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Home The Well Bathroom What You’re Feeling for During a Breast Self-Exam

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You might not be a doctor, but you can recognize an abnormal lump by doing a breast self-exam. In honor of Breast Cancer Awareness month, let’s get to know our own breasts this October.

A breast self-exam is one of the best ways women can optimize their health and lessen some of their anxiety around breast cancer. (As a physician, I never cease to be surprised by the number of women who pick up an abnormality on their own.)

Frequently examining your breasts lets you become familiar with what “normal” feels like. That way, if you ever feel something out of the ordinary you’ll know. Keep in mind that not all lumps mean breast cancer. In fact, the majority of breast lumps are not cancerous.

While many of us may know how to perform our own breast exams, we’re going to take it one step further by diving into when to do an examination and what, specifically, to examine for.

First, Divide Your Breast Into Four Parts
Although cancerous lumps can occur anywhere in the breast, the most common location is the upper outer quadrant. (When describing what you feel, divide the breast into four sections: upper outer, upper inner, lower outer and lower inner.)

What to Feel and Look For
When performing a breast exam, look for the following seven characteristics:

  • Size: Small or large?
  • Texture: Hard or soft?
  • Mobility: Fixed or mobile?
  • Location: Where is the lump located?
  • Pain: Painful?
  • Nipple: Nipple discharge? If so, does it appear spontaneously or can you express any when you gently squeeze your nipple? What color is it? Does the nipple look cracked or dry or reddened in any way?
  • Skin: Any skin changes? Does the skin over the breast “dimple” (or indent) or in any other way look different?

Although it is impossible to say if a lump is normal or abnormal just on physical examination, there are some clues.  Most of these are related to the mobility of the lump and presence of pain.  A fixed lump usually means it’s not normal, and, surprisingly, a painful lump means it’s more likely to be normal.

Please note, however, that if you feel anything different at all, you owe it to yourself to seek immediate medical attention!

What “Likely Normal” Feels and Looks Like

  • Size:  The lump may change over the course of the month, as your cycle changes or just before your period starts. You may simply be feeling an increase in the normal nodularity (bumpy or increased density) of your breast tissue. Breast tissue changes in response to hormonal fluctuations during your cycle.
  • Texture:  A mass with well-defined borders may be a cyst.
  • Mobility:  Benign breast lumps are often freely mobile. Cysts — usually just benign fluid-filled lumps — almost feel grape-like or even like a marble.
  • Pain:  Breast pain can occur during a regular hormonal cycle. It may be due to increased caffeine consumption or physical activity without a supportive bra. Everyone describes pain differently (sharp, dull, stabbing, etc).

Pay attention to whether the pain is in one breast only or if it’s in both.  If it’s in one breast, it may just be a cyst.  If it’s in both breasts, it may be from not wearing a sports bra during your latest workout.  If the pain changes with your cycle, it could be related to hormones. And remember, most pain is not associated with breast cancer!

What “Possibly Abnormal” Feels and Looks Like

  • Texture: A mass without clear borders may not just be a cyst. Sometimes it’s harder with abnormal lumps to feel a clear demarcation, especially if they are fixed to either the chest wall or a muscle.
  • Mobility: Abnormal breast lumps are often fixed and difficult to move.  They may be  attached to the chest wall, an underlying muscle or even the skin. A solid lump may feel like a dried bean.
  • Pain:  Often both breast cysts and breast cancer lumps are completely painless.
  • Nipple Discharge and Skin Changes:  New nipple discharge, sudden nipple inversion or changes in the skin over the lump suggest that the lump may be abnormal.

2 Ways & 3 Places to Perform a Breast Exam
There are two common ways to examine your breasts. For both, start by visually inspecting your breasts in front of a mirror.  Then, either finish the examination lying down or in the shower. It doesn’t matter which one you choose, as long as you choose one and do it!

I tend to recommend sticking with one method for consistency, but as long as you examine your breasts with some regularity, it doesn’t matter which method you choose.

A couple of key points to remember: On both breasts, examine your breast tissue in all four quadrants, including your armpits.

  • In front of a mirror: Begin by visually examining your breasts in the mirror — first with your arms at your sides, then with your arms raised up overhead. Before you actually examine each breast individually, place your hands on your hips, pull your chest back and push your arms forward a bit. Does either breast look different now? Spend time looking at each breast separately. Does the skin on either breast look different? Does one side appear larger or smaller? Can you actually see a lump?
  • Lying down: Examine one breast at a time. To do so, place one arm behind your head and use the opposite hand to examine your breast in a circular motion with the pads of your fingers.  Start on the outside and work toward the nipple.  When you get there, squeeze the nipple gently to check for any discharge. Repeat on the other side. Alternatively, you can examine each breast from top to bottom and left to right. Regardless, be sure to also feel under all of each armpit as well.
  • In the shower: Examine one breast at a time in a circular motion with the pads of your fingers.  Start on the outside of the breast and work toward the nipple. When you get there, squeeze the nipple gently to check for any discharge. Repeat on the other side.

Through these practices, you will get indicators of whether or not you need to notify your physician.

The Best Time to Examine
I recommend that you pick the same time of the month every month to examine your breasts.

While you are still getting periods, your breast tissue is responsive to the hormonal fluctuations that occur throughout your monthly cycle. This may affect what you are feeling.  In particular, in the days leading up to your period, your breasts may be more nodular.  I don’t recommend doing an examination at this time. Instead, wait until you are mid-cycle. Once you’ve gone through menopause, I recommend that you pick one day and stick with it each month (e.g., the first day of the month or perhaps your birth date).

This post first appeared in www.livestrong.com

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