Breast Self-Exams

Women can be an advocate for their breast health by learning to perform breast self-exams. A breast self-exam is a way for a woman to discover any changes or abnormalities of her breast. It is recommended that a self-breast exam be performed monthly.

An easy way to remember the best time to perform a breast self-exam is to perform the exam on the day a woman's menstrual bleeding ends. Women who are post-menopausal or who have had a hysterectomy should pick a consistent day of the month to perform their breast self-exam. Remember, if your ovaries were not removed during hysterectomy, your body is still maintaining your hormonal monthly cycles. Try to maintain your breast examinations at the expected monthly cycles if possible.

The best time to perform a breast self-exam is the tenth day following the first day of a woman's menstrual cycle. Women who are post-menopausal or who have had a hysterectomy should pick a consistent day of the month to perform their self-breast exam.

If you feel a lump or notice anything abnormal, make an immediate appointment to have the abnormality evaluated. If you do not have a primary care physician, call the Health First Breast Center at 321.728.6002 to assist you in making an appointment with a qualified physician.

Five Steps of a Breast Self-Exam

Step 1

Look at your breasts in the mirror with your shoulders straight and your arms on your hips. Breasts should be:

• Their usual size, shape and color
• Evenly shaped without visible distortion or swelling

Any of the following changes should be brought to your doctor's attention:

• Dimpling, puckering or bulging of the skin
• A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
• Redness, soreness rash or swelling

Step 2

Raise your arms and look for the same changes in Step 1.

Step 3

While at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky or yellow fluid or blood).

Step 4

While lying down, feel your breasts, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use an up and down vertical motion, like mowing the lawn.

Cover the entire breast from top to bottom, side to side - from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

Follow a pattern to be sure that you cover the whole breast. Be sure to feel all the tissue from the front to the back of your breasts. For the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel your ribcage.

Step 5

Finally, feel your breasts while you are standing or sitting. Cover your entire breast, using the same hand movements described in Step 4.

Breast Clinical Exams

A clinical exam is an exam performed by a qualified nurse or doctor. They will check for lumps or other physical changes in the breast. If the exam detects a suspicious site, further evaluation is needed.

Women in their 20s and 30s should have a clinical breast exam done as part of a regular check-up by a health professional, preferably every three years. Women 40 and older should have a breast exam done by a health professional every year.

What Diagnostic Tests are Used?

Doctors often use the following tests to examine breast tissue:

• Breast Ultrasound. A machine uses sound waves to make detailed pictures, called sonograms, of areas inside the breast. Ultrasound can be very helpful to further characterize abnormal findings on mammogram and symptomatic breast regions.
• Diagnostic Mammogram. If you have a breast symptom or an abnormal screening mammogram, your doctor will order you get a diagnostic mammogram. This is a detailed X-ray of the breast using low dose radiation exposure. Our centers create both the 2D digital images and 3D tomosynthesis digital images of the breast to evaluate the areas of concern viewed on computers.
• Magnetic Resonance Imaging (MRI). This technology uses a magnet and radiowaves linked to a computer. The MRI scan will make detailed pictures of areas inside the breasts in multiple planes. Contrast is administered to evaluate an abnormality or to screen for an abnormality.
• Biopsy. This is a test that removes tissue or fluid from the breast to be looked at under a microscope and other needed histologic testing in the pathology department. There are different kinds of biopsies (for example, fine-needle aspiration, core biopsy or open biopsy).