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Understanding Your Breasts

 

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It’s important to remember that every woman’s breasts are different, and they can change throughout your menstrual cycle. Hormonal changes can cause breasts to feel lumpy or tender at different times. Familiarize yourself with how your breasts normally look and feel so you can more easily detect any changes.

Your goal is to establish a baseline awareness so you can easily identify any new or persistent changes.

When is the Best Time to Check?

 

Adult women of all ages are encouraged to perform a breast self-exam at least once a month. Consistency is key!

If you have a menstrual cycle: Perform the exam a few days after your period ends, when your breasts are typically least tender and swollen.

If you are post-menopausal or have had a hysterectomy: Choose a specific, easy-to-remember day each month (like the 1st or the 15th) to perform your exam.

 

Beyond the Lump: What Are the First Signs?

 

While a new lump or mass is the most common symptom, many early warning signs are visual or subtle, and may not involve a lump at all. Look for these changes, which may be the first indicator of a problem:

Skin Changes: Dimpling, puckering, or bulging of the skin, sometimes resembling the texture of an orange peel (known as peau d’orange).

Nipple Changes:

A nipple that suddenly turns inward (inverts), a rash, scaliness, or crusting on the nipple or areola.

Swelling: New swelling or thickening of part of the breast, which may feel like a hardened knot rather than a distinct lump.

Discharge: Any clear, milky, or bloody fluid leaking from the nipple when you are not pregnant or breastfeeding.

Color/Temperature Changes: Redness, heat, or soreness on the breast that is persistent.

Lymph Node Swelling: A lump or swelling in the armpit or around the collarbone.

Persistent Pain: Pain in the breast or armpit that does not go away (though pain alone is rarely the sole sign of cancer).

 

The 3-Step Breast Self-Exam Guide

 

The National Breast Cancer Foundation recommends three steps for a thorough, monthly check. You should use the pads (or flats) of your three middle fingers for the physical checks.

 

1. In the Shower (The Standing Check)

 

With wet, soapy hands, raise one arm and use the opposite hand. Check the entire breast and armpit area.

Pressure: Press down with light, medium, and firm pressure to feel the tissue closest to the skin, deeper tissue, and tissue closest to the chest wall, respectively.

Technique: Use a systematic pattern—either moving in a vertical strip pattern (up and down) or in a circular pattern from the outside of the breast toward the nipple.

 

2. In Front of a Mirror (The Visual Check)

 

Stand with your arms at your sides and visually inspect your breasts. Look for any changes in size, shape, or symmetry. Notice any dimpling, puckering, or bulging of the skin. Check for any changes in nipple position or if the nipple is inverted (pulled inward). Look for any redness, soreness, rash, or swelling. Next, raise your arms high over your head and look for the same changes. Finally, press your hands firmly on your hips, bowing slightly forward. This position flexes your chest muscles and can highlight any subtle changes.

 

3. Lying Down (The Deep Tissue Check)

 

Lie down on your back with a pillow under your right shoulder. Place your right arm behind your head. Using your left hand, with the pads of your three middle fingers, examine your right breast. Use the same systematic approach as in the shower (circular or up and down strips). Apply different levels of pressure: light pressure to feel the tissue closest to the skin, medium pressure to feel deeper, and firm pressure to feel the tissue closest to your chest wall. Repeat this process for your left breast, placing a pillow under your left shoulder and your left arm behind your head.