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The Importance of Breast Self-Exams

Monday, December 2nd, 2013

Breast cancer is a major topic of interest these days, partly because so many women will eventually get it, and partly because education can make such a huge difference in a given woman’s prognosis. According to the National Cancer Institute, the 5-year survival rate ranges from 98% when the cancer is caught early and has not metastasized to around 24% when it not found until after it has already spread to other parts of the body. This is precisely why screening measures such as breast self-exam, clinical exams by a doctor, and regular mammograms after age 40 are so important.

Breast Self-Exam

Self-exam is the most important and most effective screening method available to women younger than 40 years of age. It is free, takes very little time, and saves thousands of lives every year. No one is as familiar with your own unique breasts as you are, so you can often find changes, thickening, lumps, or skin changes that other people might not notice during an examination.

Examine your breasts during the same time each month – for example, ten days after your period starts. If that is too hard to keep track of, then do the exam on the last day of your period. Before or during your period is not a great time because your breasts may be enlarged, making it hard to determine what you are feeling.

Look at your breasts in the mirror, checking for symmetry. If one of your breasts has always been slightly larger than the other, then this is nothing to worry about. However, if one of your breasts has newly become larger than the other, this is something to get checked out. Look for any changes in the skin, such as dimpling, pitting (like an orange peel), or redness. Look for any retraction of the skin that occurs when you raise your arms above your head.

To feel for lumps or changes inside your breasts, the best place is in the shower because your hands slide more easily over wet, soapy skin. Use your fingers to make concentric circles all over your breast, working your way in toward the nipple, and checking for any unusual lumps and also squeezing the nipple to check for any discharge (there should be none unless you are lactating). Don’t forget to check your armpit for lumps as well. After your shower, repeat this exam lying on your back with your arm raised above your head and lotion or baby oil on your skin.

Why Is Breast Self-Exam Important?

In just a few minutes once a month, you could very well save your own life. Women have many reasons for not performing self-exams. They may be afraid of what they will find (ironically, breast self-exams keep women much safer). They may not think it necessary, since their doctors examine their breasts (but a tumor can do a lot of spreading in a year’s time). Or they may forget or not think about it for months at a time. However, the statistics show the importance of making an effort to remember this.

Clinical screening methods are also important and can catch things that a woman might not be able to feel or see in her own breasts. An annual exam by your gynecologist as well as regular mammograms are important screening tools that save many lives – but neither is as effective or as important as being familiar enough with your own breasts to be aware of a change the moment it happens. If you do feel or see a change in one of your breasts, but your doctor seems to think it’s nothing, don’t worry – he or she is probably right – but do insist on following up with a mammogram to take another look. No one knows your body like you do. You are the expert on your unique body, you are the one responsible for your own well-being, and you are the one in charge of watching for signs of breast cancer and getting medical attention immediately if they do appear.

If you are older than 40 years of age, then a mammogram is the preferred approach to evaluation of your breast (perhaps with an adjunctive sonogram for dense breasts).  A Canadian Task Force concluded that breast self-examination in older women (40-69 years) )should not be performed due to increased anxiety and unnecessary biopsies for benign disease.  However, as I have stated in my women’s health book, “Inside Information for Women”, I believe that breast self-examination has the potential to detect breast cancer that you can feel and still should be recommended.

– Yvonne S. Thornton, M. D., M. P. H.