exam should cover a rectangular area extending from the armpit down to the bra line, across to the sternum, and up to the collarbone.
Monthly breast self-exams (BSE), annual clinical breast exams by your doctor, and screening mammograms are part of keeping in optimal health. It is important that we get to know our breasts so that we can detect changes as early as possible.
If there is a change noted, it is critical to consult with your doctor immediately. Not all lumps are cancer, but all lumps and breast changes need to have follow-up medical examination.
Think of a BSE like a monthly ritual that involves examining your breast tissue in an organized way through feel and visual inspection to note any changes from month to month. You can do a portion of the exam while you are in the shower. Incorporating it into a normal activity can make it easier to do and less of a time constraint.
When is the best time of month to perform a breast self-exam?
To get the most accurate feel for your tissue, timing your exam correctly is helpful:
If you menstruate: Perform your BSE 2–3 days after the end of your period when swelling and tenderness are lowest.
If you do not have periods: Choose a specific calendar day each month (like the 1st) and stick with it.
If you take oral contraceptives: Perform the exam on the very first day you start a new pack of pills.
Tip: Pick a "BSE Buddy." You can remind each other to do your monthly self-exams on time.
What should you look for during a visual breast inspection?
It is completely normal for one breast to be a different size or shape than the other. Stand in front of a mirror and inspect your tissue under different movements:
Resting position: Look at your breasts with your arms at your sides. Are they round and falling symmetrically? Are the nipples pointing in the same direction? Is the skin smooth? Check for dimpling, rashes, rough spots, irritation, or any area pulling inward like a tugged string.
Arms raised: Raise your arms high above your head and turn side to side. Check for any asymmetrical pulling or skin changes.
Hands on hips: Place your hands on your waist and push down firmly to engage your chest muscles. Look for pulling, dimpling, or changes in nipple direction under pressure.
What is the step-by-step method for feeling breast tissue?
Follow these steps to ensure you cover all tissue thoroughly:
Lie down flat: Place your right arm behind your head. Lying down flattens the breast tissue evenly across your chest wall, making it much easier to feel deeper layers.
Define your boundaries: Create a mental rectangle that starts midway in your armpit, extends down below your breast to the bra line, reaches over to your sternum (breastbone), and goes up to your collarbone. This area includes surrounding lymph nodes.
Use the right fingers and pressure: Use the pads of your middle three fingers to make quarter-sized circular motions. Apply three levels of pressure at each spot:
Light: To feel the top skin layer.
Medium: To feel the fatty tissue layer.
Deep: To feel down to the muscle and rib cage underneath.
Follow a pattern: Move up and down the rectangular boundary in a vertical strip pattern (like mowing a lawn). Crawl your fingers along without lifting them off the skin so you don't miss any spots. Be sure to palpate the nipple area as well.
Switch sides: Repeat the entire process for your left breast.
We hope that this helpful information encourages you to make BSE a part of your life. Be your own best friend and health advocate, and encourage your friends and family to get started!
For more wellness and early detection information, explore our guides on navigating medical anxiety during breast screening.
You don't have to navigate this alone.
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