I think the title is pretty self-explanatory, but just in case, here is your warning. This week I’m going to be talking about ta-tas. Specifically, how to do self-breast exams. If, for some reason, that makes you uncomfortable, just keep moving on. Because you know what makes me and millions of people across the world uncomfortable? Breast cancer. And we all know that the first line of defense against breast cancer is early detection. And self-exams are the first line in that first line of defense.

I think that we can all agree that no one knows our bodies better than we do. This means we are often the first to notice when something isn’t right or the same that it was before — this is where self-exams come in and why they are so critical in the early detection of breast cancer.

Before we get to the details on doing the self-exam, let’s go over a few things. First, ladies, we should be performing self-exams monthly. So, pick a day and stick to it. Maybe it’s the first or last day of the month, or perhaps your favorite number; just try to stay consistent. Also, remember that while these exams are important, they should never replace regular screenings with your doctor.

On to the details!

What are the steps of a breast self-exam?

1. Visual inspection: With your shirt and bra removed, stand in front of a mirror. Put your arms down by your sides. Look for any changes in breast shape, breast swelling, dimpling in the skin, or changes in the nipples. Next, raise your arms high overhead and look for the same things. Finally, put your hands on your hips and press firmly to make your chest muscles flex. Look for the same changes again. Be sure to look at both breasts.

2. Manual inspection while standing up: With your shirt and bra removed, use your right hand to examine your left breast, then vice versa. With the pads of your three middle fingers, press on every part of one breast. Use light pressure, then medium, then firm. Feel for any lumps, thick spots, or other changes. A circular pattern may help you make sure you hit every spot. Then, press the tissue under the arm. Be sure to check under the areola and then squeeze the nipple gently to check for discharge. Repeat the steps on the other side of your body.

3. Manual inspection while lying down: When you lie down, your breast tissue spreads more evenly. This is a good position to feel for changes, especially if your breasts are large. Lie down and put a pillow under your right shoulder. Place your right arm behind your head. Using your left hand, apply the same technique as step 2, using the pads of your fingers to press all parts of the breast tissue and under your arm. Finally, swap the pillow to the other side, and check the other breast and armpit. Be sure to check under the areola and then squeeze the nipple gently to check for discharge.
Results and Follow-Up
When should I call my doctor about something I find in my breast self-exam?

If you find a lump or any other worrisome changes, stay calm. Most self-exam findings are not signs of breast cancer. But you should still call your healthcare provider if you notice any:
– Change in the look, feel, or size of the breast.
– Change in the look or feel of the nipple.
– Dimpling or puckering of the skin.
– Lump, hard knot, or thick spot in the breast tissue.
– Nipple discharge.
– Nipple or other area pulling inward.
– Pain in one spot that won’t go away.
– Rash on the nipple.
– Swelling of one or both breasts.
– Warmth, redness, or dark spots on the skin.

There you have it. Once again, a self-exam should never replace your regular screenings with your doctor. If you have a 4 or higher at the front of your age, remember that you should be getting yearly mammograms or whatever your PCP recommends.