Do Monthly BSE

C. Breast Self Examination (BSE)

1. How to do BSE

  • Breast self examination (BSE) is to be performed each month in addition to an annual mammogram or breast ultrasound.
  • Make a regular date for your BSE.

If you are pre-menopausal:
Set a regular time to examine your breasts a few days after your period ends (when hormone levels are relatively stable and breasts are less tender).

If you are already menopausal (have not had a period for a year or more):
Pick a particular day of the month to do the exam, and then repeat your BSE on that day each month.

2. Visual Exam – Hands on Hips

  • Strip to the waist and stand in front of a mirror with the torso exposed to view. You will need to see both breasts at the same time. Stand with your hands on your hips and check the appearance of your breasts.
  • Looks in the mirror for visual signs of dimpling, swelling, or redness on or near the breasts. Look at the nipples and areolas, to see how healthy they look.
  • Take note of changes in size, shape, outline, colour and texture of the skin and nipple.

3. Visual Exam – Arms Over Your Head

  • Now raise your arms over your head and see if your breasts move in the same way, and note any differences.
  • Look at size, shape, and drape, checking for symmetry. Pay attention to your nipples and areolas, to see if you have any dimples, bumps, or retraction (indentation).
  • Look up toward your armpits and note if there is any swelling where your lymph nodes are (lower armpit area).

4. Manual Exam – Stand and Stroke

Circular Motion
  • Raise your left arm above your head, use your right-hand fingers and apply gentle pressure to the left breast. Press gently but firmly, feeling for lumps or thickening of tissue.
  • Stroke from the top to the bottom of the breast, moving across from the inside of the breast all the way into your armpit area.
  • Circular motion also can be used, being sure to cover the entire breast area.
  • Keep your fingers together and use the flat part of three fingers to feel the breast. Move your fingers in a small circles – about the size of a 20 cent coin.
  • Imagine your breast as the face of a clock. Start at 12 o’clock and feel along the boundary till you return to your starting point. Move down a finger’s width and repeat in a smaller circle till you reach the nipple. Push this aside and feel under and around the nipple. You may find a ridge of firm tissue under the breast. This is normal tissue that helps to support your breast.
  • Take note of any changes in texture, color, or size.
  • Switch sides and repeat the same process.

5. Manual Exam – Check Your Nipples

  • Then lower both arms.
  • With the index and middle fingers of your right hand, gently squeeze the left nipple and pull forward. Does the nipple spring back into place? Does it pull back into the breast? Note whether or not any fluid leaks out.
  • Reverse your hands and check the right nipple in the same way.

6. Manual Exam – Recline and Stroke

  • Lie flat on your back with a pillow under the right shoulder. This allows the breast tissue to spread.
  • Put your right hand behind your head.
  • Use your left hand to examine your right breast. Examine the area from under the collarbone to the bra area.
  • Stroke the breast and underarm, as you did in step 4.
  • Take note of any changes in texture, color, or size.
  • Switch sides and repeat.

Tips For Doing Your BSE

  • Mark your calendar to remind yourself to do your BSE regularly. This is a good way to prevent worry if find a normal cyclic change.
  • Stay relaxed and breathe normally as you do your BSE. Becoming tense will produce some knots that you may mistake for something worrisome.
  • Report any changes or unusual pain to your doctor. Keep a log of changes, if that helps you remember.
  • Remember to have an annual breast ultrasound or mammogram.

Note: The above BSE images are taken from National Cancer Institute and it is used only for educational purpose.

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