Skills Laboratory:

PERFORMING
BREAST SELF – EXAMINATION
Jonnafe G. Gayatin, RMT, RN, MAN

Note: This presentation is made for educational purposes

and must be treated in respect to privacy and
confidentiality.
 • The best time to do a breast self-
Special exam is right after your period,
Consideration: when breasts are not tender or
swollen.
 STEPS RATIONALE
1. Remove any clothing that is For better
above your waist and stand facing a visualization of
mirror with your arms hanging the breast.
down to your side.
STEPS:
2. Look for any change in the
surface of your breasts, such as
dimpling, puckering, scaliness or
any other changes in the surface of
your skin from what you have
observed the last time.
Areola and
Nipple

• Assess for size, shape, color, symmetry,

lesions or discharges

http://livinglovinghobart.com.au/llh/wp-content/uploads/2017/09/breast-self-exam-5.jpg
Abnormal
Findings during
Inspection
https://images-prod.healthline.com/hlcmsresource/images/galleries/breast-cancer/642x361_SLIDE_4_Pictures_of_Breast_Cancer.jpg

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 • Females: Rounded shape; slightly unequal
in size; generally symmetric
• Males: Breasts even with chest wall; if
obese: may be similar in shape to female
breasts
Normal • Skin uniform in color, smooth and intact
Findings: (some may have stretch marks, moles etc.)
• Areola color may be light pink to dark
brown. Irregular placement of sebaceous
glans (Montgomery’s tubercles). Nipples
pointing in the same direction
• No tenderness, masses, nodules or nipple
discharge
 STEPS RATIONALE
3. Slowly turn to each side to allow a Lactating
full view of both sides of both mothers may
breasts. Examine your areola and see a little
your nipple for any changes, such as encrusted
scaly skin or newly inverted nipple. material on the
nipple itself.
STEPS:
4. Continue to stand facing the
mirror and lift your arms up over
your head (straight up). Hold them
there and look for the same
symptoms (mentioned earlier).
Continue while slowly turning to
each side. Don’t be in a rush, move
slow enough to see everything.
 STEPS RATIONALE
5. While still facing the mirror, place Accentuates
your hands on your hips and push retraction of
inward and downward, flexing the the breast
chest muscles under your breasts. tissue.
Again, look for the same symptoms
(as mentioned earlier)
STEPS:
6. Keep your hands on your hips and
lean forward, allowing your breasts
to hang freely away from the chest.
Watch the breast surfaces as they
move. You are looking for the same
symptoms (mentioned earlier).
 Inspection of the Breast
• Source: Berman, A., Snyder, S. & Frandsen, G. (2016). Kozier & Erb’s fundamentals of nursing: Concepts, Process and Practice (10th ed.). Pearson Education Limited. page 596.
 STEPS RATIONALE
7. Lie on your back, on a bed or other This position
flat surface. Elevate your shoulder distributes the
(the side you are examining) with a breast tissue
folded towel or pillow. Place your more evenly on
hand behind your head. the chest.
If too much breast tissue falls to the
STEPS: side and under your arm, and your
nipple is not pointing directly up
toward the ceiling, you may need to
assume a side lying position. (To do
that, lie on your right side to examine
your left breast, and pull your left
shoulder down onto the folded
towel.)
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ams_bse-102269/breast_self_exam-fig_4.png
 STEPS RATIONALE
8. Use the pads of your three
middle fingers on your left hand to
feel for lumps or thickening. Your
finger pads are the top third of
each finger.
STEPS:
9. Press firmly enough to know
how your breast feels. A firm ridge
in the lower curve of each breast is
normal. Move around the breast in
a set way. Either circle, up and
down, or the wedge.
BREAST PALPATION • Source: Berman, A., Snyder, S. & Frandsen, G. (2016). Kozier &
TECHNIQUES Erb’s fundamentals of nursing: Concepts, Process and Practice
(10th ed.). Pearson Education Limited. page 596.
 • After palpation, compress each nipple
to determine the presence of any
discharge.

Note: • If discharge is present, milk the breast

along its radius to identify the
discharge producing lobe. Assess any
discharge for amount, color,
consistency, and odor. Note any
tenderness on palpation.
 STEPS RATIONALE
10. Check your entire breast using a
lengthwise strip pattern. Feel all of
the tissue from the collarbone to the
bra-line and from the armpit to the
breast bone. Start in the armpit and
work down to the bottom of the bra-
STEPS: line. Move one finger-width toward
the middle and work up to the
collarbone. Repeat until you have
covered the entire breast. Repeat
this procedure on your left breast.
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 STEPS RATIONALE
11. Move your fingers in small,
coin-sized circles using different
levels of pressure to examine all
the breast tissue. Move in a
STEPS:
spiral pattern around your entire
breast. Avoid lifting your fingers
away from the skin as you feel
for lumps, unusual thickness, or
changes of any kind.
 STEPS RATIONALE
12. If you find changes, see your doctor right
away.
A. Any new lump. It may not be painful to
touch.
B. Unusual thick areas.
STEPS: C. Sticky or bloody discharge from your
nipples.
D. Any changes in the skin of your breast or
nipples, such a puckering or dimpling.
E. An unusual increase in the size of one
breast.
F. If one breast is unusually lower than the
other.
Summary: BSE in
Pictures
DOCUMENTATION:
If you detect a
mass, record the
following data: