Women's Topic

  BREAST EXAM

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The breast examination is an integral part of the well woman exam.  The provider will ask you to raise one arm over your head.  Taking her/his  hand and pressing in a gentle motion around your breast tissue and under your arm, the provider will check your breast for lumps. The provider will squeeze the nipples checking for any nipple discharge and check under your arms for swollen lymph nodes. The provider will then examine the other breast  in the same manner.

  

Breast self-exam is recommended monthly, the week after your menstrual period...  The technique is as follows:  

  1. Examine your breasts in the mirror, first with your arms at your sides (A1) and then with both arms over your head (A2).  The breasts should look the same.  Watch for any change in shape or size, or for dimpling of the skin.  Occasionally a lump that is difficult to feel will be quite obvious just by looking.

  2. Next, while lying flat, examine the left breast using the inner fingertips of the right hand and pressing the breast tissue against the chest wall.  Don’t pinch the tissue between the fingers; all breast tissue feels a bit lumpy when you do this.  The left hand should be behind your head while you examine the inner half of the left breast (B1) and down at your side when you examine the outer half (B2).  Don’t neglect the part of the breast underneath the nipple or that which extends outward from the breast toward the underarm (B3).  A small pillow under the left shoulder may help.

  3. Repeat this process on the opposite side.

Any lump detected should be brought to the attention of your practitioner.  Regular self- examination will tell you how long it has been present and whether it has changed in size.  80% of breast lumps are not cancerous and  breast cancers are curable if caught early.  Most women will  have a lump in a breast at some time during their life. Some women’s breasts are naturally lumpy (so-called benign fibrocystic  changes).

 

Breast self-exam is a supplement to other  screening tests for breast cancer, not an alternative.  Mammography can detect smaller lumps, particularly in women with large or lumpy breasts.  Hence, we strongly recommend mammography yearly after age 50 and after age 40 for women with a strong family history of breast cancer.