How to Perform a Breast Self-Exam

A breast self-exam (BSE) is a method you can use to check your own breast tissue at home for lumps and other concerns. Breast self-exams may help you identify any changes or abnormalities that you may consider discussing with a healthcare provider. Knowing why breast self-exams are important and how to perform one can help you stay informed about your breast health and know when to reach out for medical care.

Why You Might Need a Breast Self-Exam

Some people conduct breast self-exams to feel for lumps, tenderness, nodules, and other potential signs of breast cancer. BSEs can also help learn how your breasts feel, so you can potentially notice any changes to your breasts early on. However, the efficacy (or, how well something works) of breast self-exams is still somewhat controversial among healthcare providers and leading health organizations. 

For example, the American Cancer Society (ACS) no longer recommends breast self-examinations as a tool in the diagnostic process. There’s some evidence that breast self-exams can lead to an overuse of imaging tests. Some research also suggests that breast self-exams alone don’t lower your risk of dying from breast cancer. Instead, the American College of Obstetrics and Gynecology (ACOG) recommends routine mammogram screening with your provider starting at age 40. 

It's important to note, however, that the American Cancer Society does acknowledge that BSEs can help you get to know your own body, including the typical look and feel of your breast tissue. If any concerning changes occur, you can bring them up with your healthcare provider right away.

When to Do a Breast Self-Exam

It's common for your breasts to change throughout the month due to hormonal shifts during your menstrual cycle. For example, you may notice that your breasts feel tender, firmer, and denser just before your period begins.

Generally, you may opt to perform a breast self-exam once a month. To get consistent results from a breast self-exam, it’s best to check your breast tissue about three to five days after the start of your period. If you don’t have regular periods or if you’ve already gone through menopause, it's best to conduct a breast self-exam at the same time each month.

How The Breast Self-Exam Works

A breast self-exam should only take about 15 minutes to complete. Use the following steps to conduct the exam accurately:

• Step 1: Lie on your back and put your right hand behind your head
• Step 2: Use the pads of your three middle fingers on your left hand and press down to examine your whole right breast
• Step 3: To check all layers of your breast tissue, change how much pressure you apply from light to moderate to firm
• Step 4: Sit up and press deeply into your armpit to check for lumps while your right hand is still raised
• Step 5: Gently squeeze your nipples to check for any discharge. 
• Step 6: Lie back down, switch arms, and repeat the process on your other breast
• Step 7: Stand up and visually inspect your breasts in the mirror with your arms at your side to notice any signs of swelling, lumps, or discoloration 
• Step 8: Perform a second visual inspection while standing with both of your arms up to look for any concerning signs you may want to discuss with your healthcare provider

What You Should Look For

When you do a breast self-exam, you should manually and visually inspect for anything that appears unusual, such as:

• Nodules, cysts, lumps, and bumps
• Changes in the texture, size, or shape of your breasts
• Nipple discharge
• Dimpling or puckering (small ripples in your breasts)
• Indents on your breasts
• Areas of hard or thickened skin
• Painful or sore spots

It's important to remember that most breast changes, including lumps, aren’t a sign of cancer. There are many reasons that breasts can feel different at different times, including hormonal changes just before your period, pregnancy, menopause, birth control medications, and the natural aging process.

Limitations

For years, breast self-exams were recommended as part of the breast cancer screening process because they are quick, low-risk, and inexpensive. However, recent research suggests that BSEs have key limitations in how effective and useful they are. 

Some studies have shown that BSEs don’t reduce breast cancer-related deaths. Additionally, breast self-exams may not be able to detect smaller lumps, especially in the early stages of the disease. Sometimes, breast self-exams can also lead to unnecessary testing and false positive results.  

However, your breast self-exams can help you be more aware of your breast health and what your breasts look like. If something does look abnormal down the road, you're able to talk to your provider about the changes you notice. Whether or not you opt to perform a BSE, you should follow existing clinical guidelines about getting screening mammograms each year starting at age 45. People with a higher risk of breast cancer may need to start screenings sooner for early detection.

When to See a Healthcare Provider

It’s important to talk to your healthcare provider about any concerns you have about your breasts, including:

• Any changes you notice, such as new bumps or lumps
• Pain and tenderness that aren’t period-related
• Redness, swelling, or heat in or around your breast
• A lump near your collarbone or in your armpit
• Discharge, blood, or pus coming from your nipples

A Quick Review

Breast self-exams are a simple, at-home screening technique for lumps and other symptoms of breast cancer. While not all healthcare providers and organizations specifically recommend them, breast self-exams may help you learn more about your breasts so you can identify any changes you notice as early as possible.

Ultimately, it’s best to talk to your healthcare provider if you’re thinking about doing a breast self-exam. They can help you understand whether it’s right for you and how to do it safely and effectively. Be sure to also let your healthcare provider know when you notice any concerning signs in your breasts that might need testing.