Breast Self-Exam: How to Check for Lumps and Other Breast Changes

Breast cancer is a common diagnosis in today’s world, but the outcomes vary based on a number of factors. For those who were diagnosed early when the cancer was still localized to the breast, the 5-year survival rate is a whopping 100%. Early detection is absolutely key in identifying breast cancer early and ensuring women can live long and full lives, even after a breast cancer diagnosis. While clinical breast exams and mammograms are recommended every 1-3 years depending on your age and family history, breast self-exams are the most common way for women to discover a problem and the best way to ensure early detection should an issue ever arise. Breast self-exams should be done once a month, usually starting around age 20. They can help women familiarize themselves with the look and feel of their breasts, ensuring that they notice any changes in the future. They allow women to check for lumps and other changes, and they can be a great starting point for having conversations with a doctor if there is a concern. Here, we break down how to do a breast self-exam, what you should be looking for during these exams, what is considered normal, and when you should make an appointment with your doctor.

How to Do a Breast Self-Exam

It is important to note that not all indications of cancer will be apparent in a breast self-exam. Mammograms can detect minuscule lumps that breast self-exams often cannot. However, the important part of breast self-exams is knowing what is normal for your breasts. Johns Hopkins Medical Center found that about “40% of diagnosed breast cancers are detected by women who feel a lump” during an at-home breast self-exam. Since early detection is key, it’s incredibly important that all women learn how to do a breast self-exam.

You should examine your breasts once a month, usually a few days after your menstrual cycle has ended. You should do the exam in three places: in the shower, in front of a mirror, and lying down. While in the shower, move the pads of your fingers around your entire breasts in a circular motion. You should move from the outside of the breast towards the center, and be sure to check the armpit areas as well. It is best to do this with your arm raised above your head. Next, you should stand in front of a mirror and visually inspect your breasts. Start with your arms at your side and look for any noticeable changes in your breasts, such as color changes, dimpling of the skin, swelling, and so on. Next, raise your arms above your head and look at your breasts again, looking for the same changes in visual appearance. Then, put your hands on your hips and push your elbows forward to flex your pectoral muscles, again looking for visual changes in your breasts. Finally, when lying down, you should complete your breast self-exam by placing a pillow under your shoulders and raising one arm above your head. Using the same circular motion with the pads of your fingers, move around the breast in a circular motion, traveling from the outside in, including the armpit area. Feel for lumps, bumps, or other changes using light, medium, and firm pressure. To end, you should squeeze your nipple slightly and look for lumps or discharge.

As you discover how to do a breast self-exam, you should be proactive but not panicked if you come across something concerning. Definitely schedule an appointment with a physician if you discover something unusual, but don’t jump to the worst conclusions immediately. About 8 out of 10 lumps found in breasts are not cancer, so even if you find something that worries you, don’t assume the worst immediately. Take the necessary precautions to get it checked out further but continue to believe the best in the meantime.

What Should I Be Looking For?

As you get better at knowing how to do breast self-exams, they will become easier as you familiarize yourself more with the look and feel of your breasts. You should be looking and feeling for anything unusual. This includes lumps, bumps, dimples, puckers, color changes, and discharge from the nipple. If something wasn’t there last month but is there this month, you should make an appointment to get it looked at. In the first few months of doing a breast self-exam, you may find yourself panicking at what you feel, especially because there are several lymph nodes and glands in and around your breasts. If you haven’t had a clinical breast exam in a while, it is a good idea to schedule one right around when you first learn how to do breast self-exams so you can be assured that what you’re seeing and feeling is normal, just as a baseline guide to start with.

What Is Normal or Abnormal?

Only your doctor can truly determine what is normal or abnormal, so we recommend scheduling a visit upon discovering something that seems out of the ordinary to you. However, note that in most cases, feeling fibrous bumps or ridges are normal, primarily because of all the tissue and glands that are located in the breasts. Many women will feel soft or firm lumps that appear to be movable, which are most commonly fluid-filled cysts or fibrous lumps, both of which are completely benign. Additionally, it’s normal for breasts to swell and grow and change from time to time, primarily due to influxes of estrogen or other changes in hormones. Even tenderness, itching, and inflammation of the breasts are fairly common, though those things could be a sign of inflammatory breast cancer, which is quite rare. If you see small pimple-like bumps on your nipples, especially during pregnancy, don’t worry about them. They are perfectly normal even when not pregnant. Slight nipple discharge is also normal, but blood in the discharge is not normal and should result in a call to your doctor. If you have lopsided breasts, be sure to be thorough in your breast self-exams. While all women have unsymmetrical breasts to some degree, a British study from 2006 found that there may be a link between larger size discrepancies in breasts and the risk of breast cancer. While there are many things that are normal for breasts, and even more things that may be abnormal but still not cancer, it is best to consult with a doctor if you’re concerned.

When to Consult a Doctor

Any breast changes that you can see or feel are reasons to contact your physician. Particularly if you are concerned about something you found, it is better to make an appointment, rule out health issues, and get your peace of mind back. Be sure to go to your regular clinical breast exams and mammograms as often as your doctors recommend, and be sure to continue your breast self-exams each month. No concern is too small to contact your doctor, so the more proactive you can be about your breast health, the better.