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The Breast Self Exam (BSE)
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The Breast Self Exam (BSE) should encompass: OBSERVATION, exam while UPRIGHT, exam while LYING DOWN and DOCUMENTATION.

PREFACE: 

I teach this every single day LOL--it's verbose, but I think it is really thorough.

 

1.  My best advice--get to know what is "normal" for YOU--that way you know when you have a change & can report it. Most women are lumpy to some extent.

 

There are LOTS of different textures you may feel--my surgeon uses food analogies: "That feels like cottage cheese in a water balloon, that feels like oatmeal, that feels like peas & carrots in a water balloon. That feels like a dense little island of Play-doh." Funny but effective!

 

2.  Another key is if you feel something on ONE side, check the same spot in the OTHER breast. Chances are, if it's there TOO, it is most likely NORMAL for you. However, DON'T hesitate to report something you are not comfortable with!!

 

OK--here we go:

 

 

OBSERVATION: Stand in front of a mirror that lets you see your breasts clearly. Look at both breasts. You are looking for anything unusual. This includes puckered, dimpled or scaly skin (like a red rash), or any discharge (clear or colored fluid) from nipples.

 

Now, look carefully to see if there is any change in the shape of your breasts. First, clasp your hands behind your head and press your hands forward.

 

Next, press your hands on your hips - firmly - and continue to look for changes in the shape of your breasts. Bend slightly toward the mirror as you hunch your shoulders and pull your elbows forward.

 

Choose your pattern Lines, circles or wedges?

 

Use one of the following three patterns to examine your breasts. The one you choose is not important. What IS important is that you don't miss any areas. Examine the entire breast from collarbone down and over to your breast bone, as well as the entire fleshy part of your breast to your underarm.

 

LINES--Begin in the underarm area and move your fingers down until they are below the breast. Move your fingers in toward the center and go slowly back up. Cover the whole area, going up and down.

 

CIRCLES--Begin at the outer edge of your breast, moving your fingers slowly around the entire breast. When you come back to where you started, make a smaller circle and do it again. Continue, working toward the nipple. Check your underarm and upper chest areas too.

 

WEDGES--Start at the outer edge of the breast and move your fingers toward the nipple and back. Do the whole breast, covering one wedge-shaped section at a time. Check your underarm and upper chest areas too.

 

With any pattern, be sure to check the area under your nipples too.

 

Begin examining your breasts for lumps and thickness, using one of the three different patterns.  It is important to examine while upright AND lying, as a lump may be felt in ONE position and not necessarily in the OTHER. Everyone is different.

 

STANDING or SITTING: Raise one arm, putting your hand behind your head. With the opposite hand, use the pads of your fingers (the flat part) to check the breast, the area between the breast and underarm, the underarm itself and the area above the breast, up to the collarbone and over to your shoulder. Check each area firmly, carefully and completely.

 

Some women prefer to do this in the shower. It's a good idea, because fingers glide easily over soapy skin, making it easier to feel for changes underneath.  You may also choose to use lotion if examining outside the shower. The effect is the same.

 

The usual problem I find with the SHOWER method is that we take 2 minute showers--and you REALLY need to spend about 2 minutes PER BREAST to do a thorough exam!!!

 

LYING DOWN: Repeat while lying down. Lie flat on your back, with your right hand behind your head and a pillow or folded towel under your right shoulder. With your left hand, examine the right breast and area around it very carefully. Then switch hands and repeat the procedure for the left breast. You can use any of the patterns listed.

 

HELPFUL HINT FROM MIKKI—this next part is especially helpful if you have lumpy, bumpy breasts or have so many different things in there that it may be hard to keep track from month to month. This will really alleviate a lot of frustration especially if you say, “Heck, I can’t tell what’s going on in there—I’m so lumpy anyway…it doesn’t run in my family….” And then you blow off your exam. No excuses---Keep a “boob diary.”

 

DOCUMENTATION: Trust me, your DOCTOR does this in your chart to keep track of where lumps or different textures were found in your breasts. The doc refers to these at each visit. What better way to evaluate every “Larry, Moe or Curly” that resides in your breasts?

 

1.  Get a small notebook to keep in your bathroom cupboard or drawer. Draw a pair of boobs (like a “W” with rounded bottoms), including nipples. Now, while standing in front of the mirror with lotion on your right hand, begin to examine your left breast. Chart your findings as if plotting a graph in the notebook. Repeat for the opposite breast. (Now chuckle at your slimy pen and horrible writing with your non-dominant hand). Make sure to jot down the date of the exam to keep track.

 

When it’s time to do your BSE again, bring out the notebook (check the date of your last exam). Repeat the exam and check on any “old friends” in there as well as any “new arrivals.” Document all changes.

 

If you want to be creative, use different colored pens or pencils, or use tracing paper and start at the BACK of the pad, with each new exam charted on the overlying sheet.

 

 

Best time to do BSE: if pre-menopausal, examine 7-10 days after your period STARTS (least lumpy/tender then). If post-menopausal—pick the same day every month so that it is easiest to remember.