Breast Self-Exam | Parkview Cancer Institute

The power to protect is in your hands

A breast self-exam is an early-detection method that uses a combination of sight and feel to check for signs and symptoms of breast cancer. It’s important for you to become familiar with how your breasts normally look and feel so that you can more easily detect any changes.

How to do a breast self-exam

The best time to examine your breasts is usually 1 week after your menstrual period starts, when your breasts are least likely to be swollen or tender. Examining your breasts at other times in your menstrual cycle may make it hard to compare results of one exam with another.

If your menstrual cycle is irregular, or if you have stopped menstruating due to menopause or the removal of your uterus (hysterectomy), do your examination on a day of the month that's easy to remember.

A breast self-exam normally doesn't cause any discomfort. If your breasts are tender because your menstrual period is about to begin, you may feel slight discomfort when you press on your breasts.

Breast self-exam steps

Step one
Remove all your clothes above the waist.

Step two
Lie down. Lying down spreads your breasts evenly over your chest and makes it easier to feel lumps or changes.

Step three
Check your entire breast by feeling all of the tissue from the collarbone to the bottom of the bra line and from the armpit to the breastbone.

Use the pads of your three middle fingers—not your fingertips.
Use the middle fingers of your left hand to check your right breast.
Use the middle fingers of your right hand to check your left breast.

You can use an up-and-down pattern or a spiral pattern. Move your fingers slowly in small coin-sized circles.

Use three different levels of pressure to feel all of your breast tissue.

Light pressure is needed to feel the tissue close to the skin surface.
Medium pressure is used to feel a little deeper.
Firm pressure is used to feel your tissue close to your breastbone and ribs.

Step four
Avoid lifting your fingers away from the skin as you feel for lumps, unusual thicknesses, or changes of any kind.

In addition to examining your breasts while lying down, you may also check them while in the shower. Soapy fingers slide easily across the breast and may make it easier to feel changes. While standing in a shower, place one arm over your head and lightly soap your breast on that side. Then, using the flat surface of your fingers—not the fingertips—gently move your hand over your breast, feeling carefully for any lumps or thickened areas.

It takes practice to perform a breast self-exam. Having fibrocystic lumps also may make a breast self-exam difficult, because lumps occur throughout the breast. Ask your doctor for tips that can help you do it correctly.

When in doubt about a particular lump, check your other breast. If you find the same kind of lump in the same area on the other breast, both breasts are probably normal.

When should you see a doctor after a breast self-exam?

After you know what your breasts normally look and feel like, any changes should be checked by a doctor. Changes may include:

Any new lump. It may or may not be painful to touch.
Unusual thick areas.
Sticky or bloody discharge from your nipples.
Any changes in the skin of your breasts or nipples, such as puckering or dimpling.
An unusual increase in the size of one breast.
One breast unusually lower than the other.

Remember that most breast problems or changes are caused by something other than cancer.

Breast self-exams don’t replace regular clinical screenings. Talk to your doctor about having regular mammograms as well as regular breast checkups at your doctor's office.

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FAQ: Breast self-exams and clinical exams

How often should I perform a breast self-exam?

Adult women of all ages are encouraged to perform breast self-exams once a month. Here are some more specifics:

Women still menstruating: Perform your exam a few days after your period ends.
Postmenopausal women: Perform your exam on the same day each month.

What should I look for with a breast self-exam?

Let your primary care provider or ob-gyn know if you detect any of the following:

A new lump (it may or may not be painful to touch)
Dimpling, puckering, bulging, or unusual thickening of the skin or nipples
A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
An unusual increase in the size of one breast, including one that is unusually lower than the other
Redness, soreness, or swelling
Any signs of fluid coming out or one or both nipples (this could be watery, milky, yellow fluid, or blood that may be sticky)

What is a clinical breast exam? Do I need to get one if I do a self-exam?

A clinical breast exam is a physical examination of the breasts performed by a primary care provider or ob-gyn. It’s a routine exam used to detect any changes or abnormalities with your breasts.

Yes, you still need to get a clinical breast exam because self-exams do not replace these. Speak with your primary care provider or ob-gyn about the right frequency for your exams based on your personal and family history.

Will a clinical breast exam hurt?

No, you shouldn’t experience any pain during this exam unless your breasts are already tender. Let your primary care provider or ob-gyn know if this is the case.

How can I prepare for a clinical breast exam?

