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Breast Self-Exam

A breast self exam (BSE) should be done each month. This frequency will help. There are two main components to the BSE — visual inspection and palpation. Palpation is done in two steps — standing and lying down. During visual inspection, look for: discharge or scaling of the nipples, puckering, dimpling or redness of the skin, and changes in the size and shape of the breast

How to do the visual inspection:

  1. Stand facing a mirror. With your arms down at your sides, turn side to side. Inspect both breasts for any changes in the skin or nipples.
  2. Raise you hands above your head and turn side to side while watching closely in the mirror. Again, inspect both breast for any change.
  3. Place hands palm to palm and press together so that you can feel your chest muscles tighten. Look for any changes in the shape or contour of your breasts.
  4. Next, with your hands firmly on your hips, bow slightly toward the mirror as you pull your shoulders and elbows forward. Again, look for changes in the shape or contour.

To be effective, palpation must be done both lying down and standing up. When palpating, you are feeling for a lump that stands out or one you've never felt before. If you find a new lump or change in your breast, call your health care provider for a clinical breast exam.

How to do the first phase of palpation, lying down:

  1. Lie flat on your back with your left arm raised over your head and a pillow or folded towel under your left shoulder. This position flattens the breast and makes it easier to examine.
  2. Use the pads of your middle three fingers of your right hand to explore your left breast. Firmly roll the tissue between your fingers and ribs. Using lotion may help your fingers glide more easily.
  3. Using either the circular, vertical, or wedge examination method, palpate outward from the nipple. Choose the method with which you are most comfortable and use it consistently each month.
  4. Repeat first three steps on right breast.

How to do the vertical exam method:

  1. Beginning at the outer edges where your collar bone and chest bone meet, press the flat part of your fingers in small circles, moving the circles vertically up and down the breast.
  2. Gradually work across the nipple. Be sure to check the entire breast. Pay special attention to the area between the breast and the underarm, including the underarm itself. Feel for any unusual lump or mass under the skin.
  3. Repeat first two steps on your right breast.

How to do the second phase of palpation, standing (Note that some women do this while in the shower, using soap and water to help fingers glide easily):

  1. Use either the vertical, circular or wedge examination method on your left breast while in a standing position.
  2. Repeat examination on your right breast.
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