Breast self-exam (BSE), or regularly examining your breasts on your own, can be an important way to find a breast cancer early, when it's more likely to be treated successfully. Not every cancer can be found this way, but it is a critical step you can and should take for yourself.
Over the years, there has been some debate over just how valuable BSE is in detecting breast cancer early and increasing the likelihood of survival. For example, in summer 2008, one study of nearly 400,000 women in Russia and China reported that breast self-examination does not reduce breast cancer mortality and may even cause harm by prompting unnecessary biopsies (removal and examination of suspicious tissue). Because of the ongoing uncertainty raised by this and other studies, the American Cancer Society has chosen to advise women that BSE is an “optional” screening tool.
Breastcancer.org still believes that BSE is a useful and essential screening strategy, especially when used in combination with regular physical exams by a doctor and mammography. About 20% of the time, breast cancers are found by physical examination rather than by mammography. We recommend that all women routinely perform breast self-exams as part of their overall breast cancer screening strategy. Read what Marisa Weiss, M.D., president and founder of Breastcancer.org, has to say about the July 2008 study of breast self-exam.
Tips for performing BSE
Few women really want to do a breast self-exam, or BSE, and for many the experience is frustrating — you may feel things but not know what they mean. However, the more you examine your breasts, the more you will learn about them and the easier it will become for you to tell if something unusual has occurred. Breastcancer.org believes that BSE is an essential part of taking care of yourself and lowering your risk of breast cancer.
Some tips for BSE:
- Try to get in the habit of doing a breast self-examination once a month to familiarize yourself with how your breasts normally look and feel. Examine yourself several days after your period ends, when your breasts are least likely to be swollen and tender. If you are no longer having periods, choose a day that's easy to remember, such as the first or last day of the month.
- Don’t panic if you think you feel a lump. Most women have some lumps or lumpy areas in their breasts all the time. In the United States, only 20% of women who have a suspicious lump biopsied turn out to have breast cancer.
- Breasts tend to have different “neighborhoods.” The upper, outer area — near your armpit — tends to have the most prominent lumps and bumps. The lower half of your breast can feel like a sandy or pebbly beach. The area under the nipple can feel like a collection of large grains. Another part might feel like a lumpy bowl of oatmeal.
What’s important is that you get to know the look and feel of YOUR breasts' various neighborhoods. Does something stand out as different from the rest (like a rock on a sandy beach)? Has anything changed? Bring to the attention of your doctor any changes in your breasts that last over a full month's cycle OR seem to get worse or more obvious over time.
- You may want to start a journal where you record the findings of your breast self-exams. This can be like a small map of your breasts, with notes about where you feel lumps or irregularities. Especially in the beginning, this may help you remember, from month to month, what is “normal” for your breasts. It is not unusual for lumps to appear at certain times of the month, but then disappear, as your body changes with the menstrual cycle (if you are still menstruating). Only changes that last beyond one full cycle, or seem to get bigger or more prominent in some way, need your doctor's attention.
Learn the Five Steps of a Breast Self-Exam.
The biggest misconception about mammography is that it picks up every breast cancer. In fact, mammography misses at least 10 percent of breast cancer. So if you feel a lump that doesn't show up on a mammogram, bring it to your doctor's attention. Get it evaluated.
Susan Greenstein Orel, M.D.