Breast self-examination (BSE) is the examination of one's own breast by the person. Overall, 40% of women detect their lumps themselves. Regular self-examination is likely to detect breast lumps early. This may enable women to report to doctors with earlier stage of disease. There is no firm guideline for the exact age for starting BSE. Women should preferably start BSE at the age of 20 years, but can start earlier if desired.
BSE should be done once a month. It should preferably 2-3 days after the end of monthy period. It is best to keep the same day post period for examination which means if you are doing on the 3rd day after completion of periods, keep it as the 3rd day post periods for all your future monthly examinations. The firmness of breast changes in relation of the menstrual cycle. For post-menopausal females, any date of the month can be chosen, repeated every month.
Steps to conduct a Breast Self-examination
1. Stand in front of a reasonable size mirror. Put your hands on the waist and examine your breasts in mirror. Look for areas of dimpling, puckering or bulging of skin. Also, watch out for an area of redness, soreness, rash or swelling.
2. Now raise your arms over your head. Look for the same changes as mentioned above.
3. Keeping your arms still over your head, look for any signs of discharge or fluid coming out of one or both nipples.
4. Now lie down on your back. Use your right hand to feel your left breast. Complete an outer circle. Then move in one inch towards the nipple and complete another circle. Keep repeating till you reach the nipple. You're looking for the lump. Keep repeating the same for the other breast.
5. There are other patterns to examine your breast. These include vertical parallel strips from midline of body, outwards. Alternatively wedge shaped area from nipple, outwards to the periphery of breast can be examined. Finally breast can be examined in an outward spiral manner from nipple to the outer edge of the breast. The intent is to cover all the portions of the breast and avoid missing any segment.
6. It is advisable to use finger pads (rather than tips of your fingers) with massage oil or shower gel, so that the finger pads glide easily over the breast.
7. Alternatively, try in the shower. It's easier when the skin is wet and slippery. Cover the same hand movements described in step 4 and 5.
If you find some changes during BSE, please do not panic. Remember that breast lump or swelling does not always mean breast cancer. Most of the changes can even happen in non-cancerous conditions. Please see your physician, who will guide you, if needed, to the relevant specialist.
(Dr Anusheel Munshi is Head of Department of Radiation Oncology at Manipal Hospital, Dwarka, New Delhi)
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