Be prepared to have a discussion with your primary care provider or ob-gyn. Mention anything of note, such as the following:

Have a new lump or change in your breasts (this includes a change in the way your nipples look or if you have any nipple discharge)
Have pain in one breast, especially if the pain is not related to having your period
Are or might be pregnant
Are breastfeeding
Have breast implants
Have had a breast biopsy
Have completed menopause
Are taking hormone therapy
Have a personal or family history of breast cancer

If you still have a menstrual cycle, you may want to have your exam one to two weeks after your period ends, since your breasts are less likely to be tender at that time.

Talk to your primary care provider or ob-gyn about any concerns you have regarding the need for the exam, the risks, how it will be performed, or what the results may mean.

What can I expect from a clinical breast exam?

A clinical breast exam is performed by your primary care provider or ob-gyn. It’s a routine exam used to help detect any changes or abnormalities with your breasts. You can expect the following during an exam:

You will be asked to remove your clothing from the waist up. You’ll be provided with a gown to wear so that you’ll be more comfortable during the exam. Your primary care provider or ob-gyn will leave the room while you change for your privacy.
The visit typically starts with a conversation regarding your medical history, breast changes you’ve noticed, and whether you have concerns or risk factors for breast cancer. This is the perfect time to talk about anything that feels different or worries you.
Next comes the exam. Your primary care provider or ob-gyn will examine each breast, underarm, and collarbone area for changes in breast size, skin changes, or signs of injury or infection, such as bruising or redness. You may be asked to lift your arms over your head, put your hands on your hips, or lean forward and press your hands together to tighten the muscle beneath each breast during this part of the examination. You may also lie flat on the table and put your arm behind your head while your primary health provider or ob-gyn checks your breast tissue.
Your primary care provider or ob-gyn will then feel (palpate) each breast for any unusual or painful areas or for a dominant lump. A dominant lump in the breast is any lump that is new, larger, harder, or different in any other way from other lumps or the rest of the breast tissue.
Your primary care provider or ob-gyn will gently press on the breast tissue from about one inch below the breast up to the collarbone. They also will examine your armpit (axillary area) and your neck for swollen glands (lymph nodes). Finally, they will likely press gently on your nipple to check for any discharge.
After the examination, your primary care provider or ob-gyn may teach you how to examine your own breasts (breast self-exam) and help you practice.

What can affect the results of a clinical breast exam?

Here are a couple of reasons why you may not be able to have the exam or why the results may not be helpful:

Your period. The changes in your body that occur during your menstrual cycle may make your breast tissue feel or look different.
Having fibrocystic lumps. Fibrocystic lumps make a clinical breast examination difficult because many lumps are present in the breast.

If either of these things are true for you, speak with your primary care provider or ob-gyn about what type of screening may be best for you.

What do the results of a clinical breast exam mean?

Normal findings

The nipples, breast tissue, and areas around the breast look normal and are normal in size and shape. One breast may be slightly larger than the other.
A small area of firm tissue may be present in the lower curve of the breast below the nipple.
Tenderness or lumpiness that occurs in both breasts is normal for many women. Many women have the same lumpiness or thickening in both breasts during the menstrual cycle.
A clear or milky discharge (galactorrhea) may be present when the nipple is squeezed. This may be caused by nursing, breast stimulation, hormones, or some other normal cause.
One breast may have more glandular tissue (lumps) than the other one, especially in the upper outer quadrant of the breast.

Abnormal findings

A firm lump or area of thickening.
Changes in the color or feel of your breast or nipple. This can include wrinkling, dimpling, thickening, or puckering or an area that feels grainy, stringy, or thickened.
A nipple may sink into the breast. A red, scaly rash or sore may be found on the nipple.
Redness or warmth over a painful lump or over an entire breast. This may be caused by an infection (abscess or mastitis) or cancer.
A bloody or milky discharge (galactorrhea) may occur without stimulation (spontaneous nipple discharge).

Normal findings during a clinical breast exam don’t mean that breast cancer is not present. Depending on your age and your personal and family history of breast cancer, your health provider recommend other tests, such as a mammogram.

If a breast abnormality is found, the next step depends on the finding:

Cyclic breast pain, fibrocystic changes, or cysts may just be rechecked to see if they change or go away on their own. Cysts may also be checked by ultrasound or drained with a needle (aspirated) to make sure that they are cysts and to help relieve pain.
A mammogram, magnetic resonance imaging (MRI), or ultrasound may be needed if a lump is found. Breast tissue may be taken out with a needle (needle aspiration or core biopsy) or through a small cut (biopsy) to be looked at under the microscope.
Nipple discharge, especially if it is spontaneous or bloody, may be looked at under a microscope for unusual cells.

The Breast Self-Exam

The power to protect is in your hands

How to do a breast self-exam

When should you see a doctor after a breast self-exam?

FAQ: Breast self-exams and clinical exams

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