Breast – Self Examination

Self Examination of Breast

By
Dr.V.Kasiviswanathan M.S.
General Surgeon/ Formerly Sr.DMO/Indian
Railways/PGT
Visit my website for nursing students at
www .examnnotes.com
contact me at kasiviswanathanv@yahoo.com
Introduction

• Breast self examination can be taught to individuals or to groups.

• BSE is best performed after menses (day 5 to day 7)

For postmenopausal women once a month.

• Many women have grainy-textured breast tissue, but these areas

are usually less nodular after menses.

• Women should begin practising BSE at their late teens or early 20s.

• The nurse plays a pivotal role in preventive education.

 The most effective programme for early detection
includes 3 steps

1. A breast examination by a health care professional At

least
every 3 years starting at age 20
Every year after age 40

2. A mammogram every year starting at age 40

If under age 40 with a family history of breast cancer

3. monthly BSE, or breast self examination, beginning by

age 20
• Bse takes only a few minutes

• Breast self examination could be the best time

investment of your lifetime

The best time for self examination

• At the end of the periods - least tender

• Menopausal women on the same day of each month

• Breast feeding mothers - after the breasts are emptied -

after suckling the baby
 Breast examination
• There are two parts to BSE –
looking and feeling

Looking
• Use a mirror
• Check the shape and size of the breasts
• The color and texture of your skin ….

• First with the arms down

• Then with the arms in the air.
It is not unusual for one breast to be
larger than the other.
The woman should learn what is normal
for her so that she can spot any changes
immediately.
• Then pushing down on the hips,
to tighten her chest muscles
And bending forward at the waist, with the hands on the hips.
This will help spot dimpling
 Feeling

• Done most effectively while lying down

• Place a folded towel or pillow under the
shoulder and extend the arm out at an
angle, to spread the breast tissue more
evenly
• Check - from the collar bone to the bra line.
• Using three fingers, make three coin – sized
circles.
• One just lightly
• One deeper
• One deeper still.

This will enable the woman to check the full

thickness of her breast.
• Use the pads of the fingers.
• Keep the fingers straight

• Move the fingers down and circle again.

, Light medium deep

• While moving the hand, it should not be

lifted away from the skin to avoid missing a spot.

• The entire area,is palpated spot by spot, going up and

down in strips about as wide as the three examining
fingers
• Then the armpit is examined.

• Next the other breast is

checked.

• Look for a firm lump or area of

thickening that is different
from the rest of the breast
tissue.

• If it is not sure whether what

you’re feeling is normal, visit
the doctor and get his opinion.
 Variations
• Women with larger breasts
should lie down on their side to
check the outer half of the breast.

• Then, keeping the hand on the

nipple to mark the midline, roll
into the flat position to examine
the inner half of the breast.

• If the woman has had breast

surgery or breast implants, she
has to follow the same steps –
looking and feeling
Clock pattern Circle pattern Grid pattern
 Conclusion
• Look – in four positions.
1. With the arms down at the sides
2. With the arms over the head
3. Pressing on the hips to tighten the
chest muscles
4. And bent forward with the hands
on your hips

• To feel, prop up with a towel or

pillow
• Three finger pads should be used
• Three small circles are made and
the whole area is checked.
• To effective the early detection
plan must combine monthly BSE
with regular clinical breast
examinations and mammograms.
 War ning Signs of Breast Cancer
• Due to the increased use of mammography, most women are diagnosed at very early
stages of breast cancer, before symptoms appear. However, not all breast cancer is
found through mammography.

• Change in the look or feel of the breast, nipple discharge.

These are listed below: 

• Lump, hard knot or thickening

• Swelling, warmth, redness or darkening

• Change in the size or shape of the breast

• Dimpling or puckering of the skin

• Itchy, scaly sore or rash on the nipple

• Pulling in of your nipple or other parts of the breast

• Nipple discharge that starts suddenly

• New pain in one spot that doesn’t go away

Clock pattern
Circle pattern
Grid pattern
Mammogra
m
 Warning Signs of Breast Cancer
• Due to the increased use of mammography, most women are
diagnosed at very early stages of breast cancer, before
symptoms appear. However, not all breast cancer is found
through mammography. The most common symptoms of breast
cancer are a change in the look or feel of the breast, a change
in the look or feel of the nipple and nipple discharge. These are
listed below: 
• Lump, hard knot or thickening
• Swelling, warmth, redness or darkening
• Change in the size or shape of the breast
• Dimpling or puckering of the skin
• Itchy, scaly sore or rash on the nipple
• Pulling in of your nipple or other parts of the breast
• Nipple discharge that starts suddenly
• New pain in one spot that doesn’t go away