BREAST SELF - EXAMINATION

Introduction to Breast Self-Exam
Regularly examining her own breasts allows a woman to become familiar with how her breasts normally look and feel and can help her more readily detect any changes that may occur. Many women naturally have some lumpiness and asymmetry (differences between the right and left breast). The key to the breast self-exam is to learn how to find changes in the breasts that persist over time.

What is BREAST SELF - EXAMINATION?
Breast self-examination (BSE) is a method for finding abnormalities of the breast. The method involves looking at and feeling each breast for possible distortions or swelling. Self- Examination involves both inspection and palpation procedures and should be conducted once a month.

Why it is done?
A breast self-examination is done to detect breast problems, such as a lump or change in appearance, that may indicate breast cancer or other breast conditions that may require medical attention (such as mastitis or a fibro adenoma).

When is the best time to examine?
The best time to examine your breasts is usually one week after your menstrual period begins, when your breast tissue is least likely to be swollen or tender. If you’re menstrual cycle is irregular, or if you have stopped menstruating due to menopause or the removal of your uterus (hysterectomy), do your examination on a day of the month that's easy to remember. Women who are pregnant or breast-feeding can continue to examine their breasts every month. Breast-feeding mothers can examine their breasts after a feeding or after using a breast pump so that the breasts have as little milk as possible, making the examination easier and more comfortable. For premenopausal women, BSE is best done at the same stage of their period every month to minimize changes due to the menstrual cycle. Older, menopausal women should do BSE once a month, perhaps on the first or last day of every month.

How to perform BSE?

The steps involved in self exam are:
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Stand in front of a mirror with top exposed. Place hands on hips. Look for signs of dimpling, swelling, soreness, or redness in all parts of your breasts in the mirror. Repeat with arms raised above your head. While still standing, palpate your breasts with your fingers, feeling for lumps. Try to use a larger area of your fingers rather than prodding. Feel both for the area just beneath the skin and for the tissue deeper within. Go over the entire breast while examining. One method is to divide the breast into quadrants and palpate each quadrant carefully. Also examine the "axillary tail" of each breast that extends toward the axilla (armpit). Repeat palpation while lying down. Check the nipples and the area just beneath them. Gently squeeze each nipple to check for any discharge.

Palpation: lying position - Place a pillow under your right shoulder and place the right hand behind your head. This position distributes breast tissue more evenly on the chest.

- Use the finger pads (tips) of the three middle fingers on your left hand to feel
for lumps. - Press the breast tissue against the chest wall firmly enough to know how your breast feels. A ridge of firm tissue in the lower curve of each breast is normal. - Use small circular motions systematically all the way around the breast as many times as necessary until the entire breast is covered. - Bring your arm down to your side and feel under your armpit where breast tissue is also located. - Repeat the exam on your left breast, using the finger pads of your right hand. Optional: Do the upright BSE in the shower. Soapy hands glide more easily over wet Skin.

The Seven P's method
A similar method of self-examination is known as the Seven P's of BSE: 1. Position: Inspect breasts visually and palpate in the mirror with arms at various positions. Then perform the examination lying down, first with a pillow under one shoulder, then with a pillow under the other shoulder, and finally lying flat. 2. Perimeter: Examine the entire breast, including the nipple, the axillary tail that extends into the armpit, and nearby lymph nodes. 3. Palpation: Palpate with the pads of the fingers, without lifting the fingers as they move across the breast. 4. Pressure: First palpate with light pressure, then palpate with moderate pressure, and finally palpate with firm pressure. 5. Pattern: There are several examination patterns, and each woman should use the one which is most comfortable for her. The vertical strip pattern involves moving the fingers up and down over the breast. The pie-wedge pattern starts at the nipple and moves outward. The circular pattern involves moving the fingers in concentric circles from the nipple outward. Don't forget to palpate into the axilla. 6. Practice: Practice the breast self-exam and become familiar with the feel of the breast tissue, so you can recognize changes. A health care practitioner can provide feedback on your method. 7. Plan: Know what to do if you suspect a change in your breast tissue. Know your family history of breast cancer. Have mammography done as often as your health care provider recommends.

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