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Breast Cancer Awareness Tip No. 7: The first day of every month since I was a twentysomething, I performed my monthly breast exam. Standing in the shower or lying down on my bed, I would diligently search for a lump, a bump, a frozen pea, a marble, or any changes in my breast. Scheduled for my annual exam with my gyno recently, I made a surprise out-of-routine visit to my breasts so I could report any new findings or oddities to my doc. Sitting on a gurney with a cape barely covering my breasts and a small, thin blanket barely covering my bare nethers, I shivered because of my new discovery in my breast more than my lack of clothing. My young and fully dressed doctor walked in and said, "Any new changes?" I muttered, "Well, my left breast is bruised from performing my self-exam a few times," while thinking to myself, "432 times to be exact." "Tell me about it." "Honestly, I have never been able to tell a lump from a bump to a frozen pea. But a few days ago I discovered something different in my left breast." "What did it feel like?" "It didn't feel like a lump, per se. Not a frozen pea. Not a marble. More tubular." "Tubular?" "Yes, tubular." "Well, let's check it out." My doc circled my breasts like a dog in heat while tears of perspiration trickled down the back side of my arms. "I can't find anything. Why don't you show me." "Right here," pointing to the black and blue hematoma that I had created from my overzealous searches. "Oh. That's a rib." Translation: Not another skinny b**ch. "It's fantastic that you noticed something 'different' in your breasts. I'm proud of you for being so aware of any changes in your breasts ." Translation: You are OCD. "As a result of menopause and the lack of estrogen, your breast tissue has spread." Translation: Your breasts are droopy. "The good thing is, since we can feel your rib cage, we can locate any lumps hiding in your rib cage." Translation: You have the smallest breasts on the planet. Relieved and laughing, I said, "Tubular," meaning "Cool, the way surfers in the 1980s used to say, "Dude, that's so tubular, I want to yark!" My doc just looked at me and smiled. Translation: I need to check this patent's meds. Self breast exams should be a part of every woman's breast cancer prevention routine.
How to perform a self breast exam:
- Lie down and place your right arm behind your head. The exam is done while lying down, not standing up. This is because when lying down the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue.
- Use the finger pads of the 3 middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue.
- Use 3 different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. A firm ridge in the lower curve of each breast is normal. If you're not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot.
- Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle).
- There is some evidence to suggest that the up-and-down pattern (sometimes called the vertical pattern) is the most effective pattern for covering the entire breast, without missing any breast tissue.
- Repeat the exam on your left breast, using the finger pads of the right hand.
- While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, or dimpling, or redness or scaliness of the nipple or breast skin. (The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.)
- Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it harder to examine.
This procedure for doing breast self exam is different than in previous recommendations made by the American Cancer Society. These changes represent an extensive review of the medical literature and input from an expert advisory group. There is evidence that this position (lying down), area felt, pattern of coverage of the breast, and use of different amounts of pressure increase a woman's ability to find abnormal areas.
See your health care provider right away if you notice any of these breast changes:
- Lump, hard knot or thickening
- Swelling, warmth, redness or darkening
- Change in the size or shape of the breast
- Dimpling or puckering of the skin
- Itchy, scaly sore or rash on the nipple
- Pulling in of your nipple or other parts of the breast
- Nipple discharge that starts suddenly
- New pain in one spot that doesn’t go away
Source: American Cancer Society