Monthly breast self-exams are a part of many women’s wellness routines, just like exercising or skin care. But conflicting advice has raised questions about whether self-exams are still necessary.
Some studies show that regular breast self-exams don’t help reduce deaths from breast cancer, leading many health organizations to recommend against them.
Other research shows that 1 in 5 breast cancer survivors found their cancer after noticing breast changes while showering or getting dressed.
RUSH diagnostic radiologist Lauren Green, MD, says not recommending breast self-exams at all risks delaying a cancer diagnosis.
“I think breast self-exams and self-awareness of changes to your body are very important,” she says, “especially in young women who are not yet eligible for other forms of breast cancer screening.”
Green emphasizes that breast self-exams do not replace screening tools like mammograms, breast ultrasounds or breast MRIs — but that they should be used together.
“Breast imaging tests are shown to be more sensitive and reliable at detecting breast cancer in comparison to breast self-exams,” Green says. “So examining yourself periodically to look for breast changes, in combination with other recommended breast screening tests, is ideal.”
‘Breast self-awareness is key’
Breast cancer affects people of all genders, so everyone should be aware of changes in their breasts.
“This means being generally familiar with how your breasts look and feel normally, so that if there are any changes, you can identify them."
But everyone’s breast tissue is different — and some can feel lumpier than usual, especially depending on the time of the month.
“It’s normal for breast tissue to vary and to feel lumpier around one's menstrual period. And those lumps can feel smaller or even disappear afterward,” she says. “So it is important to learn what is normal for you.”
If you experience a menstrual period, Green recommends performing a breast self-exam about three to five days after the end of your period.
Other things that can be normal are asymmetrical sizes between your breasts or inward nipples, but Green says the important difference is whether these changes are new. That’s when it’s time to get help.
What breast changes to look for
When checking for abnormal breast changes, Green recommends starting with a visual inspection.
For a visual inspection, stand in front of a mirror and press your hands firmly on your hips (and or with your arms over your head). Be on the lookout for the following changes:
- The size or shape of your breasts
- Dimpling of the skin
- Redness or scaliness of the nipple or skin
- New inversion, or turning inwards, of the nipple
Moving on to the physical inspection, lie down with a support, like a pillow, under your right shoulder and right hand behind your head. Next, use different levels of pressure with your left hand's middle fingers to feel for lumps, moving in a small circular motion over the entire breast. Afterward, sit up and check your underarm for lumps, and then repeat the physical inspection on the other side.
Other changes to feel for include:
- Lumps (like a frozen pea or a marble in the breast)
- Focal pain
- A thickening of an area of the breast, like a ridge
- Suspicious types of discharge other than milk, such as bloody, brown or even clear discharge
“If you notice a change or something that you’re unsure about, always contact your primary care provider or OB-GYN,” Green says. “Most breast changes are not related to breast cancer, thankfully, but it is best to be cautious.”
To learn more about your breast health, or to schedule an appointment for a breast cancer screening, contact our breast specialists.