How To Do A Breast Cancer Self-Examination

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Breast cancer is the leading type of cancer affecting South African women. 

According to the National Cancer Registry (NCR), the top five cancers affecting women in the country are breast, cervical, colorectal, uterine, or lung cancer.

Early detection through screening can pick up changes sooner and lead to earlier treatment and an improved chance of survival. 

Awareness of symptoms and what to look out for is crucial when you do a self-examination. These include a rash, scarring, lumps, abnormal nipple changes, abnormal dimples on the skin, and discharge from the nipples. 

Because the risk of women getting breast cancer increases as you get older, experts urge women to start breast self-examining at least once a month from your 20th birthday onwards. And always a few days after your period as your breasts would no longer be swollen and tender.

Self-examination could very well save your life by getting you to the doctor and hospital in time before it spreads throughout the body. 

Johns Hopkins Medical Centre says 40 percent of women who are diagnosed with breast cancer discover the lump themselves while doing a self-examination. 

Know what to look for

According to the American Breast Cancer Foundation, some breast cancers are invisible and are only detected when screening is done by a healthcare professional or with a regular doctor’s check-up. 

These are the changes and abnormalities that you should look out for when doing a self-examination: 

  • Nipples: tenderness, thickening or lump in or near the breast or underarm. A turned inward or inverted nipple. Clear, bloody or milky discharge when a woman is not breastfeeding. The skin of the nipple or areola that is red, scaly, swollen or dimpled like an orange peel
  • The skin of the breast: change in skin texture or enlargement of pores. Red, scaly, swollen patches or orange peel dimples on the skin
  • The shape of the breast: change in the size, shape and asymmetry of the breast. Unexplained swelling or shrinkage of the breast, especially if it is only on one side.
  • Lumps: immovable lumps or lumps that can move under pressure.

All of these should be examined further by a healthcare professional. 

Performing breast self-examinations

Things to do

In the shower or bath because many people prefer examining their breasts under a shower spray or when they’re in the bath.  

  • You have to raise first your right arm over your head and, using the tips of the three middle fingers on your left hand, apply pressure moving in circles across your breast and under your arm, checking for lumps, thickening, tight knots or other changes. Repeat on the left side. 
In front of a mirror
  • With your arms at your side, have a look at your breasts from all angles. Lift first one arm up and check for bulges, contour changes, nipple changes, swelling, shrinkage and orange peel dimpling. Repeat on the other side. Then with hands on your hips, flex your chest muscles, checking for puckering of the skin, change in texture and colour tones.  
Lying down
  • When you are lying down flat on your back, the tissue in the breast spreads out evenly along the chest wall. First, put a pillow under your right shoulder and position your right arm behind your head on the right side. With your left hand, move your three fingers in circles across your right breast to your armpit to feel for lumps, skin texture changes and discharge from the nipples. Repeat these steps on the other side. 
What to do with unusual findings

If you find a lump, don’t panic. This goes for any other breast changes. “You shouldn’t be alarmed, but you need to be aware,” says Dr. Keating, who specializes in breast cancer screening to MSKCC. “The likelihood that it’s benign is much greater than it not being benign, especially if you’re younger.”

It is important to remember that not every breast lump is cancer, and benign masses that may be tender, smooth, and movable are very common. They may also change in size. However, you cannot determine the seriousness by a physical exam alone. 

Any newly discovered lump requires attention. Book an appointment with your doctor, who will do a check-up before sending you for further tests, which usually involves a mammogram screening, blood and tissue tests. 

Most lumps are benign, the experts say, because women’s breast tissue change many times over a lifetime, usually due to hormonal changes. Some of the common causes of benign lumps are normal changes in breast tissue, injury, infections, or inflammation in the breasts. 

The lumps may be fibroadenomas that can be removed surgically. Or they are fibrocystic changes that are a result of hormonal changes during your menstrual cycle.

There are also simple cysts, wart-like growths called intraductal papillomas, or traumatic fat necrosis caused by a breast injury. All of these can be treated by your doctor with simple procedures.