A few readers over the past several months have asked me to do a post on self breast exams—how to do them, when to do them, how often to do them. I’m betting, ladies, if we’re honest with ourselves, most of us probably don’t check our girls with as much consistency as we should. And I’m guessing some of us have never done a self breast exam at all.
Here’s the scary truth: About 1 in 8 women in the U.S. will develop breast cancer in their lifetime, with over 230,000 new cases diagnosed just last year. Breast cancer is the most common form of cancer in women by a long shot. And even if you don’t have a history of breast cancer in your family, you’re still at risk.
The good news is most breast cancers present early, and most women can live well beyond breast cancer; as of 2011, there were more than 2.6 million breast-cancer survivors in the U.S. But early detection is key. That means, ladies, we have to be vigilant about getting our annual exams (including mammograms, if the doctor orders them) and performing regular self breast exams in between.
Earlier this week, I chatted with a world-renowned leader in breast-cancer care and treatment, a doctor who just so happens to be the director of breast-health outreach and breast-radiation oncology at Lankenau Medical Center. Marisa Weiss treats patients by day, all the while maintaining one of the Web’s leading go-to resources for breast cancer information, Breastcancer.org, a site she founded in 2000. A breast-cancer survivor herself—her own doctor found a tumor in her left breast in 2010—Dr. Weiss has experience with both sides of the coin: the patient’s and the clinician’s.
Here’s what she has to say about early detection, self breast exams, cancer risk, and much more.
If I go to the gynecologist every year, why should I do self-checks in between?
No one really wants to do them. Most people don’t feel qualified, and you’re always concerned about what you might feel. But it’s a good idea to become aware of your body. What feels normal, the same, or different for you? We’re all so busy and overwhelmed by our demands and commitments, we have to focus on things that matter most. When it comes to a woman’s health, breast cancer is the thing that matters most—it’s the most common cancer to affect women. Even the thin yoga instructor who’s a vegan—she’s at risk for breast cancer. Less than 15 percent of women who get breast cancer have a family member who has been diagnosed with it, and only 5 to 10 percent of breast cancers are thought to be caused by inherited gene mutation. No matter what your source of breast cancer is, the environment influences all cases. So given the risk, it makes sense to do what you can to minimize it—that’s where early detection is crucial: finding the cancer as early as you can, when it’s most treatable with the least aggressive therapy. We’ve come a long way, and although there’s no perfect test, we can use the tools we do have to get the best outcome possible. That means digital mammography, clinical breast exams and self breast exams. It’s the correlation of those three things that over time gives you the best chance for early detection. Self breast examination is the easiest one to do. You live with yourself, you don’t need to make an appointment, you know yourself better than your doctor. You’re in best position to take command of your breast health.
Who should be doing self-checks?
People who have breasts. The fact is that most breast cancers don’t run in families. I think it’s important for women to get to know their bodies—their own turf—even at a young age when breast-cancer risk is low. Get to know your breast tissue so that if there are significant changes that persist or get worse, you can bring it to the attention of your doctor.
Once a month is the most frequent you would need. If not, do it quarterly—if you can remember. You definitely have to do it after your period is over if you’re still menstruating, and close to the same time in the month. The idea is that you want to compare apples with apples. So a few days after your period is over is usually the safest bet.
Do you have any tips for how to remember when to do them?
Put it on your calendar. Women are pretty good about keeping track of when they get their period, and they’re often meticulous about calendar-keeping. So put in there.
How should you do the exam?
You’re taking a look to see if there’s any change in the appearance of the breast—the size, shape, contour. Is there a rash? Is there asymmetry? A bulge? An indentation? Puckering? A dimple? Any discharge? Did the nipple used to stick out and now it’s inverted? Is the breast large and shiny? Is it hot to the touch? You’re taking it all in, first with your arms above your head and then with your hands on your hips.
Then it’s time to examine yourself. You’ll use your left hand to examine the right breast, and the right hand to examine the left breast. You want to examine all of each breast. That means top to bottom, right to left, front to back. There are two different techniques: one is you start at the nipple and radiate out like a spiral. Or you can start in one corner and go up and down like you’re mowing the lawn. Whatever works for you. You just want to make sure you feel all of each breast: top to bottom from just below the collar bone to the fold underneath the breast, and left to right from the midline over past the edge of the breast to the bottom of the armpit—as far as your hand can go backwards.
In order to feel the front and back of the breast, you want to use the pads of two or three fingers, applying them to the breast in a circular motion. You only need a little pressure to feel the front of the breast, a little more to feel the middle, and a bit more to feel the back, which is up against the chest wall.
You’ll do the complete exam in two positions, standing up and lying down. A lot of people do the standing up part in the shower. It’s a popular place to do a self breast exam because when the slippery surface makes the body easier to examine.
What exactly are you looking for?
You want to be mindful of the fact that the breast is not like a pillow and not just a mount of fat. There’s a gland in there. You’re going to feel lumpy, bumpy stuff in there—that’s normal. The gland is not always going to feel the same. It’s in different neighborhoods on different people. A lot of women have the most prominent bumpiness in the upper outer quadrant. If you can, get a notebook or journal and draw a map of what’s going on in your breast so you have a good baseline. Then, in terms of what could be abnormal, you’re looking for anything that feels like a peanut in the middle of a bowl of oatmeal—that kind of thing. Something like that could easily be benign, it could due a cyst, a collection of breast tissue in a ball. Those are the most common reasons for lumps in women’s breasts. Eight out of 10 times in adult women, the bumps turn out to be benign. If you find something, don’t worry about it too much. But if if it persists or gets worse, you want to bring it to your doctor’s attention.
>> Need a visual? Check out the slide show below for drawings showing how to perform self breast exams.