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.