Begin with a visual examination of your breasts
Sit or stand shirtless and braless in front of a mirror with your arms at your sides. To inspect your breasts visually, do the following:
- Face forward and look for puckering, dimpling, or changes in size, shape or symmetry.
- Check to see if your nipples are turned in (inverted).
- Inspect your breasts with your hands pressed down on your hips.
- Inspect your breasts with your arms raised overhead and the palms of your hands pressed together.
- Lift your breasts to see if ridges along the bottom are symmetrical.
If you have a vision impairment that makes it difficult for you to visually inspect your breasts, ask a close friend or a family member to help you.
Next, use your hands to examine your breasts
Common ways to perform the manual part of the breast exam include:
- Lying down. Choose a bed or other flat surface to lie down on your back. When lying down, breast tissue spreads out, making it thinner and easier to feel.
- In the shower. Lather your fingers and breasts with soap to help your fingers glide more smoothly over your skin.
When examining your breasts, some general tips to keep in mind include:
- Use the pads of your fingers. Use the pads, not the very tips, of your three middle fingers for the exam. If you have difficulty feeling with your finger pads, use another part of your hand that is more sensitive, such as your palm or the backs of your fingers.
- Use different pressure levels. Your goal is to feel different depths of the breast by using different levels of pressure to feel all the breast tissue. Use light pressure to feel the tissue closest to the skin, medium pressure to feel a little deeper, and firm pressure to feel the tissue closest to the chest and ribs. Be sure to use each pressure level before moving on to the next spot. If you're not sure how hard to press, talk with your doctor or nurse.
- Take your time. Don't rush. It may take several minutes to carefully examine your breasts.
Use a methodical technique to ensure you examine your entire breast:
- Place your left hand behind your head and examine your left breast with your right hand.
- Using the pads of your right three middle fingers, start at your collar bone and move toward your nipple. Be sure to use all three pressure levels — light, medium and deep — to feel all of your breast tissue.
- Then sweep or move methodically around your breast — much like it's the face of a clock — starting again from your collarbone and moving toward the nipple. Be sure to check the entire breast area.
- Place your right hand behind your head and repeat the examination on your right breast using your left hand.
- Examine your armpits while sitting or standing with your arm slightly raised.
- Examine your nipples and look for discharge. Do this by gently lifting the region (areola) around the nipple with your fingers positioned at 12 o'clock and 6 o'clock and again with your fingers at 3 o'clock and 9 o'clock.
If you have a disability that makes it difficult to examine your breasts using this technique — for instance, you have use of only one hand or you have trouble steadying your hands — you likely can still conduct a breast self-exam. Ask your doctor to show you ways you can examine your breasts.
Jul. 02, 2011
- Breast cancer. American Cancer Society. http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-detection. Accessed May 13, 2011.
- Fletcher SW. Screening for breast cancer. http://www.uptodate.com/home/index.html. Accessed May 12, 2011.
- Sabel MS. Breast lumps and other common breast problems. http://www.uptodate.com/home/index.html. Accessed May 12, 2011.
- Breast self-exam. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp145.cfm. Accessed May 13, 2011.
- Breast self-examination. Breast health access for women with disabilities. http://www.bhawd.org/sitefiles/bse/bse_broc.html. Accessed May 13, 2011.
- Mathias KL, et al. Palpable presentation of breast cancer persists in the era of screening mammography. Journal of the American College of Surgeons. 2010;210:314.
- Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. May 18, 2011.