Robert Wood Johnson University Hospital

Breast Self-Examination

Tests and Procedures - How to Perform a Breast Self-Examination

What is a breast self-examination (BSE)?

Breast self-examination (BSE) is a procedure a woman can do to physically and visually examine her breasts and underarm areas for changes. It has not been shown that BSEs alone can accurately determine the presence of breast cancer. The U.S. Preventive Services Task Force has found evidence that suggests BSEs do not lower the risk for death from breast cancer. Therefore, if you choose to do BSE, it should not be used in place of, but in addition to, clinical breast examination (performed by a health care provider every three years for women in their 20s and 30s, and every year for women ages 40 and older) and mammography.

When should BSE be done?

By doing BSE regularly, you get to know how your breasts normally feel and look so that you are able to detect any changes more easily.

Women can begin practicing breast self-examination at about age 20 and continue the practice throughout their liveseven during pregnancy and after menopause.

Breast self-examination (BSE) can be performed every month. Become familiar with how your breasts usually look and feel so that you may notice any change from what is normal for you.

Changes to look for:

Check with your physician if you find any change in your breast(s) that causes you concern. Changes in your breasts may include:

How to do BSE

1. Stand in front of a mirror that is large enough for you to see your breasts clearly. Check each breast for anything unusual. Check the skin for puckering, dimpling, or scaliness. Look for a discharge from the nipples.

Illustration of breast self-examination, step 1, arms at side
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2. Watching closely in the mirror, clasp your hands behind your head and press your hands forward.

Illustration of breast self-examination, step 2, arms raised
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3. Next, press your hands firmly on your hips and bend slightly toward the mirror as you pull your shoulders and elbows forward.

Illustration of breast self-examination, step 3, hands on hips
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Do steps 2 and 3 to check for any change in the shape or contour of your breasts. As you do these steps, you should feel your chest muscles tighten.

4. Gently squeeze each nipple and look for a discharge.

Illustration of breast self-examination, step 4, pinch nipple
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5. The breasts are best examined while lying down because it spreads the breast tissue evenly over the chest. Lie flat on your back, with one arm over your head and a pillow or folded towel under the shoulder. This position flattens the breast and makes it easier to check.

Illustration of breast self-examination, step 6, arm raised while lying down
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Use the pads of the fingers of your other hand to check the breast and the surrounding area firmly, carefully, and thoroughly. Some women like to use lotion or powder to help their fingers glide easily over the skin. Feel for any unusual lump or mass under the skin. Feel the tissue by pressing your fingers in small, overlapping areas about the size of a dime. To be sure you cover the whole breast, take your time and follow a definite pattern: lines, circles, or wedges.

Illustration of breast self-examination, step 5, one arm raised
Click Image to Enlarge

Some research suggests that many women do BSE more thoroughly when they use a pattern of up-and-down lines or strips. Other women feel more comfortable with another pattern. The important thing is to cover the whole breast and to pay special attention to the area between the breast and the underarm, including the underarm itself. Check the area above the breast, up to the collarbone, and all the way over to your shoulder. Consider using one of these patterns:

The American Cancer Society recommends using three different levels of pressure to examine your breasts:

6. Some women repeat step 5 in the shower. Your fingers will glide easily over soapy skin, so you can focus on feeling for changes underneath.

What if you find a lump?

One of the most frightening moments for a woman is if she sees or feels something different or unusual while performing breast self-examination. One of the most important reasons to do regular breast self-examination is so that you know what is normal for your breasts. If you find a lump, it is important not to panic.

If you discover lumpiness in one breast or feel something "different" in the tissue, or you feel a definite lump, there may be valid reason for concern and it is important to contact a physician. Sometimes, the lumpiness may be due to menstrual changes; but, if you have nipple discharge or skin changes such as dimpling or puckering, your physician may want to see you right away.

It is natural to be frightened when discovering a lump, but do not let the prospect of cancer keep you from taking action. Remember that most breast lumps are benign (not cancer).

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